The Synergy of Technology Usage and Human-driven Support

Activities in an AAL Pilot Region

Johanna Plattner

, Daniela Elisabeth Ströckl

, Elena Oberrauner

, Kurt Majcen

and Johannes Oberzaucher

Research Unit Active & Assisted Living, Carinthia University of Applied Sciences, Klagenfurt, Austria

Institute for Applied Research on Ageing, Carinthia University of Applied Sciences, Villach, Austria

Institute for Information and Communication Technologies, JOANNEUM RESEARCH, Graz, Austria

Keywords: AAL, Active and Assisted Living, Pilot Region, Technical Support, Usage Analysis.

Abstract: The project Smart VitAALity – the Carinthian pilot region for AAL and Smart Living Technologies was

realized in Austria between 2016 and 2019. The one-year field trial focused on testing and evaluating a set of

technologies with accompanying services to improve the health and wellbeing of older adults. During this

time, various parameters regarding the usage of the different services and devices were recorded. This paper

presents an insight into the results of the usage analysis with a focus on provided support material and the

documentation of the established human-driven support activities. The investigation shows that there are

synergies between the constantly high system usage during the field test and the provided support

opportunities.

1 INTRODUCTION

Today’s societies are facing challenges like climate

change and lots of trends such as globalization,

digitization and the demographic change, which also

interfere with each other (Petersen & Steiner 2019).

The last one – demographic change – has been seen

as an important topic in the European Union (EU) and

its member states for more than ten years. As a result,

the funding programme AAL Joint Programme

(for

Active and Assisted Living) was created, which sets

the ground for the research and development of

assistive technologies for older adults. The

programme is available to several member states of

the EU, all of which are committed to open up and

develop new technologies so far mostly used by

younger people to older adults and thus allowing

them to live a longer independent life.

1.1 Pilot Regions in Austria

Almost at the same time, Austria created a similar

AAL Programme - http://www.aal-europe.eu/

(28.01.2020)

FFG benefit - https://www.ffg.at/programm/benefit

(28.01.2020)

research funding programme on national level called

benefit

. Within this programme, collaborative

projects are realized to develop and test technologies

which ease the life of older adults in many ways.

After several years of funding research and

development projects, the benefit programme

management figured out that lots of technologies

have already been developed and that ways need to be

found on how to open markets for them.

As a consequence, in 2012, calls

for so called test

region projects

were opened. Nine projects around

assistive technologies for older adults (seven of them

described in Ates et al., 2017) have been started since

then and many of them have already finished in the

meantime. The major goals of those projects and the

technologies to be used and tested within them were

chosen by the consortia and therefore varied among

the different projects, but they had similar framework

conditions, e.g., more than 100 persons or households

should be part of the tests and the tests should run at

least for one year. Some requirements for

dissemination activities were also defined like setting

Archive of benefit calls - https://www.ffg.at/benefit/

ausschreibungsarchiv (30.01.2020)

Pilot regions in Austria - http://www.aal.at/pilotregionen-

3/ (29.01.2020)

180

Plattner, J., Ströckl, D., Oberrauner, E., Majcen, K. and Oberzaucher, J.

The Synergy of Technology Usage and Human-driven Support Activities in an AAL Pilot Region.

DOI: 10.5220/0009569901800186

In Proceedings of the 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2020), pages 180-186

ISBN: 978-989-758-420-6

up demonstration apartments which can be visited by

interested persons for the purpose of gaining

information about the project and the specific

technologies and services offered by them.

Beside the differences in goals and technologies,

the projects also defined different ways how to

involve the (potential) end-users of their systems and

how they are supported before, during and after the

test phase. In one of the mentioned pilot regions, a

structured support-system was implemented for

participants which offered different action

possibilities. The evaluation results of the necessary

effort to maintain the delivered technology and

services will be presented in this paper.

1.2 The Project Smart VitAALity

The cooperative research project Smart VitAALity

is a pilot region in the center of Carinthia, Austria

with the aim to implement AAL hardware and

services to improve the daily living of seniors at home

and empower them in using new state of the art

technologies. For the project, 227 people were

recruited, 104 people received all the technologies

and services (intervention group) and the other group

was classified as the control group without any

interventions in the one year of pilot testing (Majcen

et al., 2019; Ströckl et al., 2019).

As main interaction technologies, the participants

in the intervention group received a tablet computer

with a self-implemented Smart VitAALity

application and a smartwatch with an emergency call

system and a step counter. Furthermore, they got vital

parameter measurement devices for their blood

pressure, blood glucose and body weight; all of them

transferred the measured data via Bluetooth LE® or

ANT+ to the project server. As accompanying

services, they were able to join to a care center with

professional medical employees who had a look at

relevant parameters, intervened when necessary and

added a 24/7 call center to their emergency alarm call

chain (Majcen et al. 2019; Ströckl et al. 2019).

The described technical system and services were

developed based on the user-centered design process,

which means the later end users and other related

stakeholders were involved already in the

requirement analysis (Krainer et al. 2018). Thus, the

user-focused process was also pursued in the testing

phase of the project. In this paper, the focus is set on

a specific direct service provided to the intervention

Project Smart VitAALity - https://www.smart-

vitaality.at/ (28.01.2020)

group during the testing phase: the technical support

process, which will be further explained in chapter 2.

In 2019, the project ended after the testing phase

with the finalization of the evaluation process. To this

end, different parameters were collected during the

project to evaluate the subjective quality of life,

acceptance, socio-economical potential analysis,

technology acceptance, user experience and usage.

The comprehensive evaluation model provides the

basis for anchoring the Smart VitAALity system and

service model on the market (Plattner et al. 2018).

2 METHODS

This chapter describes two parts of the evaluation

model in detail: the usage analysis and the

implementation and evaluation of the technical

support process.

2.1 Usage Analysis

To evaluate the frequency of use of the Smart

VitAALity system, the usage behavior patterns of

participants were surveyed during the one-year test

phase and subsequently analyzed. During the

analysis, a basic distinction was made between

different types of data like direct data (usage logging

of the Smart VitAALity app), indirect data (e.g.

number of steps counted by the watch, from which the

watch usage is derived) as well as surveys of usage

behavior, which were carried out at the end of the

field test. The use of the Smart VitAALity tablet was

recorded using the open web analytic platform

Matomo

. In this way, it was possible to track

elementary interaction elements within the project

application, e.g., button clicks and opening screens.

However, since Matomo can only record usage data

of self-implemented applications, third-party apps

such as an e-mail program or WhatsApp

, which were

integrated into Smart VitAALity, could not be

recorded directly. In addition, other applications,

which were used on the tablet but outside of the

project application, could not be captured with

Matomo. In order to be able to make comparable

statements about the use of third-party applications

and about the general tablet use, the user behavior

was obtained in subjective interviews. To evaluate the

usage of the Smart VitAALity application, the total

usage (12 months) of each participant was divided

Matomo Analytics Platfom - https://matomo.org/

(28.01.2020)

WhatsApp - https://www.whatsapp.com/

The Synergy of Technology Usage and Human-driven Support Activities in an AAL Pilot Region

181

into three phases, since not all participants received

the system at the same time and therefore the usage

calculations could not be carried out based on the

actual calendar date. The first month represents the

initial phase, which includes the training phase for the

systems and merely shows whether there was a high

interest from the participant’s point of view at the

beginning. The second phase shows the actual use of

Smart VitAALity and lasts 10 months. The phasing

out phase represents the last month of use of each

participant and within this period, people tended to

use the devices less often, or if errors occurred, they

did not report it to the support team anymore, as the

year of testing was coming to an end.

In addition to the evaluation of the usage behavior

in consideration of the different phases, the analysis

of the frequency of use was also carried out on

extended dimensions such as gender, age, user type

and place of residence.

