Table 1.

Key learnings from using the customer discovery approach to examine geriatric assessment

Examples of Hypotheses	Key learnings
Oncologists need to be the primary champion for geriatric assessment implementation	Any champion within a practice can implement geriatric assessment
Oncologists prefer that interventions (e.g., physical therapy referral) are automatically linked to impairment detected on the assessments	Mixed opinions: While automated linkage is preferred, some oncologists may not like it Interventions can be linked but oncologists would like to make the final decision and determine if referral is appropriate
Time and resources are main barriers for geriatric assessment implementation	Barriers are confirmed; lack of resources varied and included the need for staff, financial support, and infrastructure to implement therapies
Health care professionals have difficulty finding information on how to implement the geriatric assessment	Many oncologists are able to find the information though information may not be consistent; they are not aware of the literature on how aging related conditions inform outcomes. They prefer simple and practical instructions Peer to peer mentoring and personal assistance from experts are very helpful
Nurses would find the geriatric assessment information helpful	Nurses are actively monitoring toxixities; information generated from the assessment may help reduce phone calls
Payors make the final decision regarding program implementation	Typically, a committee is formed; buy-in from oncologists and other healthcare professionals is needed
Payors care about readmission rates as a metric	Readmission rate is important but other quality metrics such as screening for falls and depression are important Cost of cancer drugs is a high priority; intervention to decrease the use of inappropriate and expensive drugs is valuable
Patients are not willing to share technology associated costs	It needs to be paid by the health care system or insurance companies
Advocacy groups and governmental agencies are interested in improving outcomes of older adults	Priorities may not be age- or condition-specific; may be based on issues related to patient safety (e.g., increased rate of infection)
Integration of geriatric assessment into electronic medical record would be laborious during the application development, but would prove to be more user-friendly and more likely to be implemented by health care systems A stand-alone application would be relatively simple to create, but would be less accessible to users	There are advantages and disadvantages associated with both options A stand-alone application can be created first but it should be flexible enough so it can be incorporated into the electronic medical record later