ROI Case File No.411: The Truth Told by Elderly Fingertips
The Truth Told by Elderly Fingertips
Chapter 1: The Button They Can't Press
"Elderly people can't press the button in an emergency."
The division director of ElderCare Solutions placed a small emergency alert device on the office table. It was a simple unit with a large red button in the center.
"For fifteen years, we've contracted with local governments to provide emergency alert services for the elderly. We install these devices in their homes, and when they press the button in an emergency, it immediately contacts paramedics and family members."
The director picked up the device. His hands carried the weight of someone who had spent years in this business.
"However, actual usage rates are extremely low. The devices are installed, but they aren't used when it matters most."
"Why is that?" I asked.
"The reasons are varied," the director replied. "An elderly person who has fallen and can't move can't reach the device. Those with cognitive decline can't remember to 'press the button' during an emergency. And above all—"
He set the device down and pulled out his smartphone.
"Smartphone adoption among the elderly has surged dramatically in recent years. Approximately 60% of people in their 70s and over 30% of those in their 80s now own one. They use smartphones daily to stay in touch with their families."
"In other words," Claude summarized, "a smartphone already in their hands is more likely to be used in an emergency than a dedicated device."
"Exactly," the director nodded. "That's why we're considering transitioning to a smartphone app-based emergency alert service. But we can't see how to design it or what features are truly necessary."
It was a fundamental re-examination of a service model built over fifteen years.
Chapter 2: Following the Value Stream
"The LEAN model is the optimal approach for this case."
Gemini wrote "Value Stream" on the whiteboard.
"LEAN," I began to explain, "originated from the Toyota Production System. It aims to thoroughly eliminate all activities that don't create value for the customer."
"Specifically," Claude added, "the seven wastes—overproduction, waiting, transportation, over-processing, inventory, motion, and defects—are identified and eliminated to smooth the flow of value."
The director tilted his head. "But we're not in manufacturing. Can LEAN really apply to a service business?"
"On the contrary," I replied, "LEAN is especially powerful in service industries. Because in services, 'waste' manifests as the customer's time and effort."
"Then let's visualize the 'value stream' in your current emergency alert service," Gemini proposed.
The director began his explanation. "First, the local government distributes devices to elderly residents. Then an installation technician visits their home, sets up the device, and explains how to use it. After that, the elderly person presses the button in an emergency, connecting to our call center. An operator confirms the situation and contacts paramedics or family members as needed."
"Within this flow," I asked, "which steps truly create value for the elderly person?"
The director thought deeply. "Getting help when there's an emergency. That's all that matters."
"Then," Claude pointed out, "device distribution, technician visits, usage explanations—these are all 'means,' not 'value' itself."
"Exactly," I continued. "From a LEAN perspective, these may be 'necessary evils.' But transitioning to a smartphone app could eliminate many of these steps entirely."
[Redesigning the Value Stream]
"Let's design the smartphone-based emergency alert service through a LEAN lens," Gemini proposed.
I began drawing a new flow on the whiteboard.
"First, app download and initial setup. The critical point here is that the elderly person must be able to complete it on their own."
The director said uneasily, "But elderly people struggle with app setup, don't they?"
"That's precisely why," Claude answered, "we must eliminate 'wasted motion.' Complex input fields, confusing button layouts, text that's too small—all of these are 'non-value-adding motions' for elderly users."
"Specifically," Gemini organized, "the required information is just three items: name, address, and emergency contact. One input field per screen. A button that fills half the screen. That alone dramatically reduces setup effort."
"And," I added, "the most critical element is the emergency operation itself. Eliminate 'wasted motion' ruthlessly."
"With the dedicated device, it was a single action—'press the button,'" the director said. "Can we achieve the same with a smartphone?"
"Yes," Claude answered. "A persistent emergency button on the smartphone screen. One-tap alerting from the lock screen. Or automatic alerting by shaking the phone three times—all of this is technically feasible."
[Eliminating the Seven Wastes]
"Furthermore," Gemini continued, "let's apply LEAN's 'seven wastes' to service design."