2.2 Support Evaluation

The planning and conduction of necessary support

processes and resources turned out to be rather

difficult. Technical support was already performed in

other pilot regions in different variations. Based on

experience reports, the different options were:

splitting up the support based on different system

components, so every component-owner is the direct

contact point for related support questions or using

one single contact point and performing the technical

support together with other provided services (e.g.

during the telemedicine process). However, regarding

needed time and financial resources, little to no

documentation existed. Nevertheless, it must be kept

in mind that within a pilot region usually a system

prototype with a technology readiness level (TRL)

below 8 is tested. The technology of Smart

VitAALity was categorized as level 7 at the

beginning. This means a system prototype was tested

in the future operational environment, and therefore

technical problems and issues have to be kept in mind

during planning processes. Experiences from other

pilot regions showed that the necessary technical

support process was often underestimated and not

well-considered during the planning of the field trial.

As a consequence, it was decided to create a

comprehensive documentation of all support

activities during the pilot test of the Smart VitAALity

system. To capture required first-level support

operations, an adjusted software documentation tool

Technology Readiness Levels (TRL) - https://ec.

europa.eu/ research/participants/data/ref/h2020/other/

was implemented based on web technologies. The

focus was set on the documentation of telephone

calls, driving times and stay times during service trips

and a categorization and processing of arising

problems and incidents in an issue-tracking-system.

Each ticket provides the framework to process a

problem according a standardized workflow and

documents the interaction with participants (Plattner,

2020).

2.3 3-step Support Model

Due to the fact that there was a limited possibility to

draw on documentation or evaluation of already

performed support processes in pilot projects, a new

process was developed. For the Smart VitAALity

project, it was important to design a functional

support model, to assist the 104 participants in the

intervention group in the best way possible.

Therefore, the project team decided to support

participants in a three-step model which is presented

in Figure 1. Each step provides a different interaction

possibility. As a first step, a printed manual was

developed. It comprises detailed explanations of

every component and function including pictures as

well as textual descriptions and step-by-step

instructions to make the available interaction with

each

function as clear as possible. It was handed out

Figure 1: 3-step support model developed for the pilot

region Smart VitAALity.

wp/2016_2017/annexes/h2020-wp1617-annex-g-

trl_en.pdf

ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health

182

to all participants during the system roll-out. Next, the

printed handbook was digitized and inserted as a

separate function into the Smart VitAALity

application on the tablet. Thus, participants were able

to choose how to read the instructions, like an e-book

on the tablet computer or like a normal book in a

printed booklet. Both information/support options are

meant to assist participants to get familiar with the

system – there is no communication or any other

interaction with humans provided. This provides low-

barrier access to information about the system,

especially for persons with almost no or low technical

experience. As a third support option for Smart

VitAALity participants, a communication-based

support alternative was provided. During the field test

phase, participants could call the technical first-level

support hotline from Monday to Friday between 8 am

and 4 pm and ask for help. If it was not possible to

solve problems and issues through the telephone call,

support employees drove to participants’ homes and

provided on-site service. The three different options

were meant to interlock as a support combination /

alternatives for participants, as shown in Figure 1.

Before starting the field trial, the development

team created different theories about the usage from

the different support options. The theories were:

1. Participants of the selected target-group (60-85)

are used to printed books and will preferably use

the instructions in the printed manual.

2. For more technically experienced people, the e-

book version will be the preferred option to use

because it is always available (no extra book to

carry).

3. Participants will tend to hesitate to call the

technical support hotline because of personal

reasons such as sense of shame or polite

reluctance.

At the end of the field test, these questions were

meant to give an idea which support options are

preferred and should be integrated in a pilot region

and which are maybe obsolete for future projects.

3 RESULTS

In this section, an overview of the results from the

evaluation of the support model is presented. The

results are clustered according to the three steps of the

support model.

3.1 Usage of Printed Manuals

As shown in Figure 2, 58% of participants answered

at the deinstallation survey (n=98) that they had used

the printed manual and 10% had used the printed

manual in combination with the e-book version. As a

result, 68% of participants used the written support

instructions (Step 1 and 2 of the support model).

In addition, participants answered an open

question on the frequency in which they had used the

two manual options. The informal answers were

clustered as

 unique - answers like "used it once" during

the whole test time,

 seldom - answers like "I used it very seldom"

or "I used it just to look up telephone

numbers",

 sometimes - answers like "I didn't use it very

often but sometimes" or "I used it from time

to time",

 regular - answers like "I used it regularly" or

"I used it once a week" and

 initially - which means that users added to

their answer that they just used it at the

beginning of the test time no matter how

often.

