Isabella Scandurra

Socio-Technical Challenges in Implementation of Monitoring Technologies in Elderly Care

Although new monitoring technologies (MT) supporting aging in place are continuously developed and introduced on the market, attempts to implement these technologies as an integrated part of elderly care often fail. According to the literature, the reason for that may be the prevailing technical focus applied during development and implementation of monitoring technologies in real settings. The aim of this paper was to investigate the socio-technical challenges that arise during implementation of monitoring technologies in elderly care. We used a qualitative case study and semi-structured interviews to investigate socio-technical (S/T) challenges in implementation of monitoring technologies generally and social alarms especially. Based on our findings we suggest a framework for classification of S/T challenges arising during implementation of monitoring technologies in elderly care and in this way this paper contributes to a better understanding of these challenges.

Effects of Using Care Professionals in the Development of Social Technology for Elderly

In some situations when developing technology for elderly, the intended users are too fragile and cannot participate themselves in the design process. The aim with this study was to investigate the use of care personnel as mediators for the elderly in the design process. The system that was developed was an information and communication technology system for sharing information and for keeping in touch with friends and family. Initially the care personnel misunderstood the need of technology among the elderly. During the project the care personnel changed their view and suggested new ways of using the technology. When the devices where placed in the rooms of the elderly the usage was low, but when the system was used in the dining areas as something to gather around, e.g. to show each other pictures of friends and family, the system became a success.

To Meet the Needs of Aging Users and the Prerequisites of Innovators in the Design Process

The aim of this paper is to analyze cases where participatory design with different stakeholder groups was a beacon in the development of innovations. An important aspect was a strong foundation both in the needs of the elderly and in the feasibility from the market side. Three cases were analyzed from aspects as: environment and development phase of product; participation of different stakeholders; and proxy involvement of care professionals. The impact of this approach is a benefit for aging end-users as well as increased feasibility for the innovation companies, as a result when collaboration of different stakeholders focuses on balancing the demands of the users and the prerequisites of the industry.

Patient Accessible EHR is Controversial: Lack of Knowledge and Diverse Perceptions Among Professions

In Sweden, a national eHealth service providing Patient Accessible Electronic Health Records is now being widely deployed, with 400 000 users in January 2016. Although the Patient Data Act states that patients have a right to take part of their health records, the introduction has been controversial. Results from a pre-deployment questionnaire to record-keeping care professions in a healthcare region indicate that perceptions and knowledge differ not only between the professions but, more importantly, that knowledge about current eHealth development and action plans needs to increase as implementation will affect their work processes. Staff perceptions and knowledge are considered being some of the most important issues to handle during the implementation of eHealth services aiming to provide healthcare information and communication tools for patients and relatives. To cover the gaps, specific training is needed, and all record-keeping professionals need to be more involved in the implementation of such eHealth services.

A Living Lab Method for Innovations to Increase Quality of Life for Elderly - A Pilot Case

A Swedish Living Lab has recently been established offering care organizations a test and evaluation method as an activity in their intrinsic development process. Using the method, innovations for an aging population are assessed, guided by quality criteria as well-being, dignity, value for the elderly and usability. n nThis paper describes the method through a pilot test, carried out in November 2014 by the elderly themselves and health and social care staff at a nursing home together with different academic parts in a multidisciplinary test process. The method allows for interaction between innovators and stakeholders as well as potential end-users in the elderly care sector. Simultaneously, the users quality aspects are kept in focus when innovations for the aging society are tested.

To Capture the Diverse Needs of Welfare Technology Stakeholders – Evaluation of a Value Matrix

Welfare technology (WT) is often developed with a technical perspective, which does not involve important ethical considerations and different values that come up during the development and implementation of WT within elderly care. This paper presents a study where we have applied an ethical value matrix to support systematic ethical assessments of WT intended for personal health monitoring. The matrix consists of values in a checklist and a number of stakeholders and it is possible to analyze which values are emphasized by which stakeholders. The aim was to assess the matrix and find out how the matrix supports identification of values and interests that drive the various stakeholders in the development and implementation of WT. We have realized that several values specified by different actors as especially important were not included in the matrix and that the values in the matrix did not visualize or enable identification of value conflicts.

Using Care Professionals as Proxies in the Design Process of Welfare Technology – Perspectives from Municipality Care

Bringing real users into the design process is often seen as a successful way of creating useful IT systems. However, when it comes to designing for elderly, this is not always possible since many elderly suffer from age-related decline, both with respect to physical and cognitive abilities. This paper elaborates on the approach of working with proxies, in this case elderly care personnel. Different groups of people (N = 117) working with elderly and well familiar with needs and contexts around elderly were engaged in this study. Using a questionnaire and a more in-depth workshop we explored with municipality care professionals their experiences as well as the need to create a framework to improve such a proxy approach, and whether a method using care professionals as mediators could be possible to establish in elderly care. The results described in this paper are complementary to ours and others previous knowledge and show promising commitment and willingness to work in accordance with the proposed method.

Designing eHealth Services for Patients and Relatives: Critical Incidents and Lessons to Learn

The number of eHealth services for patients and relatives is rapidly increasing as many countries are launching such services as a means to manage an ageing population, to increase efficiency in healthcare, and to empower patients. However, design and deployment of eHealth services for patients is challenging due to the complex setting and the multitude of affected stakeholders, which in turn make the task of eliciting and managing the needs and requirements equally challenging. Hence, this workshop1 aims to make use of critical incident analysis as a method for collecting and jointly reflecting on practices, assumptions, and experiences in relation to the design, deployment, and use of eHealth services for patients and relatives. The goal of the workshop is to engage in joint reflection, and to find potential ways forward in relation to critical incidents as well as supporting the shaping and reshaping of eHealth design and development. This full day workshop invites researchers and practitioners to apply/provide their critical reflection in order to derive changed practices and theories about practice. We also especially invite the patients perspective as this is crucial to achieve successful eHealth services. This workshop provides a venue for challenging the process of eHealth service design and development and is built around a concept of active participation, where the workshop participants will analyse and discuss the critical incidents together.

A User-Centered Ethical Assessment of Welfare Technology for Elderly

Welfare technology (WT) is often developed with a technical perspective, and little consideration is taken regarding the involvement of important ethical considerations and different values that come up during the development and implementation of WT. Safety, security and privacy are significant, as well as the usability and overall benefit of the tool, but to date assessments often lack a holistic picture of the WT as seen by the users. This paper suggests a user-centered ethical assessment (UCEA) framework for WT to be able to evaluate ethical consequences as a part of the user-centered aspects. Building on established methodologies from research on ethical considerations, as well as the research domain of human-computer interaction, this assessment framework joins knowledge of ethical consequences with aspects affecting the “digitalization with the individual in the center”, e.g. privacy, safety, well-being, dignity, empowerment and usability. The framework was applied during development of an interface for providing symptom information to Parkinson patients. The results showed that the UCEA framework directs the attention to values emphasized by the patients. Thus, functionality of the system was evaluated in the light of values and expected results of the patients, thereby facilitating follow-up of a user-centered assessment. The framework may be further developed and tested, but in this study it served as a working tool for assessing ethical consequences of WT as a part of user-centered aspects.

Perspectives on Design of Sensor Based Exergames Targeted Towards Older Adults.

Serious games are an established field of study, where exergames provide a combination of conducting exercises and playing games. The aim of this work was to identify important features to include in, and design recommendations for exergames using sensor technology. The outcome of this work was two-folded. Firstly, a literature review of design guidelines with respect to older adults as users of exergames resulted in a categorized summary of design guidelines for specific target groups, e.g. people undergoing physical rehabilitation after stroke or injury or users suffering from a chronic disease. Secondly, these guidelines are discussed from various perspectives, based on insights from several years of work in the area. A general design guidelines covered by most of the literature is that exergames should provide a wide range of difficulty levels and be possible to adjust to individual needs. Insights from own work in the area highlight the importance of task and context relevant tools and devices. The result will serve as a starting point for a framework consisting of both general and domain specific design guidelines when designing sensor-based exergames for older adults.