T us -based in o ma ion sys em
a chi ec u e o pe sonal wellness
Pekka RUOTSALAINENa,1, Pi kko NYKÄNENa, An o SEPPÄLÄa , Be nd BLOBELb
a
Uni e si y o Tampe e, School o In o ma ion Sciences, Finland
b
Uni e si y o Regensbu g, eHeal h Compe ence Cen e , Ge many
Abs ac . Mode n eHeal h, ubiqui ous heal h and pe sonal wellness sys ems ake
place in an unsecu e and ubiqui ous in o ma ion space whe e no p ede ined us
occu s. This pape p esen s no el in o ma ion model and an a chi ec u e o us
based p i acy managemen o pe sonal heal h and wellness in o ma ion in
ubiqui ous en i onmen . The a chi ec u e enables a pe son o calcula e a dynamic
and con ex -awa e us alue o each se ice p o ide , and using i o design
pe sonal p i acy policies o us wo hy use o heal h and wellness se ices. Fo
us calcula ion a no el se o measu able con ex -awa e and heal h in o ma ion-
sensi i e a ibu es is de eloped. The a chi ec u e enables a pe son o manage his
o he p i acy in ubiqui ous en i onmen by o mula ing con ex -awa e and
se ice p o ide speci ic policies. Focus g oups and in o ma ion modelling was
used o de eloping a wellness in o ma ion model. Sys em analysis me hod based
on sequen ial s eps ha enable o combine esul s o analysis o p i acy and us
conce ns and he selec ion o us and p i acy se ices was used o de elopmen
o he in o ma ion sys em a chi ec u e. I s se ices (e.g. us calcula ion, decision
suppo , policy managemen and policy binding se ices) and de eloped a ibu es
enable a pe son o de ine si ua ion-awa e policies ha egula e he way his o he
wellness and heal h in o ma ion is p ocessed.
Keywo ds. Wellness in o ma ion, modelling, us , p i acy, in o ma ion sys em
a chi ec u e
In oduc ion
Heal hca e sys ems cu en ly pe o m a pa adigma ic change whe e he ocus is
pa ien ’s holis ic heal h and wellness managemen . The new pa adigm is ocused on
p e en i e ca e, p oac i e se ices, and ea ly de ec ion o diseases, heal h p omo ion
and main enance, bu i also suppo s heal hy li es yles [1-5]. The ubiqui ous
compu ing echnology and he la es de elopmen s o he In e ne ha e no only s ong
impac s o he ways heal hca e se ices a e o e ed bu hey ha e also enabled he ise
o a new concep , ubiqui ous heal h, ha akes place in ubiqui ous en i onmen and
he e o e c ea es us and p i acy challenges ha do no exis in he cu en egula ed
heal hca e en i onmen [5-7]. The e o e, a no el p i acy managemen solu ion ha
akes in o accoun ea u es o ubiqui ous en i onmen , ich heal h in o ma ion collec ed
and used and he lack o p ede ined us is needed.
1 Co esponding Au ho . Pekka.Ruo salainen@u a. i, Uni e si y o Tampe e, PO Box 607, FI-33014
Uni e si y o Tampe e, Finland
e-Heal h – Fo Con inui y o Ca e
C. Lo is e al. (Eds.)
© 2014 Eu opean Fede a ion o Medical In o ma ics and IOS P ess.
This a icle is published online wi h Open Access by IOS P ess and dis ibu ed unde he e ms
o he C ea i e Commons A ibu ion Non-Comme cial License.
doi:10.3233/978-1-61499-432-9-136
136
This pape s udies ubiqui ous heal h and pe sonal wellness as me a-sys ems and
ies oge he he esul s o ou esea ch on pe sonal wellness in o ma ion modelling and
on us -based in o ma ion sys em a chi ec u e ca ied ou du ing 2009-2012 [5, 8-14].