Furthermore, 30% mentioned that they had never

used the manual. Only 10% of participants had used

the printed manual on a regular basis, 15% of

participants had used the manual just at the beginning

of the project to get used to the Smart VitAALity

system. The usage of the printed manual is visualized

in Figure 3.

Figure 2: Distribution of the usage of the written manual in

printed and e-book version.

The Synergy of Technology Usage and Human-driven Support Activities in an AAL Pilot Region

183

Figure 3: Clustering of statements regarding usage

frequency of the printed manual.

3.2 Usage of e-Book Manual

As shown in Figure 2, only around 6% of participants

used the e-book exclusively, and another 10% used

the e-book together with the printed manual. At the

beginning of the testing phase, an initial questionnaire

was done with all participants. In this, around 71

participants reported that they are used to

technologies like smartphones. Therefore, the

hypothesis was that they may use the e-book manual

more likely, but this was not the case. For follow-up

projects, it should be reconsidered if e-book versions

of manuals are necessary. The required resources to

create the electronic manual and its benefits should

definitely be weighed.

Having a closer look at the statements of

participants using the e-book manual it becomes

clearer that the development of such an option was

not relevant for the Smart VitAALity pilot region. All

six people answered that they had used the e-book

manual occasionally or just once at the beginning.

Figure 4: Monthly usage frequency of the e-book manual -

views and number of participants.

Figure 4 shows the use of the e-book manual on

the Smart VitAALity tablet. The total number of

button clicks and the number of people who used the

function at all is presented on a monthly basis. On

average, the e-book manual was used 41 times by 20

different people per month. Especially in the first

months of the field trial, the function was used more

frequently. Towards the end of the one-year testing

phase, the number of participants as well as the

number of button clicks decreased steadily.

3.3 Usage of First-level Support

Figure 5 shows the number of calls which were

recorded in each month of the field trial. Having a

participant number of 104, this shows a very high

motivation to contact the first-level support. 92

participants (89%) contacted the support hotline at

least once and almost every second person out of this

set had more than 4 calls with the first-level support.

This shows that the assumption regarding perceived

barriers to ask for personal support did not apply to

the participants of Smart VitAALity. It was possible

to solve most incidents via telephone but some issues

had to be tackled directly and resulted in

approximately 280 service trips. The number of

monthly service trips is also shown in Figure 5. There

is a slight decrease of necessary service trips after

eight months of the test duration. In the last two

months, no calls and trips were documented. This

may be based on the fact that the rollback of the

system already started in June 2019 and lasted until

mid of July 2019.

Figure 5: Monthly service trips and calls at the first-level

support hotline (Plattner, 2020).

3.4 Support Demand and System Usage

Another interesting perspective is the comparison of

usage frequency and support demand. To generate

comparability of support activities, the demand was

categorized in three groups based on the telephone

calls – low (1), moderate (2) and high (3) usage of the

ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health

184

technical support hotline. The created groups were

compared to the usage groups of the whole system –

which represent low (1), moderate (2) and high (3)

usage of the Smart VitAALity system. This

comparison is visualized in Figure 6 for the whole test

duration of 12 months. It shows that the support

demand and system usage tend to overlap, especially

in the category of low and medium users. Persons

with a high system usage (group 3) also tended to

contact the hotline more often. This may result from

the fact that persons with a high system usage

frequency were more likely to come across errors and

system bugs and tried to really contribute to enhance

the system and therefore took the opportunity to use

direct personal support. Whereas persons with a low

system usage may not have been that interested in the

system at all and also tended not to contact the support

hotline in case of issues. Users categorized in the

moderate usage group also tended to contact the

support hotline on a regular basis.

Figure 6: Comparison of usage frequency and support

demand using group allocation.

