T3.1. Independent Living Applications Portfolio. Henk Herman Nap: Ad van Berlo:

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1 T3.1 Independent Living Applications Portfolio Henk Herman Nap: Ad van Berlo: Richard Pasmans: 2013

2 Roll-out with 7000 users in real life: Active & Independent Living applications on top of the open service platform universaal

3 ReAAL Deploy within 36 months several applications in the field of active and independent living on top of the universaal platform in several pilot sites involving ca users in 8 countries. As the result of the FP7 project universaal ( the universaal platform is the most prominent candidate platform in this field. universaal s technical strategy: enable interoperability in terms of execution on a wide variety of different operating systems, allowing plug-and-play use of sensors and other equipment available on the open market and enabling easy composition of service elements to provide higher-level services. Within ReAAL, partners of the universaal project will set up a full exploitation environment that consists of ustore, Development Depot, and run-time platform components. Darmstadt, 16-Jan-2013 ReAAL Kick-off Meeting 3

4 Application Portfolio: Main Goal Demonstrate the socio-economic benefits of open service platforms as a basis for delivery of relevant active and independent living services. 1 st 2 nd Pool of ReAAL candidate Independent Living Applications Openness Maturity Risk Ranking of the candidate Applications on a set of criteria (Used criteria: Independent Living, Need of service, Openness, Maturity, Risk) 3 rd 4 th Recommended Applications to be tested at the pilots

5 Application portfolio Report about the consolidation of the ReAAL application portfolio The criteria for the ranking of independent living applications have been identified and are discussed A first list of applications is presented to be deployed in the pilot sites The ranked list of independent living applications will be dynamic and will be iteratively updated to accommodate advancing insight throughout the project phases The criteria might be enhanced and altered to meet the needs of all relevant stakeholders

6 The Stakeholder Groups Identified the following stakeholder groups (see also, the BRAID stakeholder categories) Older persons: people above the age of 55+ years who potentially are in need of independent living applications to enhance self management, social connectedness, mobility and the prevention of institutionalisation. Older persons will be the direct endusers of the applications or will be supported in the use by (in)formal caregivers. Informal or formal caregivers: people who provide care, with the distinction that formal caregivers are paid for their services and have had education in providing care, while informal caregivers have not and are usually family or friend of the person that is cared for. Service providers: people who provide services (in)directly to its users and can consist of a General Practitioners (GP) organization, an alarm centre, a hospital, a senior housing organization, and others. Application developers: people who design and develop independent living applications directly or indirectly (e.g., via OEM, a service provider etc.) to its end-users. BRAID: ttp://auseaccess.cis.utas.edu.au/sites/default/files/stakeholder%20analysis%20v5.pdf

7 Example of an Application Description Name: Telassistance service Application number: 064 AAL category: universaal "enhanced" Service category: Security/ Surveillance services Number of stakeholders: 4 stakeholders (End users: 3050 Badalona, 125,000 arround Spain) Creator: Televida Vendor: Televida / TUNSTALL Description: The teleassistance service consists of a Panic Button and alarms connected to a call center, for risky situations of the elderly. Value chain: Service of need: Risk analysis: One service provider (as tele-care assistance) + a software developer for the service + a mobile platform at home and/or panic button (the latters will have its own market players (depending on the one selected). The call center will have their own market players End users and relatives: try to avoid insecurity sense by providing a panic button to the elder ones which can be activated in dangerous situations automatically sending an alarm to the contact centre. Both public and private insurance healthcare providers: provide a tool to increase the sense of security to the elderly citizens. We still don't know if the service provider is willing to write the UniversAAL driver software. Licensing: Status: Proprietary Mature Programming language: Non Applicable Basic architecture Non Applicable Non Applicable Runtime platform: Non Applicable Certification mark: UNE :2007 Openness Non Applicable Vendor lock Non Applicable Non Applicable Rough costs estimation (in uro): Development: 0 Compliance (fixed): Installation (related to user): 200/user Energy consumption: Non Applicable Maintainance costs: 25 /user*month /month for the call center Coaching costs:: 0 Total costs: 3000 fixed costs + 25 /user*month /month for the call centre

