High Tech, High Touch: Integrating Digital and Human AAL

Advisory Services for Older Adults

Diotima Bertel

, Soraia Teles

2,3

, Flora Strohmeier

, Pedro Vieira-Marques

, Paul Schmitter

Stefan H. Ruscher

, Constança Paúl

2,3

and Andrea Ch. Kofler

SYNYO GmbH, Otto-Bauer-Gasse 5/14, 1060, Vienna, Austria

Institute of Biomedical Sciences Abel Salazar (ICBAS), Department of Behavioral Sciences, University of Porto,

Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal

Center for Health Technology and Services Research (CINTESIS), University of Porto,

Rua Dr. Plácido da Costa, 4200-450, Porto, Portugal

Zurich University of Applied Sciences, Reidbach 8820 Waedenswil, Zurich, Switzerland

{paul.schmitter, andrea.kofler}@zhaw.ch, paul@icbas.up.pt

Keywords: Engagement Platforms & Engagement Ecosystem, Digital and Human Advisors, Ambient Assisted Living

(AAL).

Abstract: While Ambient Assisted Living (AAL) solutions have conquered some market niches of service provisions

to the ageing society, those services are often still provided in isolation and in a technocentric way. In this

position paper, we build on the concepts of engagement ecosystems and engagement platforms to argue that

an integration of physical and virtual worlds is necessary for service provisions in the AAL field in general

and in advisory services in particular. We discuss the challenge on how to integrate virtual and physical

dimensions in a solution for stakeholders’ engagement. With a focus on the ‘human touch’, we conceptualize

Active Advisors, embedded in the scope of the EU-funded project ActiveAdvice. We state that the concept

of a human advisor is of utmost relevance in this field due to the digital divide still affecting older age groups.

Active Advisors help to overcome the shortage of most service and product platforms, i.e. lack of

personalization and interaction, and at the same time offer a face-to-face (f2f) experience in the consumer-

organization interactions.

1 INTRODUCTION

The fast advances in the field of Information and

Communication Technologies (ICT) have been

impelling changes in the interactions among

individuals and their environments. From a

consumer-company/organization interaction point of

view, the various touch points have evolved over time

and new technologies have been acting as great

enablers of service innovation (Breidbach and

Maglio, 2015). ICT allows consumers to expect and

receive more service, information and support than

ever before. The experience of new platform

technologies is significantly increasing consumers’

expectations and, at the same time, promoting

consumers’ empowerment. We are living in a new age

of consumer engagement, which can be defined as the

individual psychological state resulting from the

interactions between a focal engagement subject – the

consumer – and an object – the organization (Brodie

et al., 2011). Consumers also have demonstrated

willingness to become more active and engaged in the

value creation themselves. Consequently, there is a

demand for a transformation of this value creation in

the society in general, and in the organizations

providing product and/or services in particular. An

important market of service provision for the

contemporary ageing society has been opened for

Ambient Assisted Living (AAL) solutions, targeting

active and healthy ageing in the older adults’

preferred environment. It was previously noticed,

however, that services within this market have been

provided in isolation and often in a technocentric way

(Baldissera and Camarinha-Matos, 2016). Among

others, these factors are likely to contribute to the

current gap between technology development and its

uptake by end users.

Bertel, D., Teles, S., Strohmeier, F., Vieira-Marques, P., Schmitter, P., Ruscher, S., Paúl, C. and Koﬂer, A.

High Tech, High Touch: Integrating Digital and Human AAL Advisory Services for Older Adults.

DOI: 10.5220/0006799002410249

In Proceedings of the 4th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2018), pages 241-249

ISBN: 978-989-758-299-8

241

In this landscape, we start by pointing out that

organizations providing services in the AAL field

must predominantly act as enablers of engagement

platforms. Only in such capacities can they leverage

individuals’ and groups’ drive to create value for, but

mostly with them. For the implementation of these

engagement platforms, the technological

developments in the last 20 years have been

instrumental by allowing interactions among

stakeholders in virtual environments (Breidbach, et

al., 2014). However, nowadays we have rather

complex service logics to consider, as in most service

sectors the consumer journey is growing in

complexity (Peters et al., 2015). Currently, there are

also trends showing a certain shifting ‘back’ to the

physical, face-to-face (f2f) interaction, which oppose

the very dominant perception of existence of purely

virtual service landscapes, even with emerging good

examples (e.g. Google, Microsoft business cases)

(Breidbach et al., 2014). However, a real, seamless

merger of both physical and virtual worlds in the

service user journey may still be some way off.

