1、 ETSI TR 102 415 V1.1.1 (2005-08)Technical Report Human Factors (HF);Telecare services;Issues and recommendations for user aspectsETSI ETSI TR 102 415 V1.1.1 (2005-08) 2 Reference DTR/HF-00049 Keywords Design for All, health, HF, intelligent homes Essential, or potentially Essential, IPRs notified t
2、o ETSI in respect of ETSI standards“, which is available from the ETSI Secretariat. Latest updates are available on the ETSI Web server (http:/webapp.etsi.org/IPR/home.asp). Pursuant to the ETSI IPR Policy, no investigation, including IPR searches, has been carried out by ETSI. No guarantee can be g
3、iven as to the existence of other IPRs not referenced in ETSI SR 000 314 (or the updates on the ETSI Web server) which are, or may be, or may become, essential to the present document. Foreword This Technical Report (TR) has been produced by ETSI Technical Committee Human Factors (HF). Intended user
4、s of this ETSI Technical Report (TR) are those planning, deploying and implementing telecare services: standards developers (ETSI unavailability of hardware and software at reasonable costs; lack of on-line connectivity; relatively stable demographics; lack of political conviction, initiatives and s
5、upport; lack of client trust, acceptability and client expectations and habits; resistance from healthcare professionals (social patterns take generations to change); lack of proven outcome benefits. ETSI ETSI TR 102 415 V1.1.1 (2005-08) 6 Users were not ready yet, nor were the prerequisites- techno
6、logy, society, technical infrastructure, practitioners, procedures, budgets, et cetera- available and established for a successful deployment. The proliferation of fixed and mobile broadband services in and outside the home is opening up opportunities for the delivery of telecare services. Thereby,
7、the demand for end user (client) centric human factors guidelines addressing design, development, deployment, use and maintenance of telecare services is on the increase. In the 1990s, digital technology enablers (infrastructures, terminals and services) became available to the mass market. At prese
8、nt, demographic changes, limited resources, high user expectations, globalization and technology are transforming medical and social care systems in many countries. The penetration of ever-smarter devices connecting to mobile communication networks and the World Wide Web through fixed and mobile Int
9、ernet, combined with society-oriented, Europe-wide initiatives, health and social care service providers support, evidence of the existence of demographic and economical feasibility enablers, accepted changes in the delivery of health and social care services and the progress achieved in the area of
10、 medical technologies, pharmaceuticals and disposable products enable the deployment of telecare services. According to the United Nations Developing Programme, better health care services are required on a global level, but its costs and expenses are not allowed to continuously increase (without a
11、collapse of the system in the aging Western world). It is estimated that in 2051, 40 % of the European population will be 65 yeas or older. Responding to demands for better healthcare raised by an aging population can increase the cost pressure at a time when health care spending is already on the i
12、ncrease. In 1970, the healthcare-related spending of the Organisation for Economic Co-operation and Development (OECD - www.oecd.org) countries averaged 5 % of GDP. This increased to 7 % in 1990 and is more than 8 % at present. In addition, it exceeds 10 % in Germany, Sweden, Switzerland and the Uni
13、ted States. More than 75 % of all OECD health spending is publicly financed. Based on assessment of countries experiences, analysis of underlying issues and review of evidence and in order to control the increasing pressure, OECD recommends actions including the introduction of automated health-data
14、 systems, strategies making use of new technologies and improved quality of care through better information. The European Commission encourages EU Member States to seek a balanced status among the detected needs of providing quality care and social services to citizens, being compliant to standards,
15、 containing costs at a national level, and managing services at a local level. “e-Health is todays tool for substantial productivity gains, while providing tomorrows instrument for a restructured, citizen-centred health system and, at the same time, respecting the diversity of Europes multi-cultural
16、, multi-lingual health care traditions“ 29. A key ambition is better care services at the same or a lower cost. In addition, telecare has been identified and pointed out by several national European Governments (e.g. in the UK, by the Community Care Minister, Stephen Ladyman) as a strategic enabler