4 CONCLUSIONS

The presented results show that the usage of the

system and accompanying support activities are

strongly interlinked. It was demonstrated that the

opportunity for personal contact was strongly used

throughout the whole test duration. Concerns that

participants will hesitate to use the opportunity for

personal support were not confirmed. It is hard to

determine up to which point personal support has a

direct influence on the system usage but at least it

helped to avoid bigger issues and incidents such as

transmission errors and hardware problems affecting

the system usage in a negative way. The approach to

provide only one direct contact point for participants

regarding technical issues did also have a positive

effect on the support process. Requests could be

handled very easily and a clear and structured

workflow accelerated the process of integrating fixes

and improvements to the technical system.

This process was supported by the availability of

well-structured printed manuals, which were

important especially at the beginning of the test

phase. The creation of comprehensive manuals

should also be part of follow-up projects because it

facilitates the first contact with the system, especially

for people with a low technical pre-education.

Nevertheless, it is not possible to cover all

requirements only with written materials, a personal

contact opportunity should always be provided.

The needed time and staff resources to create the

described 3-step support model were very high but

the overall feedback on the provided support process

was very positive and the constantly high system

usage over the whole test duration demonstrated that

it created a benefit for the whole project. This process

also has to be taken into account when developing the

business model for an AAL solution.

Summing up it may be said that the technical

support process is an important factor for the launch

of AAL projects and solutions, and that the necessary

resources have to be allocated already in the project

proposal.

ACKNOWLEDGEMENTS

The pilot region Smart VitAALity (grant no. 858380)

is supported in the framework of the FFG program

benefit and co-financed by bmvit.

REFERENCES

Ates N., Aumayr G., Drobics M., Förster Majcen K.,

Frauenberger C., Garschall M., Willner V. Assistive

Solutions in Practice: Experiences from AAL Pilot

Regions in Austria. In IOS Press - Series: Studies in

Health Technology and Informatics, Ebook: Volume

236: Health Informatics Meets eHealth, pp 184-195,

2017. DOI 10.3233/978-1-61499-759-7-184.

Krainer, D. et al., 2018: System Definition based on a

Multidimensional Requirement Analysis within the

Pilot Region Smart VitAALity. In Smarter Lives 2018,

Innsbruck, Austria

Majcen, K., Plattner, J., Ströckl, D. E., Löffler, K.,

Schuster, E., Schaschl, P., Krainer, D., Oberzaucher, J.,

2019: AAL-Pilot Concepts in Carinthia and Styria. In

Proceedings of the 5th International Conference on

Information and Communication Technologies for

Ageing Well and e-Health (ICT4AWE 2019), pp. 289-

296, Heraklion, May 2019. ISSN: 2184-4984. ISBN:

978-989-758-368-1.

The Synergy of Technology Usage and Human-driven Support Activities in an AAL Pilot Region

185

Petersen Th., Steiner F., 2019: Megatrend-Report #01: The

Bigger Picture - Wie Globalisierung, Digitalisierung

und demografischer Wandel uns herausfordern.

Bertelsmann Stiftung.

Plattner, J., 2020. Evaluierung und Reflexion der

eingesetzten Technik und des technischen Support

Systems. Smart VitAALity - Einblicke, Ergebnisse und

Befunde aus einer AAL Pilotregion, Hrsg. Oberzaucher,

J., Krainer, D., Kada, O., Ströckl, D. E., Aigner-Walder,

B. BoD - Books on Demand, Nordstedt, Germany 2020.

Work in Progress

Plattner, J., Krainer, D., Majcen, K., 2018. Aiming for a

Market Success – Interlinked Aspects of Anchoring an

AAL Solution. In AAL Forum 2018, Bilbao.

Ströckl, D.E., Majcen, K., Plattner, J., Krainer, D., Löffler,

K., Schuster, E., Schaschl, P., Oberzaucher, J. 2019:

South Austrian Seniors “vs.” ICT for Healthcare in

AAL Pilot Regions. In Proceedings of 1st International

Conference on Finance, Economics, Management and

IT Business (FEMIB 2019), pp. 86-93, Heraklion, May

2019. ISBN: 978-989-758-370-4

ICT4AWE 2020 - 6th International Conference on Information and Communication Technologies for Ageing Well and e-Health

186