Tailored retrieval of health information from the web for facilitating communication and empowerment of elderly people

A patient, nowadays, acquires health information from the Web mainly through a “human-to-machine” communication process with a generic search engine. This, in turn, affects, positively or negatively, his/her empowerment level and the “human-to-human” communication process that occurs between a patient and a healthcare professional such as a doctor. A generic communication process can be modelled by considering its syntactic-technical, semantic-meaning, and pragmatic-effectiveness levels and an efficacious communication occurs when all the communication levels are fully addressed. In the case of retrieval of health information from the Web, although a generic search engine is able to work at the syntactic-technical level, the semantic and pragmatic aspects are left to the user and this can be challenging, especially for elderly people. This work presents a custom search engine, FACILE, that works at the three communication levels and allows to overcome the challenges confronted during the search process. A patient can specify his/her information requirements in a simple way and FACILE will retrieve the “right” amount of Web content in a language that he/she can easily understand. This facilitates the comprehension of the found information and positively affects the empowerment process and communication with healthcare professionals

Personalisation, Participation and Care

Personalisation services are developing in England as a social policy response to user demands for more tailored, effective and flexible forms of health and social care support. Across England and Wales, this process is being implemented under the personalization which is also seen as a vehicle for promoting service user rights through increasing participation, empowerment and control while also promoting self-restraint by having users manage the costs of their health and social care. This paper reviews the existing research evidence for personalization, albeit limited, and identifies themes for future research

The AI Ethics Principle of Autonomy in Health Recommender Systems

The application of health recommender systems (HRSs) in the mobile-health (m-health) industry, especially for healthy active aging, has grown exponentially over the past decade. However, no research has been conducted on the ethical implications of HRSs and the ethical principles for their design. This paper aims to fill this gap and claims that an ethically informed re-definition of the AI ethics principle of autonomy is needed to design HRSs that adequately operationalize (that is, respect and promote) individuals’ autonomy over ageing. To achieve this goal, after having clarified the state-of-the-art on HRSs, I present the reasons underlying the need to focus on autonomy as a prominent ethical issue and principle for the design of HRSs. Then, I pursue an inquiry on autonomy in HRSs and show that HRSs can both promote individuals’ autonomy and undermine it, also leading to phenomena of passive ageing. In particular, I claim that this is also due to the concept of autonomy underlying the debate on HRSs-based m-health, which is sometimes misleading, as it mainly coincides with informational self-determination. Using ethical reasoning, I shed light on a more complex account of autonomy and I redefine the AI ethics principle of autonomy accordingly. I show that autonomy and informational self-determination do not overlap. I also show that autonomy encompasses also a socio-relational dimension and that it requires both authenticity conditions and social recognition conditions. Finally, I analyze the implications of my ethical redefinition of autonomy for the design of autonomy-enabling HRSs for healthy active ageing

Empowering Community Dwelling Older Citizens to Improve Their Balance with a Novel Technology Platform

The prevalence of balance deficits increases as the population is ageing. Such deficits are associated with the increased incidence of falls which in turn is linked with substantial limited functionality and morbidity. Vestibular rehabilitation therapy (VRT) as a component of the treatment has been shown to be effective in reducing symptoms and improving balance. HOLOBALANCE is an intervention based on a novel technology platform for providing VRT unsupervised, at home which means that motivating citizens to be compliant and promoting empowerment are the cornerstones for its wide adoption. Here we present how citizens empowerment is being addressed in HOLOBALANCE

A collaborative platform for management of chronic diseases via guideline-driven individualized care plans

Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional care settings. Integrated care is a means to address the growing demand for improved patient experience and health outcomes of multimorbid and long-term care patients. Care planning is a prevalent approach of integrated care, where the aim is to deliver more personalized and targeted care creating shared care plans by clearly articulating the role of each provider and patient in the care process. In this paper, we present a method and corresponding implementation of a semi-automatic care plan management tool, integrated with clinical decision support services which can seamlessly access and assess the electronic health records (EHRs) of the patient in comparison with evidence based clinical guidelines to suggest personalized recommendations for goals and interventions to be added to the individualized care plans. We also report the results of usability studies carried out in four pilot sites by patients and clinicians