8 The creation of a portfolio of independent living applications - 47 applications were provided Service category: Welfare services 22% 31% 22% 25% Treatment, Nursing & (tele)care services Security/ Surveillance services Comfort services Application 63 SIMAP Alarm Application 64 Teleassistance Service Application 62 ITHACA Hypertension Application 61 - Home Sweet Home

9 Focus Groups and 'expert' ratings Total: 20* raters (12 ReAAL partners & 8 FG participants) rated on a MOS scale from 1 (low) to 5 (high): Relevance for independent living: Has this application, according to the application description, any relevance for independent living? Need of service: Has this application, according to the application description, any need for your pilot site? Openness: Is this application, according to the application description, open and interoperable? is a vendor-lock a serious threat? Status: Please give here any information you know about the maturity of the application. Is it stable, has been approved by certifying bodies, will come on the market, etc. Risk analysis: Has this application, according to the application description, a high or low risk in failure? * First 14 raters for 33 applications & second 6 for 14 applications

10 Example of an Application Ranking 1. General: Teleassistance service Application number: 064 Relevance for independent living: 3 Need of service: 2 Openness Status: 2 Risk analysis: 3 2. Influence on independent living: N/A Scale 1 (not relevance at all) to 5 (relevance to great extent) or Not applicable Scale 1 (not needed at all) to 5 (needed to great extent) or Not applicable Scale 1 (not open at all) to 5 (open to great extent) or Not applicable Scale 1 (not mature at all) to 5 (mature to great extent) or Not applicable Scale 1 (no risk at all) to 5 (risk to great extent) or Not applicable N/A < mean application relevance should be above scale-midpoint (>3), dependent on the category, for the end-user groups and for the outcomes below> Older persons Formal/informal caregivers Service providers (GPs, etc.) Application developers application relevance to self management 3 2 N/A N/A application relevance to social connectedness 2 2 N/A N/A application relevance to mobility 3 2 N/A N/A application relevance to prevention of institutionalisation 1 1 N/A N/A 3. Heuristics: < mean application usability should be above scale-midpoint (>3) for the end-user groups and for the usability heuristics below> Older persons Formal/informal caregivers Service providers (GPs, etc.) Application developers

11 Focus Group 1 - Spain Eight Spanish ReAAL stakeholders participated in the focus group. The group consisted of 2 software developers (aged 32 years and 30, both male), 2 older persons (1 male aged 72 years and one female aged 68), 1 formal caregiver (female, aged 51) and 1 informal caregiver (male, aged 68), and 2 service providers (both male, aged 56 and 43). 6 participants used the computer and the Internet on a daily basis, 1 on a weekly basis, and from 1 this data was missing. The perceived level of knowledge on independent living applications varied on a rating scale from 1 (low) to 5 (high) from 2 to 4, a service provider and software developer both scored 4 (relatively high), yet, the other service provider and software developer scored 2 (relatively low)

12 Focus Group 2, 3 & 4 The Netherlands Four focus groups (FGs) were held at Stichting Rijnmond Net in The Netherlands. The groups consisted of older people (FG2), (in)formal caregivers (FG3), service providers (FG4), and application developers (FG5). Ten Dutch older people participated in FG2 (M age = 77, SD age = 8.9, 6 female). Six of the participants in FG2 had never used a computer. The mean perceived level of knowledge on independent living applications had a mean score of 3.56 (SD = 0.88). [descriptions of FG3 FG5 will follow]

13 Qualitative Results - Focus Group 1: Spain Question 1 Could you share your opinions and perceptions about the relevance of the applications for independent living (e.g., the relevance to self-management, to mobility). "...I particularly like the applications that improve your self-management. Some of them don t seem so at first sight, because they just look like to increase your security. But if you think about an increased sense of security for you and your relatives it makes you more confident about being capable of handling independent living." (P8) today I was pretty surprised with the applications we saw. You showed us applications with a high technological development that enable to control your chronic disease from home. I found that pretty interesting and much more comfortable than having to move to Primary Care to take the measurements. If a physician can look at them I don t need to move to there so often. From what I see, physicians, at least at Primary Care, have almost no time because their waiting lists are full of people like me, moving in there to just take a measurement.. (P4) I love how simple ideas, with a low technology development can improve independent living. Fall detectors, panic buttons, SMS reminders for medication adherence. Plain, simple, but very useful (P1)

