ICT4AWE 2019 Abstracts

Area 1 - Ambient Assisted Living
Full Papers Short Papers
Area 2 - Independent Living
Full Papers Short Papers
Area 3 - Monitoring, Accessibility and HCI
Full Papers Short Papers
Area 4 - TELEMEDICINE AND E-HEALTH
Full Papers Short Papers

Area 1 - Ambient Assisted Living

Full Papers
Paper Nr: 3
Title:

European Specifications for Value-based Pre-Commercial Procurement of Innovative ICT for Empowerment and Self-management of Diabetes Mellitus Patients
Authors:

Vincenzo De Luca, Strahil Birov, Ozan Beyhan, Simon Robinson, Gorka Sanchez-Nanclares, Maria L. Acuña, Adriano Fernandes, Reinhard Hammerschmidt, Giovanni Annuzzi, Guido Iaccarino and Maddalena Illario
Abstract: Current demographic changes require a paradigm shift in the delivery of health and social services. Wide-scale implementation of validated ICT support to clinicians and patients is essential to ensure the quality of services to future generations of citizens. Healthcare providers from four European regions – Turkey, Portugal, Campania and Murcia– have joined forces to procure an innovative ICT solution for patient empowerment and self-management for patients with diabetes mellitus. The procurement is in the form of a joint pre-commercial procurement (PCP) of Research & Development, with participation by EU industry in competitive phases of development. The PCP is part of the EU-funded project ProEmpower, which is currently in the prototype testing phase. The challenge faced by the procurers was to jointly define specifications for the envisioned solution that reflect the needs of all four regions. After an intensive year of consultations with procurers’ experts – clinicians, IT staff, procurement specialists – ProEmpower launched a call for tender with the defined specifications, which reflect the unmet needs across the procuring regions with regards to improving management of diabetes mellitus supported by ICT. This paper presents the ProEmpower specifications, which can be easily adapted to the local conditions of any procuring region in Europe and beyond. The specifications thus represent a valuable source for any new development of ICT-supported diabetes management.
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Paper Nr: 10
Title:

Travelling with my SOULMATE: Participatory Design of an mHealth Travel Companion for Older Adults
Authors:

Lex van Velsen, Marit Dekker-van Weering, Floor Luub, Astrid Kemperman, Margit Ruis, Judith Urlings, Andrea Grabher, Marlene Mayr, Martijn Kiers, Tom Bellemans and An Neven
Abstract: Mobility is an important factor in the coming about of quality of life of older adults. In this article, we discuss the participatory design process of a mobile mobility aid for older adults (SOULMATE), which resulted in a service model and functional specifications. We conducted 12 design sessions in Austria, Belgium, and the Netherlands, in which we involved older adults and other stakeholders. The main values that older adults seek to satisfy, with respect to mobility, are comfort, speed, and affordability. They also experience a myriad of problematic situations while travelling, such as complicated ticketing systems for public transport. Participants’ thoughts on the role of technology and their reactions towards existing applications resulted in a service model for SOULMATE that consists of four modules: Travel planning, assistance, discovery and training. Their functioning is detailed in a list of (non)functional requirements. As a next step, prototypes of the SOULMATE technology will be developed and tested iteratively.
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Paper Nr: 14
Title:

Guidelines for Integrating Social and Ethical User Requirements in Lifelogging Technology Development
Authors:

Julia O. Heek, Wiktoria Wilkowska, Philipp Brauner and Martina Ziefle
Abstract: Lifelogging technologies have the potential to facilitate and enrich the everyday life of younger as well as older people. On the one hand, tracking and logging of data about activities and behavior support an active lifestyle. On the other hand, tracking medical data and movements support increasing safety by detecting, e.g., emer-gencies or falls. From a technical perspective, a variety of technologies enable lifelogging and are already available on the market. Instead, there is very little knowledge about the perception and acceptance of lifelog-ging technologies from users’ socio-ethical perspective. Hence, this paper presents research results from four online survey studies (n = 1107) aiming at covering a broad range of lifelogging applications and reaching di-verse target groups. Being based on insights gathered from the quantitative data collection, this paper derives guidelines for integrating ethical and social perspectives in lifelogging technology development and emphasiz-es gaps within the research landscape regarding its perception and acceptance.
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Paper Nr: 15
Title:

Wind of Change? Attitudes towards Aging and Use of Medical Technology
Authors:

Wiktoria Wilkowska, Julia O. Heek, Philipp Brauner and Martina Ziefle
Abstract: Shifts in demographic developments have led to changed needs and requirements in healthcare. Rising life expectancy and improved medical healthcare enable a more independent and healthier lifestyle of (older) persons, but also changes expectations and perceptions of aging, and health-supporting technologies. Knowledge about attitudes towards aging, medical assistive technologies, and impacting user factors (especially age and health status) is limited with regard to a broad sample of participants. In the present study (N=585), we therefore examined in an online-survey current attitudes towards aging and quality of life in older age, as well as perceptions and acceptance of health-supporting technologies, taking age and health status as user factors into account. Results revealed significant effects of age and health condition on the perception of life quality in older age. In addition, positive perceptions of aging, technology acceptance, as well as benefits and barriers were significantly influenced by the respondents’ age. In contrast, health status significantly affected the negative perceptions of aging. Under impacts of age and health condition as user factors, results of the study allow a deeper understanding of changing patterns of perceived aging and prevailing opinions regarding acceptance of medical technology.
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Paper Nr: 44
Title:

Back to the Roots: The Perspectives of Multiple Stakeholders about a Seamless Physical-Virtual AAL Advisory Service
Authors:

