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User Experience Design Guidelines for Telecare

Bruno von Niman 1 Alejandro Rodriguez- Ascaso 2
vonniman consulting LST– UPM
Dalen 13 E.T.S.I. Telecomunicación
SE- 132 45 Saltsjö-Boo, Sweden Ciudad Universitaria s/n
+46 733 66 1234 28040 Madrid, Spain

Torbjørn Sund 2 Steve J. Brown 2

Telenor AS BT Group
Ipswich, United Kingdom
Oslo, Norway +44 1473664112

All authors members of:

ETSI Specialist Task Force 299
1 2
Leader Expert
560, Rue des Lucioles, Sophia Antipolis, France

ABSTRACT The number of older people and people with functional

The present paper introduces the telecare user experience limitations is growing rapidly, resulting in an increase of
guidelines under development in the European Telecommunication dedicated supportive efforts required for those unable to cope
Standards Institute (ETSI),, co-funded by the with common technologies, necessary to perform everyday
European Commission and EFTA. activities. For the elderly population, access to telecare services is
This work is performed under the policy framework defined by the important but often difficult, due to their lack of familiarity with
European Commission’s e-Europe 2005 action plan, by and in ICT.
close collaboration between major industry players and ETSI.
With the technical development offering seamless and more
Categories and Subject Descriptors continuous access to fixed and mobile broadband networks, the
H.1.2 [User/Machine Systems]: Human Factors vision of a world where ICT resources around us improve the
quality of our lives becomes realistic. New applications and
services can increasingly be used to perform necessary tasks and
General Terms
activities of daily living.
Design, Human Factors, Standardization, eHealth, Telecare

The changing demographics of Europe indicate a development

Keywords towards a population getting older and living longer than ever
Design for All, e-Inclusion, health, e-Health, intelligent homes,
interface, MMI, Telecare, usability, UI, User Experience, UX, before. The aging of our society has unveiled the problem of
Guidelines dependency, as the number of dependant citizens is increasing,
especially at the higher levels of the population pyramid. The
1. INTRODUCTION majority of the dependant population receives informal care, but
Telecare is a strategic enabler for the provision of independent the population of informal carers is decreasing and aging. These
living to older people in their own homes, driven by demographics facts may be causing a decrease in the family support to older
and enabled by mobile and broadband technologies and public people and people with disabilities and therefore demand new
policies. paradigms to provide support to dependency and independent

Copyright is held by the author/owner(s).

MobileHCI'06, September 12-15, 2006, Helsinki, Finland.
ACM 1-59593-390-5/06/0009.

The maintained delivery of traditional health care services to these 1. Basic level: by mid-2004, a European Health Identity Card
user groups would lead to a considerable increase in the cost, at a (EHIC) was introduced;
questionable perceived quality, as these clients expect freedom of 2. National level: by 2005, EU member states are required to
choice, mobility and personal attention on demand, see ETSI TR develop national and regional e-Health strategies;
102 415 [1]. In addition, as mobile and broadband communication 3. Interoperability level: by 2006, national healthcare networks
technologies mature and the average user knowledge level is should be well advanced in their efforts to exchange
considerably increased, these clients have an already established information, including client identifiers;
experience and trust in the use of more sophisticated ICT products 4. Networked level: by 2008, health information and services
and services. accessible over fixed and mobile broadband networks (e.g.
e-prescription and Telecare) are to become commonplace.
Human factors and the user experience related to the delivery of
health and social care to individuals within the home or a wider 3. OUR APPRAOCH
community, with the support of systems enabled by ICT is a Our approach to telecare services builds on the framework
complex area. It involves a large number of influencing elements described in [1], whereby personal monitoring, security
based upon trust, such as availability and reliability, integrity, management, electronic assistive technologies and information
confidentiality, privacy, ethics, legal issues and safety. Other services are used to support personal health and well-being. Our
considerations relate to usability and accessibility and should task is to develop guidelines to address the issues of trust,
address issues relating to setup, configuration and maintenance, usability and accessibility of these services.
ease of installation, interaction, organisational and multicultural
issues, service related issues, personalisation, localisation, training Telecare is generally associated with care of older people, but is
and education. applicable irrespective of age. In addition, telecare may empower
people with sensory, physical, cognitive or other impairment(s),
Telecare should clearly be distinguished from telemedicine, temporary or permanent. Telecare solutions must embrace the
customarily defined as the use of ICT to support cooperative work philosophy of design-for-all, promoting accessibility by as large
between health professionals, a business-to-business service. proportion of end users as possible. Complementary solutions
In accordance with TR 102 415 [1], the following definition based on assistive technology must be available, when required.
applies: “Telecare is the provision of health and social care
services to individuals, within or outside of their homes, with the In addition, as telecare services can be used not only in but also
support of systems enabled by ICT”. outside of the home, usability aspects relating to the specifics of
The main aim of telecare is to reduce the need for hospitalization mobile environments and equipment and service use need to be
and institutionalization and refers to cases where services are covered.
provided to an end user, it can thus be classified as a kind of
business-to-consumer service. By means of user experience, telecare services can gain
considerable benefits from applying human factors expertise, e.g.
In the 1990s, digital technology enablers (infrastructures, terminals [3]. The guidelines are foreseen to have a considerable impact on
and services) became available to the mass market. At present, all involved stakeholders including clients, carers, health and
demographic changes, limited resources, increasingly high user social care and equipment providers, public administrations and
expectations, globalization and technology are transforming policy makers.
medical and social care systems in many countries.
The deployment of telecare services is enabled by several, recent
developments: the penetration of ever-smarter devices connecting
to mobile communication networks and the World Wide Web ETSI references are available free of charge at
through fixed and mobile Internet; society-oriented, Europe-wide [1] ESI TR 102 415: “Human Factors (HF); Telecare
e-Health initiatives; social care service providers' support; evidence services; Issues and recommendations for user
of the existence of demographic and economical feasibility aspects”.
enablers; accepted changes in the delivery of health and social care [2] European Commission, Directorate General
services; and the progress achieved in the area of medical Information Society: “Report from the Inclusive
technologies, pharmaceuticals and disposable products. Communications (INCOM) subgroup, Working
Document (January 2004)”.
2. A EUROPEAN e-HEALTH AREA [3] ETSI EG 202 132: "Human Factors; Guidelines for
The milestones required to build a “European e-Health area” have generic user interface elements for mobile
been defined by the European Commission on four levels: terminals and services”.