Abstract:
Over the past decade, healthcare costs and especially senior healthcare costs have increased rapidly and are making traditional healthcare concepts unaffordable for many developed countries. Telehealth is thought to be a solution for effective senior healthcare. However, existing telehealth systems are focused on treating diseases instead of preventing them, suffer from high initial costs, and lack extensibility. They also do not address the social and psychological needs of the patients. In this thesis, a novel patient-centric telehealth system for seniors called Healthcare4Life is presented and evaluated. The system provides access to a variety of health-related applications, which encourage positive lifestyle changes. Users are able to locate other users or patients suffering from similar diseases, enabling them to share experiences, motivate each other, and engage in health-related activities, such as tracking physical activities and vital signs. Similar to Facebook, the system has an open architecture that enables third-party providers to add new content and functionalities. User requirements of Healthcare4Life were elicited via interviews conducted with potential users. Web 2.0 technologies are evaluated with regard to their suitability for the development of extendable telehealth systems with social networking capabilities. Based on these findings, a system prototype is developed and evaluated. A formative evaluation approach is presented, confirming that seniors are satisfied with the overall concept and usability. A summative evaluation conducted with support from senior community centres with a larger sample size is presented, demonstrating the overall feasibility and acceptability of the system. The results demonstrate that the combination of telehealth functionalities with social components and user-generated content is a promising way to enable users to proactively manage and improve their health. However, the results suggest that in order to be useful in practice the system needs a large user base and must offer services making it attractive to application developers and content providers. Web standards, such as OpenSocial, and a content management system, such as Drupal, integrate successfully and provide a foundation to convert ordinary systems into open-ended platforms. The evaluation indcates that the target user population, seniors, were keen to leverage Healthcare4Life for their healthcare, provided there is a range of health applications tailored towards individual needs. Social networking functionalities are desired, but should have a clear purpose such as social games or exchanging information, rather than broadcasting emotions and opinions. Results further suggest that web-based telehealth systems hold great potential to positively change the attitude of users that health is not controlled by others such as health professionals, but consumers have the power to positively affect their well-being. iv