Rita Tavares de Sousa, Soraia Teles, Diotima Bertel, Paul Schmitter and Diogo Abrantes
Abstract: An articulation between the real/physical and the virtual world, i.e. an integrated service logic, is necessary for advisory service provision in the AAL field in order to best suit the consumers’ needs. However, personalised feedback is generally missing on digital advisory platforms that promote assistive technologies and services. This manuscript builds on previous research carried out in the scope of the EU-funded ActiveAdvice project, that is based on the premise that, in the AAL field, an engagement platform must promote not only AAL products and services but also empower stakeholders and facilitate the co-creation of value. Therefore, the concept of an Authorised Active Advisor was created. This paper presents and discusses the results from a qualitative study carried out to refine the concept of Authorised Active Advisors, by identifying, their added value and role within an integrated AAL advisory system, as well as their profile, required knowledge and skills.
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Short Papers
Paper Nr: 22
Title:

Privacy Perceptions in Ambient Assisted Living
Authors:

Eva-Maria Schomakers and Martina Ziefle
Abstract: Ambient Assisted Living (AAL) Technologies may help address the challenges that the ageing populations pose on the health care systems by supporting older adults in ageing-in-place, improving independence, and quality of care. Technology acceptance by the potential users and particularly privacy concerns are decisive obstacles to the widespread use of AAL. In order to examine privacy perceptions in detail, 86 participants (50% older than 50 years) evaluated AAL technologies and privacy concerns in a questionnaire approach. Additionally, with Maximum Difference Scaling the importance of AAL system characteristics to privacy perceptions by the users was investigated. Overall, the attitude towards AAL is positive, privacy concerns regarding the misuse of data, feeling of surveillance, and obtrusiveness of the technology are prevalent but not tremendous. Who has access to the data is by far the most important characteristic of an AAL system for the users’ privacy. Prominence of the system, sensor location, and sensor types are least important. The results contribute an important understanding of how AAL technologies need to be designed to respect users privacy.
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Paper Nr: 24
Title:

Scaling-up of ICT Solutions in Active and Healthy Ageing through Twinning Actions
Authors:

Strahil Birov, Christianne Lavin and Veli Stroetmann
Abstract: Despite an increase in life expectancy in today’s rapidly ageing society, unhealthy life years still make up a big portion of a person’s life. Digital innovations in health and care services need to be scaled up to enable more citizens to access and lead healthy, active and independent lives while ageing. Under the EU funded ScaleAHA study, a twinning scheme was conducted to scale up ICT solutions in active and healthy ageing. Forty-three organisations from thirteen European countries have successfully participated in financed twinning actions ranging from knowledge exchange and training to full adoption and acquisition of an innovative practice. Twinning topics included EHRs, ePrescription solutions, integrated health and social care ICT service platforms, and homecare and telemonitoring solutions, among others. The twinning scheme was a new concept that aimed to de-risk investment in innovative ICT solutions by financing small but concrete ideas with high potential for replicability and scaling up. The twinnings led to benefits for the participating organisations themselves as well as various stakeholders such as patients and their carers, healthcare providers and regional authorities. This paper presents the results and lessons learnt from the twinning scheme and recommendations to further refine future twinning actions.
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Paper Nr: 39
Title:

AAL-Pilot Concepts in Carinthia and Styria
Authors:

Kurt Majcen, Johanna Plattner, Daniela E. Ströckl, Kerstin Löffler, Eva Schuster, Pierre Schaschl, Daniela Krainer and Johannes Oberzaucher
Abstract: Seven pilot region projects for developing and evaluating Active and Assisted Living technologies are implemented in Austria until 2019. Two of them (RegionAAL in Styria and Smart VitAALity in Carinthia) are introduced in this paper according to their realization, implementation and evaluation concepts. The first results and perceptions of these pilot regions are also described.
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Paper Nr: 41
Title:

Generation of Multi-Party Dialogues among Embodied Conversational Agents to Promote Active Living and Healthy Diet for Subjects Suffering from Type 2 Diabetes
Authors:

Kuthethur J. Das, Tessa Beinema, Harm D. Akker and Hermie Hermens
Abstract: Diabetes Mellitus is a chronic condition that is highly prevalent in the geriatric population. Self-management plays a key role in the management of this condition. Leading an active lifestyle and having a healthy meal are cornerstones in managing this condition. Now with the advancement in Information and Communication Technology (ICT), continuous and proactive care from the affected individual’s side is possible. A change in the individual’s behaviour would be beneficial in pursuing physical activity and adopting a healthy diet. This paper focuses on providing a dialogue based virtual health coaching through multiple Embodied Conversational Agents (ECAs), using strategies such as Motivational Interviewing (MI), Theories of Behaviour Change and Behaviour Change Techniques (BCTs). The dialogues are constructed to induce a behaviour change and promote motivation in the affected subjects to work on improving their physical activity and diet plan.
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Paper Nr: 33
Title:

Dispatching and Management Center for Optimizing Home Care Integrated Services
Authors:

Virginia Săndulescu, Sorin Pușcoci, Monica Petre, Sorin Soviany, Mirabela Chirvașă and Alexandru Gîrlea
Abstract: The paper summarizes the design specifications for a complex ICT platform for optimizing home care integrated services. It is based on the work involved in implementing the project with the same title – “Dispatching and Management Center for Optimizing Home Care Integrated Services”. The project aims to create a network of centers that offer services to home care service providers (HCPs). The centers in the network should optimize the activity of the home care service providers and support them in offering quality standardized services through the usage of a complex platform that optimizes most of the activities involved in offering home care services. The proposed system does not focus on the home care system, but concentrates on the software and hardware components that will allow a home care services provider to perform in a very efficient way. It may be compared to an ERP (Enterprise Resource Planning) system customized and dedicated to HCPs. As far as we know, there is no such system implementation currently on the market. The main beneficiaries are the home care service providers along with their end-users (elders, chronic patients or people who need ambulatory treatment), who will ultimately receive better services.
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Paper Nr: 36
Title:

e-Health Solutions for Aging in Place with Cognitive Impairment: Preliminary Results of a Systematic Review
Authors:

Samantha Dequanter, Marie-Pierre Gagnon, Mame-Awa Ndiaye, Jessica Dion, Ellen Gorus, Anne Bourbonnais, Anik Giguère, Samira A. Rahimi, Maaike Fobelets and Ronald Buyl
Abstract: Worldwide, the proportion of older adults (60+) is growing very fast, increasing the prevalence of cognitive disorders such as Mild Cognitive Impairment and dementia. Recent literature shows a clear preference of older adults towards Aging in Place (AIP). In order to realize AIP in cognitively impaired older adults, appropriate measurements regarding safety and practical feasibility need to be taken. In answer to this issue, various e-Health solutions have been developed in the last decade, targeting support of memory, social contact, daily activities and personal safety. Much attention has also been given to solutions for caregivers of cognitively impaired older adults. Since the field of e-Health research is expanding at fast pace, implementing effective e-Health solutions based on research evidence constitutes a challenge. Therefore, this systematic review aims to review recent study findings in the field of e-Health research regarding community-dwelling cognitively impaired older adults and their informal caregivers. We also consider potential adverse effects of adoption of these solutions. An initial search led to 12999 potentially relevant citations. First-level title-screening of citations was completed in January 2019. Third-level full-text screening is targeted for April 2019. If possible, effect sizes for each type of e-Health intervention will be calculated.
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Paper Nr: 45
Title:

Empathize with the CAPTAIN Stakeholders’ Community towards Understanding Older Adults’ Daily Needs and How They Cope with Them
Authors:

Despoina Petsani, Evdokimos I. Konstantinidis, Antonis Billis, Maria Nikolaidou, Nikolaos Kiriakidis, Vassiliki Zilidou, Despoina Mantziari, Michalis Timoleon and Panagiotis D. Bamidis
Abstract: This paper presents the results of the first part of the design thinking approach that was utilized within the CAPTAIN H2020 funded project. CAPTAIN aims at developing a new technology to help older adults living at home, by designing new technology that turns the home of older adults into a ubiquitous assistant. Six personas were selected for the empathize session which was conducted through plenary face–to-face open discussion meeting. 33 older adults and caregivers participated. The goal of this study was to identify the everyday difficulties that older adults face and clarify the means they are currently using to address these problems. The paper presents the approach, the design of the first session and the results from the Greek pilot site.
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Paper Nr: 46
Title:

Testing Usability in an ICT Solution for Care Cooperatives: A Case Study
Authors:

Thomas W. Jensen and Bodil Sørensen
Abstract: This paper describes a usability test design in the development of an ICT management system in an EU project under the Ambient Assisted Living (AAL) programme. The population of Europe is aging, and the elderly population is increasing. This demographic change will create an increasing need for social and healthcare services. The purpose in developing the ICT management system is to meet this challenge by creating an effective ICT management system for elderly people in need of assistance. Results from the usability test give the developers insight into features to be changed to create a user-friendly software. The methods used in this study were standard usability tests and emotional wheel scores. Representative end users were given a number of tasks while conducting thinking aloud tests and emotional wheel scores followed by qualitative interviews. The test results were categorised in terms of effectiveness, efficiency and satisfaction. In general, the end users’ response were positive. They suggested improvements and identified a number of challenges mainly related to effectiveness. Emotions ranged from happiness and joy, especially after successfully completing a task, to anger and frustration when obstacles occurred.
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Area 2 - Independent Living

Full Papers
Paper Nr: 6
Title:

An Italian Business Case for an eHealth Platform to Provide Remote Monitoring and Coaching Services for Elderly with Mild Cognitive Impairment and Mild Dementia
Authors:

Monika Jurkeviciute, Lex van Velsen, Pietro D. Trimarchi, Ladan Sarvari and Fabrizio Giunco
Abstract: The purpose of this study was to define a business case for an eHealth platform to provide remote monitoring and coaching services for elderly with mild cognitive impairment and mild dementia in the Italian context. 107 patients with mild cognitive impairment and mild dementia were divided into the intervention and control groups. The data was collected using standardized instruments Clinical Dementia Rating Scale (CDR) and EuroQoL-5D-5L, and tailor-made instruments, such as surveys to technology and healthcare providers, and semi-structured interviews to patients and healthcare professionals. The data that was not collected in the study, was obtained from the scientific literature. Benefit/cost ratio was calculated for three years. The study shows that a digital platform to provide remote monitoring and coaching services for elderly with mild cognitive impairment and mild dementia can be cost-effective from the first year, and can improve care without monetary loss for the healthcare provider. The key benefits show that the deterioration of the illness is postponed, and that the satisfaction of the patients and the healthcare professionals increases. Therefore, such an eHealth platform can be a worthy investment in Italy, and could be considered for wider nation-wide adoption.
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Paper Nr: 18
Title:

Using Laddering to Understand the Use of Gamified Wearables by Seniors
Authors:

Auke Reitsma, Ton Spil and Sjoerd de Vries
Abstract: Gamified wearables have the potential to assist seniors in living independently with a good quality of life. However, the use of (gamified) wearables by seniors is very limited. The uses and gratifications theory states that needs motivate the use of computer mediated communication. Therefore, this qualitative study aimed to find the needs that motivate the use of gamified wearables by seniors. Laddering interviews have been conducted with a group of 12 seniors that live independently in their own homes. Four needs were identified: the needs for 1) good health, 2) accomplishment, 3) independency and 4) peace of mind. The need to be healthy and the need for accomplishment could be fulfilled by the gamified wearable and motivated seniors to use it. However, the needs for independency and peace of mind were undermined by the gamified wearable Participants expected the gamified wearable to make them less independent and diminish their sense of accomplishment of being healthy autonomously. The participants also feared information anxiety caused by information about their physical health, which they expected to undermine their peace of mind. This study concludes that a more user-centric design is needed for the gamified wearable to meet the needs of seniors.
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Paper Nr: 35
Title:

Development and UI/UX Testing of an iTV Companion Application for Seniors
Authors:

Telmo Silva, Martinho Mota and Carlos Silva
Abstract: This paper presents the results of testing a second-screen mobile application designed for senior users. This work is part of the +TV4E project, a larger study which focuses on promoting info-inclusion among the senior Portuguese population by directly sending them information regarding public and social services. The developed mobile application was integrated into this project as a complement for the already existing iTV application, which delivered informative videos to seniors, serving both as a second-screen app, by augmenting the TV experience and as a standalone application, by allowing users to access their videos outside their homes. Initially, a prototype application was developed with the objective of being presented to a group of seniors in order to identify the major interface flaws, subsequently, the prototype was improved taking into consideration the gathered feedback.
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Short Papers
Paper Nr: 7
Title:

Testbed Requirements for Technology Enhanced Stroke Rehabilitation to Support Independent Living
Authors:

Awais Ahmad, Peter Mozelius and Karin Ahlin
Abstract: An identified global phenomenon is that, as the percentage of older adults increases, new challenges arise for medical care and rehabilitation. Several research studies have presented e-health as a promising concept to support the idea of independent living among patients with chronic diseases. The Mid Sweden region has a relatively old population and is a region where people live with long distances to the nearest hospital or health care centres. This study had a focus on defining testbed requirements for a technology enhanced stroke rehabilitation adapted to the specific region. The focal research question to answer in this study was: What are the requirements and their associated benefits and barriers of using technology-enhanced systems instead of traditional techniques for stroke rehabilitation in the Mid Sweden region? With Design Science as the overall research strategy, data was collected by semi-structured interviews with key stakeholders in the field of stroke rehabilitation. A deductive thematic analysis was conducted where important themes were grouped into the four main requirement categories of: Technical, Human-computer-interaction, Clinic and Sustainability. Beside the more specific requirements, an interesting finding was the division of stroke rehabilitation into the categories motoric, cognitive and speech rehabilitation; also, how technology enhanced solutions might be used in these categories. Each category has a potential for a successful use of technology enhanced services, but as the standard procedure in traditional stroke rehabilitation each patient needs a personalised treatment.
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Paper Nr: 32
Title:

Architecture and Implementation of an Internet Platform for Activating Elderly People: Case Study
Authors:

Wieslawa Gryncewicz, Robert Kutera, Maja Leszczynska and Artur Rot
Abstract: The issues related to elderly people are currently being studied by many disciplines, including biology, medicine, psychology and sociology. The problems that aging creates in societies are covered in different ways by scientists specializing in different fields. Social scientists focus on, inter alia, the social scope of activities carried out by elderly people. The said issues also fall in the areas of interest of professionals who create information systems and technologies dedicated to elderly people. Thus, what has been developed in order to meet their interests and to respond to a dynamic process of aging within societies is a concept of an ICT platform designed to increase the activity of elderly people. The platform is dedicated to members of local communities and it can be used to foster entrepreneurship, personal fulfillment and activation in the area of social life. The paper presents both the goals and the concept of such a platform as well as its information structure and model of implementation.
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Paper Nr: 38
Title:

IoT for Playful Intergenerational Learning about Cultural Heritage: The LOCUS Approach
Authors:

Ana C. Amaro and Lídia Oliveira
Abstract: LOCUS is a three-year multidisciplinary project with the goal of co-design, develop and evaluate an IoT system and understand its potential to support playful intergenerational engagement in creating and exploring cultural contents and learning about cultural heritage of rural territories from the Centre Region of Portugal, namely Amiais village, in Sever do Vouga. By implementing a playful and immersive cultural heritage tourism approach to foster Amiais' cultural and socioeconomic development, LOCUS will allow visitors to have immersive gamified experiences, by using a wearable device (bracelet) and their smartphones to interact with augmented everyday things around the village and to collaboratively learn about Amiais' culture and produce and share multimedia georeferenced contents.
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Area 3 - Monitoring, Accessibility and HCI

Full Papers
Paper Nr: 27
Title:

Age-appropriate Participatory Design of a Storytelling Voice Input in the Context of Historytelling
Authors:

Torben Volkmann, Michael Sengpiel, Rita Karam and Nicole Jochems
Abstract: With the demographic change, the percentage of older adults steadily increases. At the same time, new information and communication technologies (ICT) emerge at an ever-increasing rate, making it imperative to consider older adults in the development process to achieve the best possible usability and acceptance for older adults. This paper describes the development of a storytelling input component in the context of Historytelling (HT), which provides a digital interactive platform for older adults to share life stories across generations, potentially improving their health and wellbeing. HT follows the HCD+ (Human Centered Design for Aging) approach, claiming that older adults should be integrated as co-designers throughout the development process. A total of 19 older adults (M=68 years old) participated in 3 studies to analyze, evaluate and design a storytelling voice input, investigating voice communication technology for conversational agents. They were successfully involved in the design process, with methods adjusted to accommodate specific user characteristics of older adults and substantially contributed to the further development of the HT project, exploring the two central research questions regarding the type of voice input suitable for older adults and the minimal requirements for a conversational agent.
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Paper Nr: 42
Title:

A Balance Training Game Tool for Seniors using Microsoft Kinect and 3D Worlds
Authors:

Michail Chartomatsidis and Christos Goumopoulos
Abstract: Exercising through gaming (exergaming) based on commercial gaming platforms has been popular over the past years for fitness improving and balance training both for healthy people and for mobility rehabilitation purposes. For the elderly people, exergaming can provide motivation for increasing physical and cognitive activity and as a result improvements on posture balance, physical strength and mental well-being may be expected. However, an issue that arises is whether such gaming systems that are addressed to the general population following a fit-for-all design approach are appropriate for seniors. In this paper we address this issue by developing a new game based on the Microsoft Kinect sensor and creating an engaging three-dimensional world by using a popular 3D game engine. A human centered design approach is followed by involving main stakeholders in the development process for achieving an effective and user-friendly balance training. An evaluation of the proposed game tool with twelve seniors has been performed assessing system usability as well as the balance training efficacy measured by the Berg Balance Scale and the 30 seconds sit-to-stand test. The analysis of the feedback provided by the users and the performance statistics exported by the system indicates a positive acceptance and the potential for promoting health in older adults through balance improvement.
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Short Papers
Paper Nr: 16
Title:

Multi Low-resolution Infrared Sensor Setup for Privacy-preserving Unobtrusive Indoor Localization
Authors:

Christian Kowalski, Kolja Blohm, Sebastian Weiss, Max Pfingsthorn, Pascal Gliesche and Andreas Hein
Abstract: The number of home intensive care patients is increasing while the number of nursing staff is decreasing at the same time. To counteract this problem, it is necessary to take a closer look at safety-critical scenarios such as long-term home ventilation to provide relief. One possibility for support in this case is the exact localization of the affected person and the caregiver. A wide variety of sensors can be used to remedy this problem. Since the privacy of the patient should not be disturbed, it is important to find unobtrusive solutions. For this specific application, low-resolution infrared sensors - which are unable to invade the patient’s privacy due to the low amount of sensor data information - can be used. The objective of this work is to create a basis for an inexpensive, privacy-preserving indoor localization system through the use of multiple infrared sensors, which can be for example used to support long-term home ventilated patients. The results show that such localization is possible by utilizing a support vector machine for classification. For the described scenario, a specific sensor layout was chosen to ensure the highest possible area coverage with a minimum amount of sensor installations.
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Paper Nr: 28
Title:

Making Reading from a Tablet Computer Easier for Older People in Thailand and the UK: Effects of Text and Background Colours
Authors:

Maneerut Chatrangsan and Helen Petrie
Abstract: This study investigated the effects of text and background colour on tablet computers on reading performance and preferences for older and younger readers from two countries, Thailand and the UK. In the UK, 30 older (65 to 85 years) and 30 younger (18 to 23 years) participants took part; in Thailand 20 older (60 to 71 years) and 20 younger (20 to 23 years) participants. Participants skim read texts on a tablet computer presented in five combination of text and background colours (black text on white background, white on black, black on buff, sepia on buff and black on light blue) and answered multiple-choice questions about each text. Reading time and comprehension were measured and preferences for text/background colour combinations. Older participants in both countries took significantly longer to read the texts than younger participants and in Thailand older participants answered significantly fewer questions correctly than younger participants. However, the colour combinations had no significant effects on performance measures. On preferences for colour combinations, only the younger UK participants expressed significant trends, preferring and black/buff and black/light blue. Further research with larger samples of participants is needed to determine whether there are any clear preferences for text/background colour combinations in each country. In the meantime, black text on a pale background, either white, buff or pale blue can be recommended for presenting text on tablets to both older and younger readers in both countries.
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Paper Nr: 50
Title:

A Mobile Health Application to Assist Health Professionals: A Case Study in a Portuguese Nursing Home
Authors:

Márcia Esteves, Marisa Esteves, António Abelha and José Machado
Abstract: The rapidly aging population has been a matter of concern over years since this problematic has been posing several challenges to healthcare systems worldwide. In Portugal, which is one of the countries with the largest aging population, nursing homes have been getting a higher demand, and health professionals are overloaded with work. Furthermore, the fact that few nursing homes use health information and communication technology (ICT) resorting to paper to record information and clinically manage their residents is a tremendous problem, since this method is more prone to errors and time-consuming. Thus, this paper proposes the design and development of a mobile application for health professionals working in a Portuguese nursing home with the intention of assisting them at the point-of-care, by recording and providing all the necessary information, and helping them to schedule, perform, and digitally record their tasks. This solution will help health professionals to provide better care, by reducing time-waste and errors, and, consequently, to improve elders’ quality of life. A mobile solution was chosen since a hand-held device, which can be used anywhere and anytime, is able to give access and store all the needed information at the point-of-care.
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Area 4 - TELEMEDICINE AND E-HEALTH

Full Papers
Paper Nr: 11
Title:

Why My Grandfather Finds Difficulty in using Ehealth: Differences in Usability Evaluations between Older Age Groups
Authors:

Marijke Broekhuis, Lex van Velsen, Silke ter Stal, Jordi Weldink and Monique Tabak
Abstract: Many studies emphasize the need for more in-depth analysis of how age-related barriers influence the user acceptance of eHealth. In this study, we elaborate on existing work in this field by identifying how age differences affect usability evaluations in eHealth. We examined how older adults between 55-64 years (n=10) evaluated the usability of a game-based eHealth application in comparison to adults of 65 years and older (n=19). A concurrent think aloud protocol and the System Usability Scale (SUS) were administered to 29 participants. Usability issues were elicited from the think aloud transcripts and benchmark scores were obtained from the SUS. We conducted both: (1) a statistical analysis on the amount of usability issues and SUS score; and (2) a thematic analysis of the usability issues. Our study found that the 55-64 age group encountered significantly fewer usability issues compared to the 65+ age group. Furthermore, the thematic analysis revealed that while both groups had similar problems regarding the ‘Navigation & Structure’ category of the game-based eHealth application, there was much variation in the other usability categories of ‘Content & Information’, ‘Design & Presentation’ and ‘Other’. Our results can improve the development of eHealth that support healthy ageing.
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Paper Nr: 12
Title:

GOAL: An eHealth Application for Rewarding Healthy Behaviour. The First Experiences of Older Adults
Authors:

Stephanie J. Kosterink, Roos Bulthuis, Silke ter Stal, Aristodemos Pnevmatikakis, Sofoklis Kyriazakos, Andrew Pomazanskyi and Harm D. Akker
Abstract: It is important to motivate older adults to lead an active lifestyle. Mobile games and applications can motivate older adults to increase physical, social and cognitive activity. Such a mobile application platform is developed within the GOAL project (H2020 project no. 731656). The aim of this paper is to introduce GOAL, to provide an overview of ongoing evaluations and to present the intermediate results concerning the usability of end-user acceptance of this technology among older adults. GOAL consists of three core components: the GOAL Website, the GOAL Web Portal and the GOAL Mobile Applications. The evaluation has an iterative approach. In total, there are four evaluation phases. During the first three phases, subjects are invited for a pre-test and post-test assessment. During phase 4, subjects are invited to use GOAL by sending out a mass email to get people to sign up to GOAL for themselves. The results of phase 1, 2 and 3 of the evaluation (especially the suggestions by the target group) lead to several points of improvement for the GOAL system, to increase the adoption of this technology by older adults. Over the phases, the level of usability increased and subjects become more and more enthusiastic about GOAL.
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Paper Nr: 30
Title:

Facilitating Access to Health Web Pages with Different Language Complexity Levels
Authors:

Marco Alfano, Biagio Lenzitti, Davide Taibi and Markus Helfert
Abstract: The number of people looking for health information on the Internet is constantly growing. When searching for health information, different types of users, such as patients, clinicians or medical researchers, have different needs and should easily find the information they are looking for based on their specific requirements. However, generic search engines do not make any distinction among the users and, often, overload them with the provided amount of information. On the other hand, specific search engines mostly work on medical literature and specialized web sites are often not free and contain focused information built by hand. This paper presents a method to facilitate the search of health information on the web so that users can easily and quickly find information based on their specific requirements. In particular, it allows different types of users to find health web pages with required language complexity levels. To this end, we first use the structured data contained in the web to classify health web pages based on different audience types such as, patients, clinicians and medical researchers. Next, we evaluate the language complexity levels of the different web pages. Finally, we propose a mapping between the language complexity levels and the different audience types that allows us to provide different types of users, e.g., experts and non-experts with tailored web pages in terms of language complexity.
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Short Papers
Paper Nr: 2
Title:

A Clinical Decision Support System based on an Unobtrusive Mobile App
Authors:

Ariella Richardson, Avigail Perl, Sapir Natan and Gil Segev
Abstract: Clinical decision support systems typically rely on medical records and information collected in the doctor’s office. We propose a clinical decision support system that uses data collected from patients continuously and in an unobtrusive manner. The system uses data collected from a mobile app installed on the patient’s device (such as a mobile phone, smart-watch etc). The app collects data without user interference and combines it with conventional medical records. Our system uses machine learning methods to extract meaningful insights from the data. The output from the learning process is then presented to the doctor in a clear and meaningful fashion on a web based platform. This system can be used to assist effective treatment selection, enable early diagnosis, trigger alarms in case of an emergency and provide a tool for disease monitoring. We describe our clinical decision support system and directions for future work.
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Paper Nr: 17
Title:

The Implementation, Actual Use and User Experience of an Online Home Exercise Program That Fits the Needs of Older Adults with Mild Cognitive Impairments
Authors:

M. D. Weering, S. Jansen-Kosterink and M. Tabak
Abstract: As the population ages, the number of people in our communities suffering with mild cognitive impairment (MCI) will increase. Individuals with MCI may benefit from e-health interventions for exercise promotion, but there is a need for such an e-health program that fits the needs of older adults with MCI. The objective of this study was to evaluate the implementation, actual use and user-experience of a home-based exercise program developed for older adults with MCI. Questionnaires were filled in about the implementation strategy, actual use and user-experience (usefulness, usability and satisfaction). Fifty-seven older adults and eight formal caregivers participated in the study. Mean duration of the sessions was 18 minutes (+/-15). The user-experience of the older adults was higher than that of the formal caregivers. Formal caregivers mainly offered the program at the home care organization, but some older adults indicated that they were willing to try it at home. In conclusion, the online exercise program is feasible and potentially beneficial for older adults when taking into account the e-health literacy of older adults and attitude towards e-health of formal caregivers in the implementation strategy.
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Paper Nr: 23
Title:

“Attitude”- mHealth Apps and Users’ Insights: An Empirical Approach to Understand the Antecedents of Attitudes towards mHealth Applications
Authors:

Luisa S. Vervier, André C. Valdez and Martina Ziefle
Abstract: Mobile health apps are a solution to make people more self-sufficient with their health in relation to their lifestyle or medical needs. The mobile health landscape is growing, but still its usage rate is rather low. Since the attitude towards mhealth apps has not been extensively studied so far, we conducted a multi-method approach study in Germany. To understand people’s needs, preferences and attitudes towards mhealth applications on the one hand and the antecedents of people’s attitudes towards mhealth applications on the other hand, we chose a user-centered approach. To get first insights into users’ needs and attitudes, we conducted two focus groups (N=11). Topics such as privacy concerns, data sharing and app functions have emerged as key issues. Quantitatively, we operationalized the collected key topics as well as users’ attributes and personal health attitudes. We collected 132 complete responses from originally 180 responses. We used partially-least squares structural equation modeling to identify the antecedents of attitudes towards mhealth applications. Results indicate that time saving and daily life facilitating functions are favored app features. Further, we found advantages (e.g. drink reminder) and disadvantages (e.g. data collection). Gender and age effects could be detected regarding health literacy, privacy concerns, and data sharing. Older participants are more cautious and reserved with the usage of health apps. Women in general show a higher health-literacy. eHealth literacy and intention to share data were identified as being the strongest influence on a positive attitude towards mhealth apps. To ensure that mhealth apps further enjoy a rising popularity, it is important to meet the users’ concerns about privacy and help them to acquire eHealth literacy.
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Paper Nr: 26
Title:

Do Elderly People Enjoy the Fruits of Estonia’s e-Health System?
Authors:

Marianne Paimre
Abstract: The article focuses on the ability of senior citizens to use the highly acclaimed Estonian e-health system. Estonians are heavy internet users and are known for their innovative e-solutions in the world. E-health is a prime example of such state-of-the-art programmes set out to improve public health. The people who need health related information the most are the elderly. But do they have access to the internet and can they find relevant information and cope with e-health solutions? Acquiring a computer or subscribing to internet service could present a major financial challenge for them. A pilot study, which is the initial step to a more comprehensive research, revealed based on a focus group interview and in-depths interviews with seniors that elderly often lack the skills and experience necessary to search for online health information as well as cope with e-health solutions. Thus, the wholesome public image of Estonia’s e-success seems not to always correspond to the reality. This paper puts the much-appreciated IT solution into a broader perspective and, instead of the lavishly praised e-health applications, focuses on outlining the serious drawbacks of the digital divide and exclusion of seniors from the digital services.
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Paper Nr: 34
Title:

The Need for an International Medical Emergency Dataset
Authors:

Judith Born, Jan Wohlmann and Christian Juhra
Abstract: A significant number of problems in emergency care are caused by a lack of provider access to pre-existing patient information at the point of care. A particular difficulty is the access to information on the medical history of patients from other countries. This is due to a number of reasons such as language barriers, technical and safety hurdles, differences in expectations concerning content of the data and workflow differences between emergency room departments. With increasing numbers of travellers, a cross-national information exchange of relevant medical data in case of emergency is becoming more and more important. Therefore, this paper aims to discuss possibilities and requirements for setting up an internationally available emergency data set.
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Paper Nr: 1
Title:

Mobile Applications for Stroke: A Survey and a Speech Classification Approach
Authors:

Ariella Richardson, Shani Ben Ari, Maayan Sinai, Aviya Atsmon, Ehud S. Conley, Yohai Gat and Gil Segev
Abstract: Strokes are a cause of serious long-term disability and create an immense burden on healthcare. Among the sea of mobile applications for health, some target stroke patients, and most require active user cooperation. Our proposed application, collects data, without user intervention. We apply data mining methods to create personal feedback to the patient or doctor. We provide a survey of applications for mobile or wearables, specifically for stroke. We also survey papers that apply data mining to stroke. In addition to the survey, we present a feasibility study on using speech for classification of stroke patients. We created a new data set of unstructured speech recordings, increasing applicability. We present experimental results on classification of stroke patients. Our study provides promising insight to detecting stroke patients using a mobile application without requiring active user participation.
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Paper Nr: 20
Title:

An Information and Communication Platform Supporting Analytics for Elderly Care
Authors:

Orhan Konak, Harry Freitas Da Cruz, Marvin Thiele, David Golla and Matthieu-P. Schapranow
Abstract: Germany faces an increase of its elderly population and along with it the number of people reliant on nursing care is also rising. In this context, access to reliable information is key for all actors involved, be they family members or political decision makers. Currently, the country lacks a centralized platform on which such actors can access and exchange relevant information, e.g. as concerns finding a suitable facility or identifying trends on the demand for care spots. Existing solutions are based on regional data silos, which render information exchange time-consuming and error-prone. As a result, nursing care actors lack access to timely, reliable information to support strategic decision-making. In this paper, we introduce a software platform built upon an In-Memory database that meets the information and communication needs of the different user groups involved. The platform establishes the necessary framework for real-time data collection and information exchange, laying the foundation for deriving key performance indicators and enabling data exploration and prognoses.
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Paper Nr: 37
Title:

Cloud Infrastructure for Storing and Processing EEG and ERP Experimental Data
Authors:

Petr Ježek and Lukáš Vařeka
Abstract: Current infrastructures for experimental data, results and computational tools make a shift from locally maintained solutions to remote cloud-based infrastructures. It brings a higher availability, sustainability and performance. However, specifics of different research areas require development of customized solutions for individual research domains. For example, electroencephalography and event-related potentials (EEG/ERP) use specific devices, data formats and machine learning workflows. As a solution, a cloud-based system for the EEG/ERP domain containing a distributed data storage, a signal processing method library and a client GUI is presented. The signal processing method library is used for training of classifiers and classifying the data in the cloud-based system controlled by the GUI. The presented system was tested using a machine learning workflow based on the data stored in the system. In the workflow, various classifiers were trained and their parameters stored into the system. Finally, testing data were classified using previously trained classifiers.
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Paper Nr: 43
Title:

The Role of Hearing in Aging and Hearing Rehabilitation Technology with an Outlook on Future Applications
Authors:

Lukas B. Tietz and Gabrielle H. Saunders
Abstract: The purpose of this position paper is to raise awareness about the negative impacts of age-related hearing loss and the importance of providing good hearing healthcare. We also provide an overview of state-of-the-art hearing aids - the standard rehabilitative technology for hearing loss – along with some thoughts about the future of hearing healthcare. Provision of hearing intervention is critical because untreated age-related hearing loss is associated with numerous negative impacts on the health and well-being, such as increased odds of falling, social isolation and cognitive decline. We suggest that, hearing technologies that combine intelligent computer systems with user centred approaches to hearing healthcare provision will ensure that hearing aids result in improved quality of life for those with hearing loss.
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Paper Nr: 47
Title:

ShinyAnonymizer: A Tool for Anonymizing Health Data
Authors:

Marios Vardalachakis, Haridimos Kondylakis, Lefteris Koumakis, Angelina Kouroubali and Dimitrios G. Katehakis
Abstract: Processing and managing sensitive health data requires a high standard of security and privacy measures to ensure that all ethical and legal requirements are respected. Data anonymization is one of the key technologies to this purpose. However, the plethora and the complexity of the available anonymization techniques make it difficult for a non-expert to select and apply the appropriate technique. In this paper, we report on Shiny Database Anonymizer, a tool enabling the easy and flexible anonymization of available health data, providing access to state of the art anonymization techniques, incorporating also multiple data analysis visualization paradigms. In addition, a number of encryption and hashing techniques are presented.
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Paper Nr: 49
Title:

Healthcare Applications of Intelligent Information Systems: A Novel Technique for Medical Image Fusion
Authors:

Ahed Abugabah and Ahmad Alsmadi
Abstract: This paper executes a novel methodology of medical image fusion depending on two kinds of linear filters. The first filter is mean filter which is utilized to decay the source images to base and detail layers. The local linear filter (guided filter) is utilized to upgrade the source images from one another. Computed-Tomography (CT) images before and after freezing are being used to improve the corresponding data which lead to the right diagnosis. Likewise, examples from human magnetic resonance imaging (MRI) images are utilized to fused T1 and T2 of MRI images together. The fusion result is assessed dependent on standard deviation (Std), peak signal to noise ratio (PSNR), mutual information (MI), root mean square error (RMSE), and universal image quality indexes (UIQI). The combination result is contrasted and three existing combination rules. Hence, the numerical outcomes perform better execution among other combination rules.
Paper Nr: 52
Title:

Improving the Use of the Electronic Health Record using an Online Documentation Manual and Its Acceptance through Technology Acceptance Model
Authors:

Carina Martins, Júlio Duarte, Carlos Portela and Manuel Santos
Abstract: To a human it’s very complicated to access all the information correctly without a technology to help. The healthcare information systems (HIS) preserves all the information related to a patient and the hospital. In order to be able to share between different HIS, there must be a platform to integrate and share all the information. In Hospital Center of Porto (CHP), the platform used is the AIDA-PCE. This article proposes to make a prototype of an online documentation manual for the platform used and evaluate its acceptance, through a questionnaire with 28 questions. This acceptance was guided by the constructs of the technology acceptance model and the Delphi method. Through bench-marking was chosen the most appropriate tool for creating this manual. The purpose is to enumerate potential improvements to the platform, to reduce and optimize the time of its use and to increase the acceptance of this manual by the professionals.
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Paper Nr: 53
Title:

Clinical Workflows based on OpenEHR using BPM
Authors:

Tiago Ribeiro, Sérgio Oliveira, Carlos Portela and Manuel Santos
Abstract: The integration of clinical workflows in electronic health records systems has been problematic due to the complex nature of clinical processes. For that reason, many health institutions have opted to maintain a few clinical workflows on paper, which has been compromising the quality and efficiency of several provided services. The purpose of this study is to investigate if the OpenEHR model can be applied in the configuration and management of clinical workflows using Business Process Modelling (BPM), with the focus on clinical forms based on OpenEHR archetypes and having has background the institution Centro Hospitalar do Porto (CHP). The need to review the workflows is pertinent due to the lack of integration of clinical workflows on their Electronic Health Records system. To analyse this possibility, a prototype was created containing: i) a BPM tool to configure and manage the clinical workflows; and ii) a web application to execute them and call the external clinical forms. The obtained results proved that the use of a BPM tool to configure clinical workflows allows the interoperability and flexibility of the prototype, which helps to improve the quality and efficiency of the clinical practice.
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