A Personalized Health Monitoring System for Community-Dwelling Elderly People in Hong Kong: Design, Implementation, and Evaluation Study

Abstract

Background Telehealth is an effective means to assist existing health care systems, particularly for the current aging society. However, most extant telehealth systems employ individual data sources by offline data processing, which may not recognize health deterioration in a timely way. Objective Our study objective was two-fold: to design and implement an integrated, personalized telehealth system on a community-based level; and to evaluate the system from the perspective of user acceptance. Methods The system was designed to capture and record older adults’ health-related information (eg, daily activities, continuous vital signs, and gait behaviors) through multiple measuring tools. State-of-the-art data mining techniques can be integrated to detect statistically significant changes in daily records, based on which a decision support system could emit warnings to older adults, their family members, and their caregivers for appropriate interventions to prevent further health deterioration. A total of 45 older adults recruited from 3 elderly care centers in Hong Kong were instructed to use the system for 3 months. Exploratory data analysis was conducted to summarize the collected datasets. For system evaluation, we used a customized acceptance questionnaire to examine users’ attitudes, self-efficacy, perceived usefulness, perceived ease of use, and behavioral intention on the system. Results A total of 179 follow-up sessions were conducted in the 3 elderly care centers. The results of exploratory data analysis showed some significant differences in the participants’ daily records and vital signs (eg, steps, body temperature, and systolic blood pressure) among the 3 centers. The participants perceived that using the system is a good idea (ie, attitude: mean 5.67, SD 1.06), comfortable (ie, self-efficacy: mean 4.92, SD 1.11), useful to improve their health (ie, perceived usefulness: mean 4.99, SD 0.91), and easy to use (ie, perceived ease of use: mean 4.99, SD 1.00). In general, the participants showed a positive intention to use the first version of our personalized telehealth system in their future health management (ie, behavioral intention: mean 4.45, SD 1.78). Conclusions The proposed health monitoring system provides an example design for monitoring older adults’ health status based on multiple data sources, which can help develop reliable and accurate predictive analytics. The results can serve as a guideline for researchers and stakeholders (eg, policymakers, elderly care centers, and health care providers) who provide care for older adults through such a telehealth system.

A Digital Platform for Facilitating Personalized Dementia Care in Nursing Homes: Formative Evaluation Study

“…Previous attempts have explored the application of data-driven assistive technologies in the field of cancer care [ 19 ], physiotherapy [ 20 ], cardiovascular disease [ 21 ], and elderly care at home [ 22 ]. Conversational agents [ 23 ] and data visualizations [ 19 ] are being developed for facilitating the interactions between the technologies and their users.…”

Study on the Types of Elderly Intelligent Health Management Technology and the Influencing Factors of Its Adoption

“…The older the elderly, the worse their performance [12,28,[44][45][46] Education level Populations with a high education level tend to use new technology [28,47] Region Compared to urban residents, rural ones are not likely to use new technology [48] E-health literacy E-health literacy is considered as a prerequisite of using mobile health app [5,15,30,47,49] Information literacy People skilled in computer and Internet use tend to adopt IHMT [13,14,38,46] Ethnicity and language Ethnic and linguistic differences affect users' acceptance and use behavior [13,44] Physical difficulties Physical difficulties are an obstacle for the elderly to accept new technologies [9] Self-efficacy People with high efficacy are more willing to accept new technology [11,13,16,30,39,45,[49][50][51] Compliance Procedures/equipment that can improve compliance are easy to be continuously used [19,24,29,[52][53][54][55] Skeptical attitudes Skepticism is a barrier to the elderly using new technology [12] Perceived demand Perceived demand is an essential factor in promoting the use of intelligent health management devices [8,21,56] 1. Objective factors…”

“…These people are more inclined to adopt IHMT [38]. In Wang et al's study of the community-dwelling older adults in Hong Kong, it was found that the eHealth app for self-management is less likely to be used by older, unmarried, less educated, unemployed, and lower-income cancer survivors [56].…”

Sleep Detection for Younger Adults, Healthy Older Adults, and Older Adults Living With Dementia Using Wrist Temperature and Actigraphy: Prototype Testing and Case Study Analysis

“…Recent studies have provided increasing evidence that wrist temperature can be used for sleep monitoring [17,[20][21][22]. Low sleep quality and irregular sleep patterns become more prevalent with increasing age and dementia [23][24][25][26]. For example, poor nighttime sleep has been shown to be a key factor in older adults' tendency to have more daytime sleepiness [27], which has been associated with changes in circadian rhythms in older adults [28].…”