Feasibility of a wireless health monitoring system for prevention and health assessment of elderly people

The work presented in this paper comprises the methodology and results of a pilot study on the feasibility of a wireless health monitoring system designed under main EU challenges for the promotion of healthy and active ageing. The system is focused on health assessment, prevention and lifestyle promotion of elderly people. Over a hundred participants including elderly users and caregivers tested the system in four pilot sites across Europe. Tests covered several scenarios in senior centers and real home environments, including performance and usability assessment. Results indicated strong satisfactoriness on usability, usefulness and user friendliness, and the acceptable level of reliability obtained supports future investigation on the same direction for further improvement and transfer of conclusions to the real world in the healthcare delivery

Improving personalized elderly care: an approach using cognitive agents to better assist elderly people

Tesis por compendio de publicaciones[ES]El envejecimiento de la población a nivel global es una constante cada vez más presente en el día a día y las consecuencias derivadas de este problema son cada vez más impactantes para el correcto funcionamiento y estructuración de la sociedad. En este contexto, hablamos de consecuencias a nivel de crecimiento económico, estilos de vida (y jubilación), relaciones familiares, recursos disponibles por el gobierno a la franja etaria más anciana e inevitablemente la prevalencia de enfermedades crónicas. Es ante esta realidad que surge la necesidad de desarrollo y promoción de estrategias eficaces en el acompañamiento, prevención y estímulo al envejecimiento activo y saludable de la población para garantizar que las personas ancianas continúen teniendo un papel relevante en la sociedad en lugar de someterse al aislamiento y fácil deterioro de las capacidades físicas, cognitivas, emocionales y sociales. De esta forma, tiene todo el sentido aprovechar todos los desarrollos tecnológicos verificados en los últimos años, principalmente en lo que se refiere a avances en las áreas de dispositivos móviles, inteligencia artificial y sistemas de monitoreo y crear soluciones capaces de brindar apoyo diariamente al recopilar datos e indicadores del estado de salud y, en respuesta, proporcionar diversas acciones personalizadas que motiven la adopción de mejores hábitos de salud y medios para lograr este envejecimiento activo y saludable. El desafío consiste en motivar a esta población a conciliar su día a día con el interés y la voluntad de utilizar aplicaciones y sistemas que brinden este apoyo personalizado. Algunas de las abordajes recientemente explorados en la literatura con este objetivo y que han alcanzado resultados prometedores se basan en la utilización de técnicas de gamificación e incentivo al cumplimiento de desafíos a nivel de salud (como si la persona estuviera jugando un juego) y la utilización de interacciones personalizadas con objetos (ya sean físicos como robots o virtuales como avatares) capaces de brindar feedback más personal, creando así una conexión más cercana entre ambas entidades. El trabajo aquí presentado combina estas ideas y resulta en un enfoque inteligente para la promoción del bienestar de la población anciana a través de un sistema de cuidados de salud personalizado. Este sistema incorpora diversas técnicas de gamificación para la promoción de mejores hábitos y comportamientos, y la utilización de un asistente virtual cognitivo capaz de entender las necesidades e intereses del usuario para posibilitar un feedback e interacción personalizados con el fin de ayudar y motivar al cumplimiento de los diferentes desafíos y objetivos que se identifiquen. El enfoque propuesto fue validado a través de un estudio con 12 usuarios ancianos y se lograron resultados significativos en términos de usabilidad, aceptación y efectos de salud. Específicamente, los resultados obtenidos permiten respaldar la importancia y el efecto positivo de combinar técnicas de gamificación e interacción con un asistente virtual cognitivo que traduzca el progreso del estado de salud del usuario, ya que se lograron mejoras significativas en los resultados de salud después de la intervención. Además, los resultados de usabilidad obtenidos mediante la cumplimentación de un cuestionario de usabilidad confirmaron la buena adhesión a el enfoque presentado. Estos resultados validan la hipótesis de la investigación estudiada en el desarrollo de esta disertación