Concerns and trade-offs: Balancing privacy and safety in sensor-based monitoring of older people living at home

Introduction: Sensor technologies are anticipated to become an essential factor in the development of healthcare technologies (Lambert et al. 2005). This development is causing a major shift in society that, in turn, presents people with new challenges and possibilities. On the one hand, it is improving mental health outcomes, reducing treatment failures by identifying persons at risk of deterioration and providing timely feedback to clinicians so that they may take effective action (Lambert et al. 2005), and allowing elderly people to age in place. However, on the other hand, it imposes a heavy burden (Grøn et al. 2008) and shared participation in treatment (Strauss et al. 1985), along with a sense of responsibility on home patients, their relatives and care providers (Strauss et al. 1982). This may lead to conflicting concerns regarding the quality of care, management of illnesses (Lambert et al. 2005), and information privacy (Malhotra et al. 2004).
Objectives: The focus of this study is on the balance between opportunities and challenges within monitoring technology and information privacy, with more weight given to concerns and the trade-off between privacy and safety.
Methods: 21 semi-structured interviews conducted with 21 elderly people with an age range of [74-94] and who have been monitored 24/7 for 10 weeks.
Results: Participants are willing to accept monitoring and provide personal information, but only under certain conditions. They will disclose their personal information if the benefits outweigh the risks that threaten their health and independence. Furthermore, participants indicated that they will accept monitoring so long as it does not impose a heavy burden on them. Participants’ responses to questions regarding sharing health data with caregivers were very positive. The utility of monitoring in ensuring safety and independence was seen as the most important value of monitoring. Participants indicated that monitoring can be a supportive tool for caregivers to follow patients’ health conditions, that it reduces unnecessary control visits, and that the monitored data can be used as a supplement during face-to-face consultations.
Conclusion: A sense of autonomy is an important factor. So long as participants could maintain a sense of self-control and had feelings of increased security, they were willing to accept monitoring as a trade-off against reduced privacy. Concerns caused by monitoring such as loss of privacy can be justified by a need for the technology derived from safety concerns related to individual health.