17、of the provision of independent living to older people in their own homes, driven by demographics and new equipment technologies. The market is poised to expand rapidly over the coming years. The e-Europe 2005 action plan is built around two main groups of actions: stimulate services, applications a
18、nd content - both online public services and e-business - and the underlying (fixed and mobile) broadband infrastructure, including security matters. e-Europe has recognized that “the information society has much untapped potential to improve productivity and the quality of life“ and that this poten
19、tial “is growing due to the technological developments of broadband and multi-platform access“. It provides a policy framework to stimulate the development of ICT infrastructure and application within Europe to enable the citizens to benefit from the growth of the information society. e-Health has b
20、een identified as one of the priority objectives of the e-Europe 2005 Action Plan 29 and the e-Health Action Plan identified and set up the practical steps required to build a “European e-Health area“: Basic level: by mid-2004, a European Health Identity Card (EHIC) shall be introduced (already achi
21、eved). National level: by 2005, EU member states are required to develop national and regional e-Health strategies. Interoperability level: by 2006, national healthcare networks should be well advanced in their efforts to exchange information, including client identifiers. Networked level: by 2008,
22、health information and services such as e-prescription, e-referral, telemonitoring and telecare, are to become commonplace, accessible over both fixed and mobile broadband networks. The above means that by 2008, telecare services should be provided and be accessible over both fixed and mobile broadb
23、and networks in the European Union. ETSI ETSI TR 102 415 V1.1.1 (2005-08) 7 From the social care perspective, the 2005-2006 Work Programme of the EUs applied IST research defines the following key strategic eInclusion objectives 106: to mainstream accessibility in consumer goods and services, includ
24、ing public services through applied research and development of advance technologies. This will help ensure equal access, independent living and participation for all in the Information Society; and to develop next generation assistive systems that empower persons with (in particular cognitive) disa
25、bilities and aging citizens to play a full role in society, to increase their autonomy and to realize their potential. By means of user experience, telecare services could gain considerable benefits from applying human factors expertise, developed in various areas of ICT, during the past decades. Th
26、e present document is intended to be a first prestudy of the area, before human factors guidelines for telecare services can be developed. The present document provides support for the e-Europe policy framework to move forward on the delivery of on-line public services in the health and social care
27、sectors, by enabling and improving the delivery of telecare services with a good user experience. Human factors and the user experience of telecare solutions is a complex area, given the large number of influencing elements involving the establishment of human confidence, device setup, configuration
28、, calibration and maintenance, data collection, user procedures, cultural issues such as the use of language and illustrations, the organization of the care provisioning process, and communication with diagnostic systems and carers, human communication and confirmation and decision making, the prese
29、ntation medium and accessibility issues. In addition, as telecare services can be used not only in but also outside of homes, usability aspects relating to the specifics of mobile environments and equipment and service use need to be covered. Finally yet importantly, these services must be used by y
30、oung, older people, impaired, disabled (see 25 and 11) or temporarily ill people and should therefore be designed, deployed and maintained thereafter. ETSI ETSI TR 102 415 V1.1.1 (2005-08) 8 1 Scope The present document addresses the end user aspects of telecare, with emphasis on the delivery of hea
31、lth and social care services, in and outside of connected (intelligent) homes, with the purpose of ensuring that human factors aspects are duly considered in the current rapid progress towards ICT-based delivery of health care services. The present document identifies key stakeholders including end
32、users (comprising clients, the person in need of care and health professionals, informal carers and care coordinators), their objectives and requirements, with the following perspectives: the enhancement of human interaction by ICT; proliferation of personal data and privacy concerns; and safety and
33、 security of equipment use, mis-use, non-use and malfunctioning. Furthermore, the present document identifies and examines technical, organizational and cost-related barriers to the widespread deployment, adoption and use of telecare services, and recommends strategies to overcome these barriers. Th
