Information Technology Reference
In-Depth Information
information flow during the care process prevents
mistakes, reduces redundant work and is a major
step towards integrated home healthcare.
In reality, care systems are often used by
patients or healthcare personnel who are not
technically experienced. Technical solutions get
only accepted if they show a measurable benefit
(reduce or simplify the work). The acceptance of
a technical solution is a critical, but a nevertheless
often neglected factor, especially in the healthcare
sector (Ammenwerth, 2003). Studies like (Mayr
& Lehner, 2009), (Mayr & Lehner, 2008a) have
shown considerable anxieties of healthcare per-
sonnel. A current study (Mayr & Lehner, 2009)
conducted with caregivers in nursing homes
(n=259) shows that there is growing acceptance
of IT solutions for healthcare applications. Nev-
ertheless, an intense involvement of users in the
development process is important for achieving
user acceptance and not letting them feel over-
whelmed by technology.
Discussions about information security and
the protection of sensitive data are inevitable
according to electronic exchange of health care
information. In Austria, information security
is governed by the Austrian data protection act
(BMEIA, 1999) as well as the healthcare telemetric
act (Bundesministerium für Gesundheit, 2004).
In the USA and Great Britain, healthcare data is
used as marketable good (Heydwolff & Wenzel,
1997). The British Medical Association precisely
specifies this fact in its principles for security
in clinical information systems and completely
rejects data transfer per chip card (Anderson R.,
1996). Developments like a health-data-exchange
platform need a secure infrastructure based on
international standards for data transfer between
different healthcare institutions. Currently, this
issue is often legally covered using declarations
of consent signed by the patient or the guardian.
There are still unanswered questions concerning
the data protection act, for example, the required
declaration of consent when the affected person
can no longer communicate (Kopetzki, 2008).
Concerning device integration and interoper-
ability with healthcare providers as well as exten-
sible service infrastructures are key requirements
when developing services for the needs of elderly.
A simple service could be a continuous blood
pressure monitoring device which advances to
weight monitoring, because of a detected heart
insufficiency. It is obvious that scalability and
easy integration of services and devices are of
great concern and must be properly addressed
by AAL systems.
While physiological parameter monitoring
is becoming state of the art, the recording and
analysis of ADLs for behavior analysis is still
too immature and error-prone to be practically
feasible. One of the key challenges in behavior
analysis is the description of activities using a
proper ontology. A sound ontology makes it easier
to exchange and reason about perceived data,
but currently no common agreed AAL ontology
has been established. This leads to proprietary
ontologies, which complicate the exchange of
data and processing results. Another problem
concerning behavior analysis is the detection of
situations. Some approaches require training on
test data before a detection process can be started,
especially if supervised learning techniques are
used. In most cases gathering and preprocessing
training data is difficult and time consuming. This
initial effort can be completely avoided with a
descriptive approach (rules or grammars) where
no training phase is required. Furthermore, it offers
the advantage, that less IT specific knowledge is
required for describing activities and situations
than for training classifiers.
TECHNOLOGICAL ACHIEVEMENTS
FOR ELDERLY IN A SOCIAL-
ORGANIZATIONAL CONTEXT
Due to the demographic change, the importance of
technological development in the field of eldercare
is increasing. In Europe, there is a large number of
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