1. Me hods
A holis ic sys em heo e ical app oach was used o unde s and ubiqui ous heal h as a
concep , i s ea u es and us and p i acy conce ns. Fi s , an analysis o p e ious
esea ch conce ning ubiqui ous en i onmen and sys ems was done. The ea e ,
s epwise analysis and sys em- heo e ical amewo k modelling we e used o ecognise
he s akeholde s, iewpoin s and in e connec ions exis ing in he ubiqui ous heal h and
o de elop no el p i acy p inciples o i [5].
In pe sonal wellness in o ma ion modelling, li e a u e analysis, con ex analysis
and ocus g oup me hods we e used. Wi h li e a u e analysis, we analysed he
concep ualisa ions o pe sonal wellness and pe sonalised heal hca e. We sea ched he
ollowing da abases: ACM, ESBCOhos Academic Sea ch P emie , IEEE, PubMed,
ScienceDi ec , Sp inge Link and Google Schola . Fo he inal analysis 100 scien i ic
a icles we e included. Con ex analysis wi h equi emen s elici a ion echniques was
applied o iden i y in e nal and ex e nal con ex s o pe sonal heal h. Rega ding ocus
g oups, ou g oups wi h six mee ings and up o 10 pa icipan s, we e used o
unde s and how ci izens unde s and he concep pe sonal wellness, how hey
concep ualise i , and which ac o s a e conside ed impo an o pe sonal wellness [9].
The in o ma ion a chi ec u e was de eloped by combining sys ems heo y, sys ems
enginee ing, equi emen s analysis and sys ems design. Fi s , us and p i acy models
was selec ed and p inciples de eloped in such a way hey we e in line wi h he gene al
p i acy p inciples and legisla ion, bu a he same ime ook in o accoun he iden i ied
ea u es o he ubiqui ous en i onmen . Nex , unc ional equi emen s and se ices
we e de eloped on he basis o ea lie esea ch analysis. Based on he selec ed
p inciples, models and iden i ied unc ional equi emen s he a chi ec u al se ices and
hei in e connec ions we e de eloped using sys ems analysis me hods [12-13]. Finally
we ca ied ou a easibili y s udy wi h a pe sonal heal h case o assess whe he he
de ined us and p i acy models apply. We used as a me hod a use -scena io wi h a
de ailed walk- h ough o assess whe he he p i acy models gi e a pe son means o
con ol he access and disclose o his/he pe sonal heal h in o ma ion (PHI). We also
de ined ele an p i acy a ibu es o he componen s based on li e a u e analyses and
empi ical esea ch [14].
2. Resul s
In his esea ch, pe asi e heal h is unde s ood as a me a-sys em, and i is de ined o be
a ne wo k o sys ems o e ing heal h and wellness se ices o he pe son ( he Da a
Subjec ) in unsecu e in o ma ion space. The no el p i acy p inciples de eloped gi e
he DS igh o e i y dynamically he us wo hiness o he se ice p o ide and he
igh o use pe sonal polices o manage he way heal h and wellness in o ma ion is
p ocessed. Fu he mo e, se ice p o ide s ha e he esponsibili y o suppo he
anspa ency and openness and he e o e publish domain speci ic in o ma ion equi ed
o us calcula ion.
P. Ruo salainen e al. / T us -Based In o ma ion Sys em A chi ec u e o Pe sonal Wellness 137
The de eloped pe sonal wellness model consis s o i e in e nal componen s and
he wo ex e nal componen s social ne wo ks and en i onmen . All hese componen s
a e linked oge he , which e lec s he comple e and holis ic na u e o pe sonal wellness
[8-9]. The li es yle componen includes concep s conce ning ac i i ies, beha iou s,
choices and isk ac o s ela ed o he pe son’s li es yle. Emo ional and men al wellness
ocuses on indi idual iden i y, psychological concep s, in ellec ual wellness, emo ions,
eelings, pe son’s iews and alues. Occupa ional wellness conce ns pe son’s well-
being a wo k, in s udies, in unemploymen o in e i emen . Physiological wellness is
abou heal h and wellness, i.e. heal h s a us and condi ions, diseases, disabili ies,
unc ioning, gene ics, pe sonal obse a ions, moni o ing and measu ing o heal h da a.