34、e present document takes into account requirements of the widest possible generic client population, including the needs of older people, babies, children and disabled clients. The present document provides generic guidance and specific recommendations to standards developers, operators, service pro
35、viders, equipment suppliers, policy makers, designers and users of telecare services, applicable to: telecare service provision elements; stakeholders concerns; and ethical, privacy and security aspects. The present document should be considered as a human factors and user experience standardization
36、 study, “setting the scene“. In addition, the present document provides recommendations for future work, including the development of human factors guidelines, recommended to be initiated as soon as possible. 2 References For the purposes of this Technical Report (TR), the following references apply
37、: 1 ETSI TR 102 068: “Human Factors (HF); Requirements for assistive technology devices in ICT“. 2 ETSI ES 202 076: “Human Factors (HF); User Interfaces; Generic spoken command vocabulary for ICT devices and services“. 3 World Health Organization (WHO)- “eHealth Standardization Coordination Group: e
38、HSCG standards list“. NOTE: Available at http:/www.who.int/ehscg/resources/en/ehscg_standards_list.pdf 4 The McKinsey Quarterly (May 2005): “The economic impact of an aging Europe (Farrell, D.)“. NOTE: Available at http:/ Guidelines for ICT products and services; “Design for All“. 6 ETSI TR 102 133:
39、 “Human Factors (HF); Access to ICT by young children; Issues and guidelines“. 7 ETSI EG 202 325: “Human Factors (HF); User Profile Management“. ETSI ETSI TR 102 415 V1.1.1 (2005-08) 9 8 ETSI TR 101 806: “Human Factors (HF); Guidelines for telecommunication relay services for text telephones“. 9 ETS
40、I EG 202 191: “Human Factors (HF); Multimodal interaction, communication and navigation guidelines“. 10 ML Williams and AC Smith: “Paediatric outreach services - Journal of Paediatrics and Child Health - Volume 40, Numbers 9-10, September 2004, pp. 501-503(3)“. 11 European Commission, Directorate Ge
41、neral Information Society: “Report from the Inclusive Communications (INCOM) subgroup, Working Document (January 2004)“. 12 W3C Working Draft (November, 2004): “Web Content Accessibility Guidelines (WCAG) version 2“. NOTE: Available at http:/www.w3.org/TR/WCAG20/ 13 “The Platform for Privacy Prefere
42、nces 1.1 (P3P1.1) Specification“. NOTE: Available at http:/www.w3.org/TR/P3P11/ 14 World Population Prospects: “The 2002 Revision, Population database, United Nations Population Division“. 15 Gill, J. (2001): “Requirements for the Interconnection of Assistive Technology Devices and Information and C
43、ommunication Technology Systems“. NOTE: Available at http:/www.tiresias.org 16 Nyseth, A. et al.:“The future Home“ (in Norwegian). Telenor report R 24, 82 pages. NOTE 1: ISBN 82-423-0597-8. Oslo, 2004. NOTE 2: Available at http:/ 17 Hestnes, B., Brooks, P. and Heiestad, S.: “Mobile Eye-phone - a stu
44、dy of relevance, effectiveness and user-perceived suitability“. Telenor Report R 2/04. NOTE: Available at http:/ 18 Council Directive 93/42/EEC of 14 June 1993 concerning medical devices. Medical Devices Directive (MDD). NOTE: Available at http:/europa.eu.int/comm/enterprise/newapproach/standardizat
45、ion/ harmstds/reflist/meddevic.html 19 Lhr, H., Rosenvinge, J. H., Gammon, D., 39: 514-9. 20 Norum, J., Grev A., Moen M.A., Balteskard L., Holthe, K.: “Information and communication technology (ICT) in oncology. Patients and relatives experiences and suggestions.“ Support Care Cancer. 2003; 11(5):28
46、6-93. 21 Alzheimers association: “Safety checklist for the home“. NOTE: Available at http:/www.alzheimers.org.au/upload/cfswd11.qxp.pdf 22 Wearable positioning devices. NOTE: Available at http:/www.istsec.fi/eng/Etuotteet.htm 23 Home supervision brokers. NOTE: Available at http:/www.agingtech.org/ab
47、out.aspx ETSI ETSI TR 102 415 V1.1.1 (2005-08) 1024 Smart Thinking: Dependability and Assistive Technology. NOTE: Available at http:/ 25 CEN/CENELEC Guide 6: “Guidelines for standards developers to address the needs of older persons and persons with disabilities“. NOTE: This is the same document as
48、ISO Guide 71, republished by CEN/CENELEC. 26 International Classification of Diseases (ICD-10). (R) World Health Organization. NOTE: Available at http:/www.who.int/classifications/icd/en/ 27 ETSI EG 202 132: “Human Factors (HF); User Interfaces; Guidelines for generic user interface elements for mobile terminals and services“. 28 ISO/IEC 9241-11: “Ergonomic requirements for office work with visual display terminals (VDTs) - Part 11: Guidelines on usability“. 29 Commission of the European Communities: “e-Health- making healthcare better for European citizens: An action plan
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