Service Information Application for Elderly People

The purposes of this study were to review literature on the demand of the elderly people in their daily life and determine their most vital needs, to implement the guidelines of universal design to develop a service information application for use at home, and to test its usability. The developed service information application included four applications: hospital appointment application, taxi booking application, government social welfare announcement application, and personal daily to-do list application. Before the usability test, the service information application was modified by experts of Human Factors. Twenty elderly people, ten for each gender, participated in the test. The results showed that the participants were highly satisfied with this application. Using the touch screen, the participants had low error rate through out the whole test. In the service information application, participants emphasized the need of hospital appointment application, and however, showed low interests in the taxi booking application. 


I. INTRODUCTION
Improving the accessibility of the internet and usability of technologies to provide independence, sustainability and fulfillment in elderly people's daily lives becomes increasingly important as our society gradually moves towards aging society.
Aging society is a globalizing situation we face.According to the statistical data of the ministry of interior department in Taiwan, at the end of 2013, the population above 65 years old was close to 2.7 million (about 11.53% of the country.)The population of the elderly people is also increasing within the country and is estimated to reach 14% in 2018.The approaching of the Aged society will directly influence our living habits, work, leisure activities, consumer demands and household.
Due to the advance of technology in quality of medical treatment and living conditions in Taiwan, the average lifespan of the country has been prolonged.Living alone for healthy elderly people is going to become a trend.While high-tech product has become a part of our everyday lives and the internet enables convenient communication between people, the community with Manuscript received December 1, 2015; revised April 21, 2016.
elderly people doesn't seem to benefit from any advantage of these technologies.The frequency of elderly people using electronics is far lower than younger adults.Although high income and highly educated people are not uncommon among the elderly population, a wide range of them had not received the chance to learn the fundamental basis of accessing these technologies and the services they provide.For example, the electronic bulletin board is an extremely valuable way to provide ways to exchange messages and keep in touch with the outside world through technology [1].This kind of tool can help elderly people that live alone.Residents of nursing homes often use computers to interact, which adds to the activities of their daily lives and improves their cognitive abilities, lowering the risk of depression.
There are many ways elderly people that lives alone can benefit from technology; for example, reserving a taxi online instead of hailing one beside the road; making appointments online before going to the hospital; managing finances with the Web ATM; and accessing the library online to search for books beforehand.The possible technology available to homes would mainly be the computer; reading news online, connecting to family and friends using email, and receiving correct information on medication etc.However, an older adult may have eyesight problems that reading the labeling on a remote control would be confusing or identifying the similar coloring between letters and backgrounds, or that the controlling devices (for example, the mouse) and the displays (for example, the computer screen) might not be coordinated spatially.All these instances will reduce the frequency of the use of electronics.If we could enlarge labels, put contrast between lettering and background colors and include an additional language feedback system, we will be able to improve the convenience of using remotes and other controlling devices [2].
The factors that discourage elderly people from trying to use electronics might be hearing problems, illiteracy and being unable to understand instruction manuals.During the use, he/she might be restricted due to mental inabilities (like short term memory problems) and therefore prevent them from full use.Other than that, the slowness of an older adult's movements should be put into consideration; the display of an electronic device must be designed casually and leisurely to reduce the feeling of nervousness while using.

II. PURPOSES
A service information application for elderly people was designed, based on their need for services and information to see if it will increase their interests for use due to a better interface.This allows them access to information on health care, leisure activities, and transportation.The application was designed through advice from experts and testing to confirm what an older adult's needs from services and information, and later analyzed on its satisfaction and usability based on feedback from the elderly people.This study targets elderly people that are capable of living independently and discusses necessary activities in everyday life that are not easily handled (For example the registration system online hospitals provide) taking into consideration both the physical and mental abilities of an older adult to design an interface of modern technology which will enable these elderly people to perform daily activities easily.

III. METHODS
The interface of application was designed step by step through its fundamental use, task analysis, experts' advice, test, and feedback from users.(Fig. 1) Figure 1.The design process of service information application.

A. The Daily Needs of Elderly People
Some studies point out that the needs of elderly people come from many aspects, but are put into importance differently by the individual.Hsu put the needs of an older adult into four categories: heath and caretaking, financial security, aging in place and living adjustments [3].Lin suggested that other than the four categories mentioned above, the additional includes continuing education, leisure activities and social adaptive needs etc. [4] Chiu discovered that the five major concerns within home are economics, housing, health, social welfare and social relation [5].However the research conducted by Huang and Wu points out that the service most needed and desired by elderly people is medical treatment; for example, free heath check services, and secondarily, the government's healthcare policy that provides payment for medication and financial subsidy for self payment [6].
This research takes into consideration the needs of an older adult mentioned in all the researches above and also the basic living needs to develop three servicing subsystems for home that are most relevant to older adults' life: the hospital appointment application, the taxi booking application and the social welfare announcement application.