The heal hca e componen p esen s he heal hca e sys em, i s se ices and sys ems,
hei accessibili y, se ice p o ide s and medical documen a ion. These i e in e nal
componen s a e su ounded and a ec ed by ex e nal componen s social ne wo ks and
en i onmen . Social ne wo ks include all social ela ions ha a ec a pe son, including
digi al social media connec ions and ac i i ies. En i onmen p esen s he digi al and he
physical en i onmen ela ed o a pe son, i.e. li ing en i onmen , se ice en i onmen ,
socie y, cul u al en i onmen and socie y egula ions and no ms. The en i onmen is
e y lexible and dynamic and i may change o e ime [8-9].
The analysis o he ea u es and p i acy conce ns showed ha he widely used
p ede ined and s a ic egula o y p i acy model o heal hca e is insu icien . Ins ead, a
model whe e p i acy is a pe sonal p ope y should be used. This inding is in line wi h
he de eloped p i acy p inciples [12-13]. We ound ha in ubiqui ous heal h a pe son
needs ich se ice p o ide -speci ic us in o ma ion o make p i acy decisions.
Figu e 1: The amewo k model o he us -based a chi ec u e [13]
The de eloped 3-laye model o p i acy a chi ec u e is shown in Figu e 1. The
op laye consis s o common se ices, and he middle laye includes p i acy and us
se ices. The s akeholde s, o he use s (e.g. seconda y use s) and pe sonal heal h
in o ma ion a e loca ed a he lowes laye [13]. The us calcula ion se ice o e s o
he DS ich con ex -awa e us in o ma ion in he o m o a calcula ed us alue and
us a ibu es. T us a ibu es desc ibe he le el sys ems suppo awa eness and
anspa ency and how hey ollow p i acy egula ions and laws (e.g. EU-p i acy
ela ions and na ional da a p o ec ion ac s). The a chi ec u e mimics he way humans
P. Ruo salainen e al. / T us -Based In o ma ion Sys em A chi ec u e o Pe sonal Wellness138
use us and he e o e inal us decision is made by he DS. The ole o he policy
binding se ice is o help he DS o o mula e compu e unde s andable p i acy and
secu i y policies. The no i ica ion se ice sends hose policies o se ice p o ide s.
In he easibili y s udy, we walked h ough he selec ed ou wellness in o ma ion
model componen s, and in he scena io we used he pe son’s p i acy a ibu es de ined
o each componen based on li e a u e s udy and empi ical esea ch [5,12-14]. The
walk- h ough showed ha when in o ma ion is ans e ed om a egula ed sys em o a
non- egula ed sys em in pe asi e en i onmen , in o ma ion is conside ed o be
eliable when he pe son us s ha he su icien p ocedu es, sa egua ds and s anda ds
ha e been implemen ed in he egula ed sys em. A e he da a is ans e ed, howe e ,
he o iginal da a secu i y and p i acy policies and alues o p i acy a ibu es a e no
mo e alid. In a pe asi e en i onmen i is di icul o a pe son o know exac ly he
ac ual p i acy s a us o he se ice o he se ice p o ide . This is especially he case
when a se ice p o ide is a non- egula ed one such as in he li es yle componen , o
wi h social ne wo ks o wi h non-ce i ied In e ne se ice p o ide s.
3. Discussion
The de eloped p inciples, he pe sonal wellness in o ma ion model, and he p i acy
managemen a chi ec u e oge he o e a no el solu ion o a pe son o c ea e us , o
selec eHeal h and eWellness se ices, and o manage pe sonal p i acy in a ubiqui ous
en i onmen . The in o ma ion model p esen s de ailed ci izen-based in o ma ion and i
add esses he wellness domain om an in o ma ion sys ems science pe spec i e and
hus p esen s a s a ing poin o de elop pe sonal wellness on ology. Wellness
in o ma ion and us a ibu es a e used by a chi ec u e’s us and p i acy se ices o
c ea ing o compu e unde s andable p i acy polies. The p i acy a chi ec u e gi es o
he DS ools and means o choose pe sonal con ex -awa e p i acy policies o each
sys em i is in e ac ing wi h he help o compu a ional us in o ma ion ha co e s a
us alue and sys em-speci ic us a ibu es. Selec ed us a ibu es in o m he DS
how heal h se ice p o ide s ollow p i acy egula ions and laws egula ing he DS’s
en i onmen (e.g. which laws and how he se ice p o ide has implemen ed, and does
i enable ex e nal e i ica ion o he implemen a ion). A eal bene i is ha he
a chi ec u e o e s p o ec ion o he DS agains many o p i acy h ea s caused by he
use o ubiqui ous compu ing and unsecu e en i onmen s.
The easibili y assessmen showed ha i is necessa y ha he DS is always
in o med o he p i acy s a us o he se ices he/she is using and he DS can con ol he
way da a is p ocessed. Fo example, speci ic p i acy ules and se ices a e needed o
non- egula ed en i onmen s i hey a e in eg a ed o communica e wi h egula ed
heal h ca e se ices. We applied he sel - egula ing policies by de ining he p i acy
a ibu es o each concep in he pe sonal wellness in o ma ion model. A ich se o
con ex -awa e p i acy and us se ices a e o e ed he DS o us building and
p i acy policy c ea ion.
This esea ch has esul ed in models and me hods o a pe son o be awa e o and
o manage he p i acy o his/he pe sonal heal h and wellness in o ma ion. The esul s
a e s ill o be implemen ed and make hem a ailable and accessible o ci izens.
Implemen a ion is impo an as many s udies [15-17] indica e ha p i acy is a op
eason o ci izens’ eluc ance o adop pe sonal heal h sys ems.
P. Ruo salainen e al. / T us -Based In o ma ion Sys em A chi ec u e o Pe sonal Wellness 139
The nex s ep in ou esea ch is o de elop a ma ix ha links us a ibu es and
p i acy policies oge he . Policies should be easy o unde s and (i.e. an on ology is
needed) and use in eal li e, and hey should o e p ac ical p o ec ion agains p i acy
conce ns exis ing in ubiqui ous heal h and wellness [18].
Re e ences
[1] Codagnone C, Recons uc ing he Whole: P esen and Fu u e o Pe sonal Heal h Sys ems, PHS2020,
Eu opean Commission, 2009, h p://ec.eu opa.eu/in o ma ion_socie y/ac i i ies/heal h/docs/p ojec s/
phs2020/phs2020-book- e 16082009.pd .
[2] Tepe i J, Po e ME, Vuo enkoski L, Ba on J, The Finnish Heal h Ca e Sys em: A Value-Based
Pe spec i e. Si a Repo s 82, 2009; h p://www.si a. i/julkaisu / apo i82.pd ?download=La aa+pd .
[3] Va shney U, Pe asi e Heal hca e and Wi eless Heal h Moni o ing. Mobile Ne w Appl 2009; 12:113-
127.
[4] Hill JW, Powell P, The na ional heal hca e c isis: Is eHeal h a key solu ion? Business Ho izons 52,
2009 265—277.
[5] Ruo salainen P, Blobel B, Seppälä A, So a i H, Nykänen P, A Concep ual F amewo k and P inciples
o T us ed Pe asi e Heal h. J Med In e ne Res 2012; 14[2]:e52.
[6] Ohashi M, Ho i M, Suzuki S, Ci izen-cen ic e-heal hca e managemen based on pe asi e
au hen ica ion - New ICT oadmap o ac i e ageing. 4 h In e na ional Con e ence on Pe asi e
Compu ing Technologies o Heal hca e, Munich, Ma ch 2010, 1-8, doi: 10.4108/ICST. PERVASIVE
HEALTH 2010.8910.
