Design and usability assessment of a multi-device SOA-based telecare framework for the elderly

Telemonitoring is a branch of telehealth that aims at remotely monitoring vital signs, which is important for chronically ill patients and the elderly living alone. The available standalone devices and applications for the self-monitoring of health parameters largely suffer from interoperability problems; meanwhile, telemonitoring medical devices are expensive, selfcontained, and are not integrated into user-friendly technological platforms for the end user. This work presents the technical aspects and usability assessment of the telemonitoring features of the HEREiAM platform, which supports heterogeneous information technology systems. By exploiting a service-oriented architecture (SOA), the measured parameters collected by off-the-shelf Bluetooth medical devices are sent as XML documents to a private cloud that implements an interoperable health service infrastructure, which is compliant with the most recent healthcare standards and security protocols. This Android-based system is designed to be accessible both via TV and portable devices, and includes other utilities designed to support the elderly living alone. Four usability assessment sessions with quality-validated questionnaires were performed to accurately understand the ease of use, usefulness, acceptance, and quality of the proposed system. The results reveal that our system achieved very high usability scores even at its first use, and the scores did not significantly change over time during a field trial that lasted for four months, reinforcing the idea of an intuitive design. At the end of such a trial, the user experience questionnaire achieved excellent scores in all aspects with respect to the benchmark. Good results were also reported by general practitioners who assessed the quality of their remote interfaces for telemonitoring.