Medical Technology in Smart Homes Exploring the User’s Perspective on Privacy, Intimacy and Trust Martina Ziefle, Carsten Röcker Communication Science Human Technology Centre RWTH Aachen University Aachen, Germany {Ziefle, Roecker}@humtec.rwth-aachen.de Andreas Holzinger Institute for Medical Informatics, Research Unit Human–Computer Interaction Medical University Graz Graz, Austria A.Holzinger@hci4all.at Abstract—This paper reports on a study exploring the attitudes of users towards video-based monitoring systems for long-term care of elderly or disabled people in smart home environments. The focus of the study was on investigating the willingness of users to accept medical technology in their homes and the specific conditions under which continuous monitoring would be acceptable. Using the questionnaire method, a total of 165 users (17-95 years) were examined regarding privacy, intimacy and trust issues for medical technology in homes. The results highlight trust and privacy as central requirements, especially when implemented within private spaces. The reported concerns were mostly insensitive to gender and age. Overall, it was revealed that acceptance issues and users’ needs and wants should be seriously considered in order to successfully design new medical technologies. Keywords-Medical Technologies, Smart Homes, Ambient Assisted Living, Technology Acceptance, User Study I. INTRODUCTION Prolonged life expectancy and increasing survival of acute diseases contribute to a growing number of elderly people at risk of institutionalization [1]. But long-term institutionalization is not only a big financial burden to the healthcare system and therefore hard to maintain in the coming years, it is also not the preferred choice of many aging people. While older people are obviously in need of extended long-term care, they also wish to maintain their independence as long as possible [3]. Studies show that many older people regard their home as a sanctuary and therefore prefer to stay at home, even at an increased risk to their health and safety [4]. This wish is often related to a perceived increase in the quality of life in a familiar environment. Generally, quality of life is a quite complex concept referring to the individual perception of one's “physical health, psychological state, level of independence, social relationships, personal beliefs and relationship to salient features in the environment” [5]. But as people age, their perceived quality of life is mostly determined by their ability to maintain an autonomous and independent life [6]. Hence, a variety of authors, including Bayer and Harper [7], Shafer [8], and Mynatt et al. [9], identified the loss of personal independence as a major concern of most elderly people. While extended family structures traditionally provide internal support features for elderly family members, the analytic concept of extended families has largely diminished in recent years [10]. The profound social changes affecting the composition of families become especially evident in the growing number of elderly persons living alone. Already today, a high number of older or chronically ill people live on their own, without support by their families [12]. Over the last decades, the number of single households increased considerably, especially in the group of elderly people, and this trend is expected to continue in the coming years. It is often argued that the steep increase in single households over the last years is caused by a transformation of the social structures in many western societies. But what goes largely unnoticed is the fact that elderly people often resist family assistance as they regard the exercise of familial obligations as an assault on their dignity and moral worth [13]. This is underlined by poll results, which suggest that about 95% of the older people did not wish to live with relatives [10]. Hence, the ‘reciprocity thesis’, which suggests that elderly people look after their children so that those same children will look after them in return, is actually contradicted by the strong resistance of elderly persons to accept help from younger family members [13]. II. VIDEO-BASED HOMECARE SOLUTIONS Decreasing both the costs of healthcare services and also the load of medical practitioners requires a dramatic change in the way future healthcare services are provided [14]. A variety of medical experts [1] argue that institutionalization in senior homes is unnecessary (and even counterproductive) and promote homecare as a fundamental component of a future network of long-term care facilities. Recent developments in information and communication technology lay the groundwork for new patient-centered homecare solutions. While the majority of computer-supported healthcare tools designed in the last decades focused mainly on medical caregivers, this trend recently changed with the introduction of assistive technology for providing supportive and adaptive services to ill or disabled individuals [15]. Several authors, e.g. [1] or [16] even expect the next generation of healthcare systems to be mainly based on the 2011 35th IEEE Annual Computer Software and Applications Conference Workshops 978-0-7695-4459-5/11 $26.00 © 2011 IEEE DOI 10.1109/COMPSACW.2011.75 410 2011 35th IEEE Annual Computer Software and Applications Conference Workshops 978-0-7695-4459-5/11 $26.00 © 2011 IEEE DOI 10.1109/COMPSACW.2011.75 410