[7] Be y LL, Mi abi o AM, Inno a i e heal hca e deli e y. Business Ho izons 53, 2010; 157—169.
[8] Seppälä A, Nykänen P. Con ex ual analysis and modeling o pe sonal wellness. In: Joaquim Filipe and
Jan L. G. Die z [Eds.] KEOD 2011, P oceedings o he In e na ional Con e ence Knowledge
Enginee ing and On ology De elopmen - Pa is, F ance, 26-29 Oc obe 2011: SciTeP ess - Science and
Technology Publica ions, 202-207.
[9] Seppälä A, Nykänen P, Ruo salainen P, De elopmen o pe sonal wellness in o ma ion model o
pe asi e heal hca e. Jou nal o Compu e Ne wo ks and Communica ion, ol. 2012, a icle 596749, 10
pages.
[10] Nykänen P, Requi emen s o use - iendly pe sonal eHeal h in o ma ion sys ems. In e na ional
Council o Medical and Ca e Compune ics Con e ence. In: L Bos, B Blobel, A Ma sh and D Ca oll
[eds.], Medical Ca e and Compune ics 5, S udies in Technology and In o ma ics 137, IOS P ess, 2008,
367-372.
[11] Nykänen P, Ruo salainen P, Blobel B and Seppälä A, Resea ch on us ed pe sonal heal h and wellness
in o ma ion in ubiqui ous heal h in o ma ion space. In: O. Dössel and WC Schlegel [Eds.]: WC 2009,
IFMBE P oceedings 25/XII, 432–435, 2009.
[12] Ruo salainen P, Blobel B, Nykänen P, Seppälä A, So a i H, F amewo k model and p inciples o
us ed in o ma ion sha ing in pe asi e heal h. In: A Moen, SK Ande sen, J Aa s and P Hu len [eds.],
Use Cen ed Ne wo ked Heal h Ca e. P oceedings o MIE2011, Oslo. IOS P ess, Ams e dam, 2011,
497-501.
[13] Ruo salainen P, Blobel B, Seppälä A, Nykänen P, T us Enabled P i acy Managemen A chi ec u e o
Pe asi e Heal h. Jou nal o Medical In e ne Resea ch, 2013, 1[2], e23.
[14] Nykänen P, Seppälä A, Ruo salainen P, Blobel B, Feasibili y analysis o he p i acy a ibu es o he
pe sonal wellness in o ma ion model. In: Lehmann CU, Ammenwe h E, Nøh C [eds.],
MEDINFO2013. S udies in Heal h Technology and In o ma ics 192. IOS P ess, Ams e dam, 2013,
[ISBN 978-1-61499-288-2 [p in ] | 978-1-61499-289-9 [online] Open Access], 219-223.
[15] Pa lou PA. S a e o he in o ma ion p i acy li e a u e: whe e a e we now and whe e should we go?
MIS Qua e ly. 2011; 35[4]:977–88.
[16] Belange F, C ossle RE, P i acy in he digi al age: a e iew o in o ma ion p i acy esea ch in
in o ma ion sys ems. MIS Qua e ly 2011:35[4]:1017–1041.
[17] Smi h JH, Dine T and Xu H, In o ma ion p i acy esea ch: an in e disciplina y e iew. MIS Qua e ly
2011:35[4]: 989-1015.
[18] Seppälä A, Con ex -awa e and T us -based Pe sonal Wellness In o ma ion F amewo k o Pe asi e
Heal h. Doc o al Disse a ion. Ac a Uni e si a is Tampe ensis, 1924 Tampe e Uni e si y P ess, 2014.
ISSN 1455-616.
P. Ruo salainen e al. / T us -Based In o ma ion Sys em A chi ec u e o Pe sonal Wellness140