B. Operational Process Analysis
The operational process analysis was developed through the entire process of this service application.This analysis provides information on how the elderly people interact with the interface and is taken into consideration for the designing of the interface.For example, how each step directs the user to the next (the size of lettering, the colors of images); how the user makes decisions on each step (deciphering meaning from directions); the possible choices of actions for the user (the number of options on the interface); the needed information to carry on with each step and the information that returns (feedback from the process or finish of the task).

C. The principle of Universal Design
The idea of Universal design is to enable the majority of people to use the system while not needing to take into consideration the abilities and disabilities of each individual.Hawthorn mentioned that a lot of disabled or elderly people had tried using the Internet, browsing information of libraries, and contacting with family members and friends [7].However, using the Internet is not an easy task for them, and this is what most developers tend to overlook.
Roberta and Kenneth consider that a Universal design provides the user with required support and lowers the burden of conducting the use (Supportive design), fulfills the needs of the majority (Adaptable design), must be easy accessible (Accessible design) and safe (Safetyorientated design) [8].Mace et al. established the guidelines of universal design.[9]  Designs should be equitable to all, and conduct same ideas to all users. Designs should provide user flexibility; for example, be equally accessible to left-handed users and right-handed users.

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Designs should be kept simple so the majority of users, without former knowledge on the usage of the design, can interpret the design.Each element must be defined, so that they can be easily described by the user.

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Keep the tolerance for error in designs to a minimum, and provide fail safe functioning.Warnings should alert the user when encountering errors or danger.

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Cut down on repeating motions, and design with low physical exertion for the user, so that the user can effectively and comfortable use the design with low physical effort.
According to these design guidelines, a 10-inch touch screen was chosen as the input of the interface, and according to the operational process analysis, the service information application was created.Some points of the designs on the system interface of this research were indicated below.

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The consistency of the system interface from page to page allows ease of reading for elderly people.For example, the different colors on the options show the user which action being used.The interface also displays the current time, and the main menu button.
 Splits all services into different categories.This can prevent excessive memory required for use, and also allows the user to quickly access different services based on the categories. Interface design is not overly complicated, ensuring clarity for elderly people.Services are named with clarity, so that elderly people can easily process the information each service provides.

D. Expert Advice
The application took advice from three experts in the field of ergonomics to evolve into a new interface.The following is the advice given on the interface.
 Avoid placing "similar" options on the function keys and interface for reading them could easily confuse the elderly people. While designing "Responses" to messages which asks whether the elderly people will attend an event, make sure that the elderly people understands the options fully, for example, labeling the responding options with "Response and attend" and "Don't attend"  Note carefully the arrangement of the "Options" manual, for example spatial compatibility. Remind the elderly people of the situation and condition before and after each step. Consider the spatial compatibility of cancelling messages and where the delete button is placed. Allow the elderly people to hit the "return" button to each screen instead of automatically returning to the main screen. Colors of clarity should mark different statuses.
For example, the difference between "Available" and "Not available" when making an appointment with a doctor.

E. Usability Evaluation
The participants of this evaluation were elderly people from the age 60 to 65 who were healthy when taking the test.The main tasks of the usability evaluation were explained, and the participants each received instructions for a task in randomly ordered.The participants are taught the manipulation of the application and how to achieve the missions before taking the evaluation.(Fig. 2) The evaluation began when the participant expressed understanding the instructions.The entire process of task completion was filmed, and after the tasks were completed, the participant was required to complete a questionnaire.The participant was allowed a short period of time to rest before moving on to the next task.On the completion of all eight tasks, the participant was required to fill in a questionnaire on the overall evaluation of the system, using a Likert scale, from strongly dissatisfied to strongly satisfied.After the final interview, the evaluation ends.The variables of the evaluation were listed below:  Time spent to complete different tasks on the interface;  Reaction time to select an option and for the system to transfer to another interface;  Satisfaction whether elderly people will have problems or difficulties when maneuvering through the system and whether they would like to use the service in the future.IV.RESULTS AND DISCUSSIONS 20 elderly people, half male and half female, took part in evaluating the application.The average age of the male participants is 62 and the average age for female participants is 64.Most of them had never used a computer before and educational levels were below junior high school.The descriptive statistics of complete time for each mission was shown below.(Table I) The time for clinic booking was the longest simply due to it had 8 steps while the longer time for clinic guide was due to the reading and searching time on the guide.

