E-Health Telecommunication Systems and Networks, 2013, 2, 58-63
http://dx.doi.org/10.4236/etsn.2013.23008 Published Online September 2013 (http://www.scirp.org/journal/etsn)
Perspec
Here
Johan nen2
1Department of Electronics y, Tampere, Finland
2Depart inland
Copyright © 2013 Johanna Virkki, Pasi Raumonen. This is an open access article distributed under the Creative Commons Attribu-
permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
he people feel posi-
ve about clothes used for wireless identification purposes in healthcare and childcare, but when more information
tive. Several important points to
consider before implementation of WE for healthcare and childcare environments were brought u p.
e; Finland; Healthcare; Individual Privacy
ctations about the potential of
W
the Internet forum survey. The results are
presented and discus sed in the third section. The last sec-
and presents the conclusions
based indoor location system to support the nursing staff
[7], a radiofrequency identification (RFID) system to
track and identify patients in a children’s critical care
ture, heartbeat, and pressure [15], and a wearable health
system for non-invasive and wireless monitoring of
physiological signals [16] have been introduced. Free-
tives for Wearable Electronics in
althcare and Childca
na Virkki1, Pasi Raumo
and Communications Engineering, Tampere University of Technolog
ment of Mathematics, Tampere Uni versity of Technology, Tampere, F
Received June 3, 2013; revised July 8, 2013; accepted July 31, 2013
a.
tion License, which
cited.
ABSTRACT
This paper starts with a literature survey that introduces the possibilities of wearable electronics (WE) in different
health-care and childcare applications. Next, 24 personal interviews and an Internet forum survey were conducted in
Finland about the use of WE in the applications mentioned above. According to the results, most of t
ti
about the person is added that can be wirelessly read, the feelings become more nega
Keywords: Childcar; Wearable Electronics
of this paper.
1.1. WE in Healthcare
In healthcare application s, WE can be used e.g. in patient
monitoring, positioning, and identification in hospitals
[6]. For example, a wireless sensor network (WSN)-
ward [8], body-worn tags for the continuous tracking of
human movements in a conventional room [9], and a
system to detect life-threatening changes of daily active-
ties of older people [10] have been presented. In the fu-
ture, the importance of telemedicine and home-n ursing is
expected to grow. The adjustment of the healthcare sys-
tems to the increasing number of elderly and patients
with chronic diseases is one of the biggest challenges to
the European Union, including Finland, where this sur-
vey was done, and the future of the public healthcare is
currently a hot topic in the Finnish media. There are
many opportunities to help elders live alone in their
homes with the help of WE. For example, a system has
been proposed that is installed in footwear for location
tracking and in gloves for activity monitoring [11], as
well as an RFID-based fall detection monitoring system
that includes a dual-band RFID module, placed into a
pair of slippers [12]. WE allows the body status to be
monitored by devices that measure heart or brain activity,
blood pressure, body temperature, or other body func-
tions [13]. For example, the realization of wireless oxy-
gen saturation and heart rate system for patient monitor-
ing [14], a scheme for monitoring the patient’s tempera-
1. Introduction
One important part of the development of the future liv-
ing environment is the development of wearable elec-
tronics (WE) [1,2]. Recently, many innovative products
have appeared and expe
E are high. The history of WE is summarized in [3].
Important application areas can be found e.g. from health-
care [4,5] and childcare.
This study focuses on WE used in healthcare and
childcare environments. It includes a literature survey,
personal interviews in Finland, and an Internet forum
survey in Finnish Intern et forums. After this introduction
to the literature surv ey, the second section introduces the
interviews and
tion summarizes the results
C
opyright © 2013 SciRes. ETSN

J. VIRKKI, P. RAUMONEN 59
dom of movement achieved by WE is especially impor-
tant in home nursing [17]. Thus, another application for
WE is in the recovery of patients after an operation; in-
stead of being hospitalized for recovery monitoring, the
patients can be discharged to return home sooner. In ad-
dition to reducing the cost of the operation, home-nursing
can increase the patient’s physical activity, and thus also
speed up recovery.
1.2. WE in Childcare
In childcare applications, WE could automate the chil-
dren security and safety and thus provide help to nurses
[18]. A single cloth can keep the information of a child
(e.g. name, age, kindergarten group, allergies, etc.) easily
achieved for the nurses. In one proposed system, RFID
tags were embedded in the children uniforms in order to
automate the children security su pervision and to provide
integration with the current security management system
for the kindergarten [19]. Another study proposed a sys-
tem solution based on RFID to be deployed in schools.
The system registers arrival and departure times of pupils
and sends that information to parents via SMS and/or
e-mail [20]. In Finland, all children under seven years old
have the right to have daycare organized by municipali-
ties either on a full-time or part-time basis. Compulsory
education starts in the year when a child becomes seven
years of age and in the previous year the child can par-
ticipate in pre-primary education in a pre-primary school.
1.3. Individual Privacy and WE
One of the most important challenges in convincing users
to adopt WE is the protection of privacy. Informational
privacy is the right of an individual to exercise control
over the collection, use, disclosure, and retention of his
or her personal information. Concerns over privacy can
spread wide, particularly as wireless systems can track
users’ actions, behavior, and on-going preferences [21,
22]. It makes the adoption of a ubiquitous healthcare or
childcare system deterred [23,24]. It has been stated,
however, that privacy problems are not caused by the
technology alone, but primary through activities of peo-
ple, busi ne sse s, and governme nts [25].
Several interesting surveys have already been con-
ducted. According to one study, using an iPod jacket as
the test item, the most important adoption factors are
convenience and compatibility, and the least important
are perceived social prestige and observability [26]. It
was mentioned, that this finding might not be intuitive,
considering that potential consumers of this kind of WE
are thought to be greatly influenced by external forces
such as peer pressure, trends, and perceived social pres-
tige. In a survey fo cusing on the activities and hab its that
people do at home, which they would not want to be re-
corded, the bedroom was found to be the most private
place [27]. The willingness of older adults to share health
or activity data with on e’s doctor or family members and
concerns about privacy or security of monitoring has also
been measured [28]. A high proportion (over 72%) of
participants reported acceptance of in-home and com-
puter monitoring and willingness to have data shared
with their doctor or family members. However, a major-
ity (60%) reported concerns related to privacy or security;
these concerns increased after one year of participation.
Findings suggest that involvement in this unobtrusive
in-home monitoring study may have raised awareness
about the potential privacy risks of technology. Elderly
individuals, who were still living independently, were
asked to discuss their perceptions and concerns towards
the likelihood of using a WSN-based healthcare system
in their home [29]. The findings in this study indicate
that independence is highly valued by elderly people and
hence any system or technology that can prolong that
independence tends to be highly regarded. Thus, for ex-
ample the privacy of WSN health data might not be as
important as typically considered. Also, according to the
participants in a similar study, the results suggested
strong acceptance of the concept of home health moni-
toring and the devices to make the system work [30]. In a
study, where opinions on individual privacy were col-
lected from China and Finland, the Internet of Things
applications related to personal health were the least
worrying ones among all applications [31]. It was stated,
that in healthcare, the most important th ing is that all the
vital information is available when needed. This work
shares some similar objects to the studies above. The
goal is to gather information on ordinary people’s thoughts
about WE in healthcare and childcare in Finland.
2. Interviews and Internet Forum Survey
2.1. Interviews
In this work, 24 Finnish people of different age were
interviewed (genders and ages of the answerers can be
seen in Table 1). The personal interviews were con-
ducted by an associate of the researcher, and they took
place either at the answerers working facility, home, or at
a neutral, public place. Some of the interviews were done
by private (e-)mails between the researcher and the an-
swerers. All these interviews thus had more flexibility
than only a paper survey as both the researcher and the
answerer were able to ask for clarification. In this study,
the individual privacy refers to the evolving relationship
between the technology and the legal right to, or public
expectation of, privacy in the collection and sharing of
data about one’s self. The interview had the following
questions and a chance for free comments.
1) Would you be willing to wear hospital clothes that.

J. VIRKKI, P. RAUMONEN 60
Table 1. Genders and ages of the interviewees.
female male
minimum age 29 28
average age 36 38
maximum age 52 61
number of interviewees 12 12
1A) Would allow wireless reading of your name and
patient number for those taking part into your care?
(Yes/No)
1B) In addition to wireless reading of your name and
patient number, would allow wireless reading of your
medical and medication records for those taking part into
your care? (Yes/No)
2) How worried would you be about your individual
privacy in situations 1A and 1B? (Scale = 1 - 5, where 1
= not worried at all, 5 = very worried)
3) Would you be willing to let your child wear cloth es
in kindergarten that.
3A) would allow the nurses to wirelessly read the
child’s name and kindergarten group? (Yes/No)
3B) In addition to the child’s name and kindergarten
group, would allow the nurses to wirelessly read other
information, such as age, allergies, legal guardian, or
contact information of guardians? (Yes/No)
4) How worr ied would you be abou t your child’s ind i-
vidual privacy in situations 3A and 3B? (Scale = 1 - 5,
where 1 = not worried at all, 5 = very worried)
2.2. Internet Forum Survey
The second part of this work was a survey of discussions
on different Internet forums. Discussions on WE were
started in May 2013, on 7 Finnish Internet forums, where
people are able to discuss anonymously. Three of the
forums were focused on discussions on parenthood and
children, two of the forums were science forums, one
was a forum concentrated on electronics, and one for
media and information technology. In the message start-
ing the discussion, the potential of WE in healthcare and
childcare was introdu ced an d thou ghts of such top ic were
asked. The goal was to collect a general idea of feelings
and highlight some of the presented thoughts.
3. Results and Discussion
3.1. Results from Interviews
The results (percentages for answers “yes” and “no”)
from the questions 1A, 1B, 3A, and 3B can be seen in
Table 2. The results for how worried would the inter-
viewees be about the individual privacy in these different
situations can be seen in Table 3 and Figure 1.
Table 2. The results (percentages for answers “yes” and
“no”) from the situations 1A, 1B, 3A, and 3B.
yes/no1A 1B 3A 3B
female (%)Yes 75
(N = 9)50 (N = 6) 83 (N = 10)8 (N = 1)
No
25
(N = 3)50 (N = 6) 17 (N = 2)92 (N = 11)
male (%) Yes 83
(N = 10) 33 (N = 4) 83 (N = 10)50 (N = 6)
No
17
(N = 2)67 (N = 8) 17 (N = 2)50 (N = 6)
all (%) Yes 79
(N = 19) 42 (N = 10) 83 (N = 20)29 (N = 7)
No
21
(N = 5)58 (N = 14) 17 (N = 4)71 (N = 17)
Table 3. The average values of results how worried would
the interviewees be about the individual privacy in situa-
tions 1A, 1B, 3A, and 3B, scale 1 - 5.
1A 1B 3A 3B
average value 2.25 3.38 1.67 3.42
Answe
r
Situation
1 2 3 4 5
10
15
64 433 6
6
66 68
1 2 4
5
0
15
20
Number of answers
10
00 24
1A 1B 3B3
A
Figure 1. The results how worried would the interviewees
be about the individual privacy in situations 1A, 1B, 3A,
and 3B, scale 1 - 5.
According to our results, 79% of the interviewees
would be willing to wear hospital clothes that would al-
low wireless reading of their name and patient number
(Situation 1A). If, in addition of wireless reading of the
name and patient number, the hospital clothes would
allow wireless reading of medical and medication records
(Situation 1B), only 42% would be willing to wear the
clothes. In free comments, WE in hospitals were mostly
considered useful, especially in hospitals with a lot of
patients and a great turnover, as such clothes may pre-
vent mix-ups of patients. However, it was strongly
pointed out that the use of this kind of clothes should be
voluntary or there would have to be a good reason for it.
It was specified that availability of medical records is
good but they cannot be available for inappropriate peo-
ple, not even for thos e working in that hospital.
As can be seen in Table 3, on scale 1 - 5, the average
values for the worry about individual privacy in situa-

J. VIRKKI, P. RAUMONEN 61
tions 1A and 1B were 2.25 and 3.38, respectively. Thus,
as natural, when more information on the user of the
clothes is available, the worry about the individual pri-
vacy is stronger. However, in neither situation, the worry
cannot be considered extremely strong (scale 1 - 5).
It is shown in Table 2, that 83% of the interviewees
would be willing to let their child wear clothes in kin-
dergarten that would allow the nurses to wirelessly read
the child’s name and kindergarten group (Situation 3A).
If, in addition to the ch ild’s name and kind ergarten group,
the clothes would allow the nurses to wirelessly read
other information, such as age, allergies, legal guardian,
contact information of guardians (Situation 3B), only
29% would be willing to let their child wear the clothes.
In situation 3B, there was a notable difference between
women and men; only 8% of the answers from women
were positive, compared to 50% fro m men. The suitabil-
ity of WE for children was questioned in many ways in
free comments. It was mentioned, that if children are able
to rip an electronic component from the clothes, they
may eat it, which may cause a serious danger. It was also
pointed out, that with children, it is essential that the
caregivers should know all children in person. Since this
is not always possible, this kind of wearable safety was
seen to be one ki nd of solut ion.
As can be seen in Table 3, on scale 1 - 5, the average
numbers for the worry about individual privacy in situa-
tions 3A and 3B were 1.67 and 3.42, respectively. Thus,
WE that allow the name and kindergarten group to be
wirelessly read were not found to be a threat for individ-
ual privacy of the child. There were no free comments
related to individual privacy of WE in kindergartens, but
according to the result 3.42 (on scale 1 - 5) from situation
3B, at least some worrying issues were considered when
more information was available for wireless reading.
Due to the small amount of the interviewees, this sur-
vey does not offer statistical data for conclusions. How-
ever, this paper gives a starting point for research on this
important topic by gathering different perspectives for
WE in healthcare and childcare. Future research will in-
volve significantly more answerers in order to achieve
more meaningful results.
3.2. Results from Internet Forum Survey
The first thing that was noticed when starting conversa-
tions on different Internet forums was that it is hard to
start conversation on WE, as the topic did not enjoy a
great interest. 2 of the 7 started conversations got no an-
swers at all. However, in 5 of them, interesting thoughts
were presented.
In most of the started conversations, the idea of using
WE in hospitals and kindergartens, as long as it is done
with the person’s own permission, was seen promising. It
was also brought up that such applications already exist;
particularly tracers for children were mentioned. On the
contrary, in one conversation it was stated that WE will
never become a part of everyday life. Reasons for this
were, e.g., the fact that people want to change clothes all
the time and all clothes would need to have the same
information stored in them. Also, it was stated that no
electronic component can monitor who actually eats the
delivered drugs. In addition, WE in healthcare were
found to be the sad future direction mainly because there
is not enough staff working in hospitals.
Also, the mixing of clothes (e.g. of patients in the
same room) must be prevented, as it was mentioned in
one conversation. This may also cause care in a kinder-
garten, where clothes get easily mixed-up. Thus, instead
of preventing mix-ups, WE could cause them. The ef-
fects of continuous washing and bending on electronics
were considered. This is reasonable, since the reliability
of wearable components, e.g. in hospitals, is essential.
It was also discussed that some people may not be
willing to wear clothes with electronics, as is currently
the case with safety wristbands. It was also pointed out
that clothes could be taken off. Thus, for example a
lockable band was considered to be more suitable if
monitoring is mandatory for some reason. In addition,
the problems with drawing the limits were mentioned; at
what point we can start to monitor a demented person
without him/her knowing and how young/old child can
decide if not to wear clothes with electronics. In one
conversation, the use of current electronic devices, e.g.
mobile phones, to be utilized in such healthcare applica-
tions was also considered. Current mobile devices al-
ready have many of the needed features. In many cases,
existing mobile devices could be used instead of WE.
4. Conclusions
Many innovative applications of WE have appeared re-
cently and expectations about the possibilities are great.
WE have an important application area in the healthcare
industry and also a great potential for applications in
kindergarten and primary school environments. This pa-
per offers information on ordinary people’s thoughts to
those developing wearable electronic applications and
those working with the individual privacy in the future
wireless world. It introduces a literature survey about th e
possibilities of WE in healthcare and childcare. In addi-
tion, 24 personal interviews and an Internet forum survey
were conducted about these applications in Finland .
According to the results, most of the people feel posi-
tive about clothes used for wireless identification pur-
poses. However, when more information is added which
can be wirelessly read, the feelings become more nega-
tive. In general, the use of WE in hospitals and kinder-

J. VIRKKI, P. RAUMONEN 62
gartens, as long as it is done with person’s own permis-
sion, was seen promising. Several important points to
consider were brought up in free comments and in the
Internet forum survey, e.g., related to the safety of chil-
dren, individual privacy of people, practical issues to
consider when embedding electronics to clothes, and usa-
bility of already existing mobile devices for such future
applications.
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