14 Qualitative Results - Focus Group 1: Spain Question 2. Could you share your opinions and perceptions about the ethics of the applications (e.g., privacy for the end-user, security, etc.) I m afraid of those applications that include webcams. Who can tell me nobody is looking at me while I m at home? If I had one of those at home I would put a piece of cloth on the top of it when not using it (P2) I would like to know which encryption standards those applications use to transfer the patient information to the data centre. We must think we are talking about really sensible data, in Catalonia, the health related data is specially protected by the Data Protection Law. If any of those data was hacked it would be a real problem for the implied organizations (P3) You explained that some of the applications can track my movements inside and outside home. Of course, if I accept the service I know you are doing it. But, who is you in real? How much people have access to my movements? I want to know who can track me (P5)

15 Qualitative Results - Focus Group 1: Spain Question 3. Could you share your opinions and perceptions about the usability of the applications (e.g., the consistency, user control, etc.). Many elders need big screens, with big fonts. What is asked must be clear (P6) we need to develop solutions accessible to everyone, even for people with a sensory deficit. If the user can t see, we must adapt the application to work via voice and so on (P1) sometimes those applications drop and error which is not understandable by the ones that are not technicians. The errors must be in natural language, so everyone can understand them, they should also contain a way to solve them if possible, and if it s not who to contact and how (P8)

16 Qualitative Results - Focus Group 1: Spain Question 4. Could you share your opinions and perceptions about the costs of the applications (e.g., monthly fee, installation costs, etc.) Relating the most complicated and expensive solutions I think it s a matter of time they get extended. And you know, when you apply economies of scale the price tends to go down. We are at the beginning of it, so we should give them a chance because if none tries them what I stated before won t happen (P7) In Catalonia we are very used to get funded by our Autonomous Government or by our City Council to have access to this applications, but not everywhere in Europe works the same way. We should think about models where private insurance companies offer those services with the monthly fee. Maybe that s why we tend to evaluate what we would like to pay so low (P6) Developing full integrated applications, with healthcare measuring, domotic sensors and so on is not easy. It s not the price of the hardware but the price of the software what makes those applications so much expensive. If there s a lot of installations I think the monthly fee the enduser should pay would be lower (P3)

17 Quantitative Results Independent Living ranking order: first on Mean (high to low), Second on Variance (low to high) First statistical tests showed (with a Bonferroni correction for multiple comparisons) that the applications with the lowest scores (between 1 2) scored significantly lower than the applications with the highest scores (between 4 5)

18 Quantitative Results Need of service for the pilot site Should be decided by the pilot site

19 Quantitative Results Openness - Interoperability

20 Quantitative Results Status Maturity of the application

21 Quantitative Results Failure Risk Analysis

22 14 additional applications (N = 6)

23

24 Weighting of items (N = 22) Since the Need of Service was rated highest compared to the other items and was rated significantly higher than Status and Risk Analysis, Need of Service was assigned a weighting factor of 1.1. Relevance and Openness were assigned with an intermediate weight of 1.0, and Status and Risk Analysis were assigned the lowest weight of 0.9 since these two were rated significantly lower than the highest Need of Service

25 Quantitative Results preliminary Overall Mean (weighted)

26 Quantitative Results preliminary Overall Mean (weighted)

27 Top scoring applications (overall) per service domain including the mean overall score Service domain Application Mean Comfort Services Security/ Surveillance services Treatment, Nursing & (tele)care services Welfare services Task scheduling Welfare Services Network Agenda and Reminder Informationservice Cleaningservice Teleassistance service Self-management Diaries Magic Walk Medication Reminder SIMAP Alarm ITHACA Hypertension Rehabilitation Portal Application of NetMedical Home Sweet Home Configurable health care system MiBida screen-to-screen Good morning service Kwatch Agenda Cognitive Box 3,94 3,43 3,35 3,04 3,00 4,11 3,87 3,84 3,78 3,78 3,75 3,73 3,55 3,51 3,49 4,40 3,73 3,63 3,59 3,

28 Additional ratings and needs analysis... At the pilot sites User needs analysis Accessibility Ethics Etc

29 Let s ReAALize it! Henk Herman Nap, Ad van Berlo & Richard Pasmans

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