A. Questionnaire on the Overall Application
The analysis of the overall application includes operation satisfaction, services, text (ease of reading), whether it is of help to the participant, and whether the participant would use the application in daily life.Analysis on different aspects for each individual was taken.
On the overall of operating, participants were satisfied.On services, 50% of participants were satisfied.On text, the participants said that the overall application was successful in helping them comprehend the meaning behind the words.

B. Analysis of Variance
The independent variables in this study are gender, level of education and whether the participant has used a computer before.A two-way ANOVA was performed.The results show there is no difference on reaction time of selection and the time they needed for finishing each mission.That is to say, the gender, level of education and experience in using a computer has no impact on operating the application.

C. Interviewing of Participants
The interviews allowed the receiving of feedback from the participants on five different aspects: satisfaction with operation of the application, the difficulty of text comprehension, the difficulty of using the touch screen, and the difficulty of recognizing the coloring and the necessity of the services.
The satisfaction on the operation of the application is unanimously positive.The participants responded that the application is easy to operate.The operation of "taxi booking application" is easy and the steps are simple.
On the difficulty of text comprehension, participants expressed that the text for "Make a taxi reservation", "Information on taxi reservation" and "Cancel taxi reservation" explains each function clearly.However, for "Clinic guide" the text should be shortened.The text for "Social welfare information" is too complex.
On the difficulty of using the touch screen, female participants expressed that the options "Make an appointment" and "Clinic guide" is easier to select.On contrast, male subjects expressed difficulty in selecting options on the touch screen.However, selection for the function "Social welfare Information", male participants expressed that it was easier to operate because it allows selection without making other selections beforehand, and there were less obstructions on the interface.
On the difficulty of recognizing the coloring, all participants expressed that the colors helped with discerning different messages.Female participants were less sensitive to the colors than the male participants.On "Make a taxi reservation" and "Cancel taxi reservation", female participants expressed more opinions on the colors than males, expressing that the colors should be brighter; male participants expressed that the colors for "History" should be brighter.
On the necessity of the services, all participants expressed that hospital appointment application is necessary.Compared to female participants, male participants felt that the social welfare announcement application is more important.The taxi booking application is needed least of all.

D. Discussions
This study found that the operation of each application is quick and that the mistakes made are few.For two of the most time consuming missions, it takes an average of 7 seconds for each step on "Make an appointment with a doctor" and 5 seconds for each step on "Make a taxi reservation".It was also found that when operating on the touch screen, the errors made were relatively low, giving high satisfaction.Of all the errors made, the most were on the mission "Make an appointment with a doctor", with seven errors.The other missions yield either only one error or none at all.This service information system had special concerns on the learning ability for elderly people.Two major points affected an elderly person's learning: caution and distraction.Most elderly people were cautious, so they take their time to think before responding that slowed the learning pace.Elderly people were less effective not because their attention lifespan was shorter, but that they could not take into consideration all aspects of a message and also be affected by accumulated knowledge and previous experience.Through the interviews, participants expressed that the application was easy to learn and operate.When using the service information application, participants felt ease at the design of the interface.Participants expressed that the application would prove to help an older adult's life.
It was found from the analysis of the questionnaires that of all the services, the appointment application of hospitals is the most needed.The taxi booking application is needed the least.The general feedback given by the participants on the operation of the service application were satisfactory.The overall application also received satisfactory feedback from the participants, expressing that the application has simple steps and is easy to use and operate.The participants also expressed that the few steps were easy to memorize.These results found through the usability analysis are that how the participants operates on the touch screen, whether with the finger or the nail, might impact the operation time and the reaction time of the screen.

V. CONCLUSIONS
The service information application was made through targeting the increasing population of the elderly people, uncovering their needs on living, selecting necessary household services and information, combining an easy to operate touch screen, designing an application and the interface of each step, taking advice from experts and making final changes.This application was tested by elderly people to affirm its usability.This application can also add other functions and information based on the same design; for example, in organizational nursing homes it can add the service of making daily activity appointments and other managing information.

Figure 2 .
Figure 2. Homepage of service information application.

TABLE I .
THE COMPLETE TIME FOR EACH MISSION.(TIME UNIT: