This paper is focused on inspecting Chinese remote health-care and especially Chronic Obstructive Pulmonary Disease (COPD) that is especially common in elderly. In COPD application of alert calls can provide treatment cost savings and improve patients’ life quality. Remote health care enables elderly easier access of medical information and helps in daily life services. For service providers, remote health care can facilitate an expanded, cost effective, service palette and support new business models.

1. Xirui Wang, Timo O. Korhonen,
Shuo Liu, Iiro Jantunen
Department of Communications and Networking,
Aalto University School of Science and Technology,
Espoo, Finland
firstname.lastname@aalto.fi
Remote Health Care for China –
Case COPD
INTRODUCTION
Chronic Obstructive Pulmonary Disease
(COPD) is especially common in elderly.
Remote health care enables elderly easier
access of medical information and helps in
daily life
d l l f services. In COPD, alert calls can
l
ll
reduce treatment cost and improve patients’
life quality. For service providers, remote
health care can facilitate expanded, cost
effective service palette and support
new business models.
COPD in CHINA
COPD is caused by breathing in noxious
particles or such as cigarette smoke and
second-hand gases, smoke, air pollution, and
other occupational pollutants. COPD is the
4th leading cause of death among all other
diseases. In China, COPD ranks number one
among the burdens of diseases, is the 2nd
leading cause of death. There are 25
million people in China having COPD.
Table 1. COPD around the world in all ages [1]
ALERT CALLS
In active alert calls, users initiate a
predefined calling sequence using pendant or
tailored bracelet service access button. Alert is
then sent to a 24/7 operational monitoring
center or neighbors next door or relatives in
the city to avoid delays. Note that elderly falls
account for one-third of all non-fatal injuries
and hospital admissions in USA.
In passive alert calls, the system initiates
the call for safety confirmations (patient is safe
on a regular time interval) and reminders
(taking medication, or setting appointment
with doctor)
doctor).
elderly problems arise in (i) physical and
psychological capabilities (ii) low computer
literacy and confidence, and (iii) ethic
concerns, e.g., privacy, autonomy, integrity,
dignity, and reliability.
THE CASE and
RESULTS
We discuss in this paper COPD alert call (Fig.
1) that is intended to check medication
condition and warn bad weather that increases
COPD patient clinic visits. Effect of COPD alert
calls is depicted in (Fig.2) with 445 patients
p
and 1,785 passive alert calls [2].
The results of our usability study for the
service used in [2] are presented in the
following manner: (i) identified usability
problem is highlighted, (ii) implications from
the problem are explained (iii) design
improvements are suggested.
A. Lack of accelerators: The introduction of
service provider, alert call service and the
y
illness lasts more than 30 second for every call
is frustrating for experienced user. Remedy: A
fst forward button or a short-cut key.
B. Question repetition: After 15 seconds,
automatic question repetition is triggered that
is not controlled. Indication: Too little control
function to the users. Remedy: Dedicated
function for repeating questions dialogs.
C. Error prevention and user control: If
the choice made by the user is incorrect (for
instance, if you type a wrong number), there is
no way to modify the answer except by
hanging up the phone . Remedy: Undo or
revocation functions should be implemented.
D. Language: In Chinese version of the call,
directions are pronouncieted very slowly. This
makes then difficult to understand. This is
clearly a culture related problem. There have
maybe been a misunderstand because for
English language speaking slower improves
understanding but not necessary for Chinese.
Juha Lipiäinen
Medixine Oy, Helsinki, Finland
Juha.lipiainen@medixine.fi
COSTS and
ALERT CALLS
Chinese Labor Insurance Regulations was
issued by Government Administration Council
by year 1951; the retirement age for male is 60,
and 50 for female. Early retirement age brings
a significant pressure onto the society,
especially to healthcare. Most people over 60
have a low productivity and their life
dependents on their pensions provided by the
government. Usually, they suffer various highp
y
cost illnesses, especially with chronic diseases
which appear long lasting and require longterm medical treatments that most can be
reimbursed by healthcare insurance .
Note, the less of elderly entering of
hospital; the more money society will
save. Thus, the utilization of alert calls will
just not prevent the illnesses to attack, but also
decreases the number of hospital visits and
g
their duration (medication, diagnosis,
injection, surgery, and hospitalization). Thus
patients and society are saving both money
and time. Also, quality of living is improved.
References
[1] http://www.uninursety.com/user/
courses_n/copd.php#ch_two
[2] http://download.medixine.com/copd
/cornwall_pilot.jpg
/
ll il t j
USABILITY and
ELDERLY
Usability is studied by usability testing with
actual users, usability inspection by experts
(as cognitive walkthrough and heuristic
evaluation used here), and usability inquiry
(asking users questions about the service
verbally or in a written form). Especially for
Figure 2. Cornwall experiment and COPD admissions
UBI-SERV Project
www.ubi-serv.org
This research was supported by the Academy of Finland under grant no 129446.
Figure 1. Flowchart of a typical
alert call service