Seven items appeared on the whiteboard.
"First, 'overproduction waste'—don't build features that won't be used. What elderly users need is emergency alerting and family notification. Health records and chat functions create no value."
The director nodded. "Indeed, more features doesn't necessarily mean better."
"Second, 'waiting waste'—minimize response time after an alert. AI-powered initial response can reduce operator load while shortening response times."
"Third, 'transportation waste'—reduce information transcription and relay. If the system automatically sends the elderly person's location and medical information to paramedics, operator explanations become unnecessary."
"Fourth, 'over-processing waste'—eliminate excessive confirmation steps. Asking 'Is this really an emergency?' during an actual emergency is pure waste."
"Fifth, 'inventory waste'—in service industries, this equates to 'information stagnation.' Information transfer from alert to emergency dispatch must happen in real time."
"Sixth, 'motion waste'—eliminate operational complexity. We've already discussed this."
"And seventh, 'defect waste'—reducing false alerts. However," I emphasized, "if you add more confirmations out of fear of false alerts, you'll delay response during real emergencies. Instead, design the system on the premise that 'false alerts are acceptable.'"
The director's expression changed. "You mean prioritize emergency response speed over the cost of false alerts?"
"Exactly," I replied. "That is the LEAN philosophy of putting 'value for the customer' first."
Chapter 3: Starting Small
"So how should we go about building this smartphone app?" the director asked.
"LEAN has another crucial principle," Claude answered. "Start small and improve continuously."
"Don't try to build a perfect app from the start," I continued. "Begin with a pilot using the minimum viable set of features."
Gemini organized the plan. "Specifically, a three-month pilot. Fifty elderly participants. Only two features: an emergency button and location sharing. That's enough."
"And," Claude added, "during those three months, collect real usage data. How many people could download and set up the app on their own? How often was the emergency button used? What was the false alert rate? This data will drive the next round of improvements."
The director asked, "But what if problems arise during the pilot?"
"They will," I stated firmly. "But you can't move forward if you fear that. What matters is having a system in place to respond quickly when problems occur."
"Specifically," Gemini explained, "pilot participants will continue using the traditional dedicated device alongside the app. Even if the app has issues, they can still alert through the device. With this dual safety net, you can run the pilot with confidence."
"And," I emphasized, "three months later, build an improved version based on the data. Three months after that, improve again. Continuing this cycle is the essence of LEAN."
Chapter 4: Toward a World Without Waste
The director gazed at the new value stream drawn on the whiteboard.
"For fifteen years, we focused on 'distributing devices.' But what truly held value was 'getting help in an emergency.'"
"What the LEAN model teaches us," I replied, "is never to confuse means with ends. And to relentlessly eliminate every activity that doesn't create value for the customer."
Claude added quietly, "There's no need to cling to the 'object' called a device. You can deliver value in the 'space' of the smartphone—a tool that elderly people already use every day."
The director stood and bowed deeply. "Thank you. Next week, I'll present the pilot plan to senior management."
After he left, Gemini remarked with admiration, "The LEAN model is simple yet powerful."
"Indeed," I replied. "But the true value of LEAN isn't in 'eliminating waste'—it's in 'clarifying what constitutes value.' What is value, and what is waste? Continuing to answer that question is the essence of LEAN."
Outside the window, the evening sun bathed the office in light.
Three months later, a report arrived from ElderCare Solutions.
Of the fifty pilot participants, forty-seven had downloaded the app and completed setup on their own. There were five emergency alerts, four of which were genuine emergencies. Average response time was reduced to one-third of the previous standard.
And the most important discovery was the simple fact that elderly people "carry their smartphones with them at all times." A dedicated device can only sit in a fixed location at home, but a smartphone is always at hand—whether they're out, in the bedroom, or even in the bathroom.
The value stream had indeed begun to change.
"An activity that creates no value remains waste, no matter how long it has been performed. The LEAN model doesn't ask 'What are you doing?' but rather 'Does this create value for the customer?' And the smoothest way to optimize the value stream is to start small, verify, and keep improving."
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