Nevertheless, we build on Breidbach et al. (2014)

definition of engagement ecosystems, which

considers both physical and virtual focal actor touch

points, to argue that an integration of real/physical

and virtual worlds is necessary for service provision

in the AAL field. The challenge here, too, is how to

integrate both virtual and physical dimensions in an

optimal solution for stakeholders’ engagement.

Although of relevance for all kind of consumers

throughout a variety of different services, the

mentioned integration seems to assume particular

relevance when older adults are the target audience.

The digital divide still affects this population group

and a preference for f2f contact, usually perceived as

more trustworthy, continues to be shown by this age-

group (Teles et al., 2017). Still, even though often

treated as a homogeneous group, older adults are

heterogeneous with diverse needs and life contexts

raising the need for services that can be personalised.

In observing the ongoing present debates, two key

points of concern emerge: trust, and personalization

in service provision. We argue that the integration of

the two interaction interfaces (physical and virtual),

and of the mechanisms that allow the collaboration

between multiple stakeholders facilitate the trust

building and the degree as well as format of

personalization in service provision in the AAL field.

This paper discusses the challenges of integrating

the different interaction interfaces with respect to the

advisory in the AAL field and takes into

consideration a multi-stakeholder perspective. This is

done by building on the experience and reflexions

emerged in the scope of the EU-funded ActiveAdvice

project, which intends to set up a pan-European

advisory and decision-support platform that brings

together the broad range of available AAL products,

services and stakeholders. We take into consideration

a shift from a purely online interaction to an

integrated logic, in the scope of advisory services

targeted at stakeholders in the AAL ecosystem,

towards the promotion of services and products which

are, at best, context and situation-aware, pro-active,

and adaptive. In line with this, we will discuss the

concept of human advisors, so-called ‘Active

Advisors’, an idea born within the ActiveAdvice

project and reinforced by the insights from user-

centred requirement interviews conducted with

multiple stakeholders (ibid.). These advisors facilitate

the integration of the previously stressed different

interaction interfaces. We argue that, both, human

and digital advisory for older adults on AAL solutions

need to be integrated, as a mean to jointly improve the

user experience (e.g. in terms of trust and

personalization) and promote user empowerment.

Additionally, we reflect on what different kinds of

advice older adults need regarding AAL products and

services. By doing so, we seek to evaluate how advice

is going to be best provided, keeping in mind that we

discuss a field that is highly sensible to external

interference and is by definition individualized, as we

all consider ourselves being and living in unique

situations with very specific needs. We keep in mind

what has been said for other fields. So, e.g. for the

finance and investment domain, Roy (2016) posted:

“I believe digital tools can enhance the advisor-

investor relationship, not end it”. The author

summarizes that technology is not going to replace

the human advice, it will complement it. The next

chapters will discuss the concept as well as the

framework of engagement ecosystems and

engagement platforms. We attempt to answer the

questions of how an engagement ecosystem for AAL

can integrate digital and human advice, what features

need to be guaranteed when providing a service with

both digital and human advice to older adults, as well

as to formal/informal caregivers, governmental

bodies, local authorities and other relevant

stakeholders of the AAL ecosystem.

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2 ENGAGEMENT PLATFORMS

INTEGRATING VIRTUAL AND

REAL ENVIRONMENTS

Ramaswamy and Gouillart (2010) framed

engagement platforms in the virtual sphere as

purpose-built ICT-enabled environments. Breidbach

et al. (2014) proposed an expansion of Ramaswamy’s

definition for engagement platforms by describing:

“physical or virtual focal actor touch points, which

are designed to provide structural support for resource

integration, and that intend to ensure co-creation in

relation to a focal actor or object, in order to enhance

an actors’ [sic] ability to experience engagement with

such focal object” (p. 7). As exemplified by Blasco-

Arcas (2015), engagement platforms can have a

social focus namely in online brand communities

such as Harley-Davidson; or a socially driven

approach to transactions as illustrated by Amazon’s

and Nike’s social commerce platforms. The logical

question to ask, then, is: What features must a

platform have to be qualified as an engagement

platform? Ramaswamy and Gouillart (2010)

characterize engagement platforms through

transparency (visible interactions for a wider

audience), access (user opportunity to integrate

resources), dialogue (exchange of information) and

reflexivity (platform’s adaptability to changes). Other

definitions tend to share this view. Yet, there is

another question to be raised: If at all, to what extent

are the current service platforms in the AAL field

acting as engagement platforms? To kick-start the

discussion on this question, we carried out a search

for and analysis of websites/ portals/platforms that

promote assistive technologies and services for older

adults. In total, we analysed 42 articles along the

topics of (i) studies on AAL user information; (ii)

platforms (discussed & evaluated in

research/studies); (iii) user feedback and social

features; (iv) digital support algorithms; and (v)

authorization process (Kofler et al., 2016). In

addition, a sample of 12 service platforms

were

selected to be analysed in detail regarding stakeholder

involvement, interaction and feedback features. We

also looked into whether advice was provided to

customers and if so, how it was conducted (e.g.

personalization). We present key points on interaction

and personalization for compelling engagement

experiences.

Of the twelve service platforms under review, three were from

the USA, two from the UK, three from France (one including

The articles analysed illustrated that the

establishment of platforms in the context of

technology promotion for older adults is not a

priority. Less than one third dealt explicitly with the

development and establishment of platforms and

online information portals. None explicitly discussed

a meta-AAL platform, which would be integrating

services, products, and different stakeholders, nor is

there anything like an EU-wide AAL marketing

platform. These are, indeed, some of the gaps the

ActiveAdvice project aims to bridge. However,

among those platforms under review, the promotion

of ICT and/or home care products and services and

the sharing of information could be observed. The key

observation clearly is that most of the platforms target

older adults and their relatives, and thereby attempt to

simple link manufacturers with potential consumer. A

multi-stakeholder perspective is generally missing.

This is especially relevant in the context of AAL, as

such an approach, leading to more collaboration and

coordination among stakeholders, could help

addressing the current challenges on solutions uptake

by its primary end users (Teles et al., 2017).

Secondly, among the twelve platforms, only eight

guarantee immediate or direct feedback. They offer

neither personalised feedback and/or advice nor

interaction in the manner of e.g. a user forum. Thus,

it seems that the main features characterizing

engagement platforms are missing in many service

platforms targeting ICT and ageing well. With respect

to the building up of an engagement platform, we

argue that interactivity and stakeholder involvement

are the key elements to focus on. Guaranteeing

interactivity has, however, been proven to be

challenging, especially when developing a platform

that supports sharing of information, knowhow and

products, as well as building up networks of different

stakeholders. Yet, as previously demonstrated, more

and more people prefer to actively contribute rather

than to only consume information from others in the

online environment (Blasco-Arcas et al., 2016). This

was, indeed, one of the insights emerging from the

requirement interviews carried out within the

ActiveAdvice project, where consumers expressed

interest in becoming more active users as well as

commenters in online environments. The conclusions

presented here are based on 38 interviews carried out

across European Union member states with 12

consumers, 14 businesses and 12 government

representatives (Teles et al., 2017). The more

interactive platforms are, the more likely their users

Belgium), one from Australia, one from Canada and two had a

European scope.

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become providers of content “in the form of

evaluations, recommendations, opinions,

instructions, facts and experiences“ (Sheng and

Zolfagharian, 2014, p. 467). This kind of engagement

has also been proven to foster empowerment, as

consumers become aware of their roles and influences

(Blasco-Arcas et al., 2016). Thus, the psychological

attachment to an online community can be, indeed, a

strong driving force. Within a community, it is easier

to ask for information, seek advice or obtain feedback

(Kofler et al., 2016). From the consumer perspective,

these interactions are particularly relevant for

empowering them through learning from other

consumers’ experiences and choices. Consumer-to-

consumer (C2C) interaction facilitates the decision-

making process, as it can help diminishing the

overload of information and the effort needed to filter

it, therefore reducing uncertainty and complexity

(Miceli et al., 2007). It seems that advice in form of

contributions and reports by peers is a mean to

generally increase trust in online advice. Hence, in

this landscape, older adults and informal caregivers

themselves have the opportunity to become ‘advisors’

on AAL solutions through experience sharing, thus

upgrading their participation as content consumers to

content generators.

From the user studies conducted

for the ActiveAdvice project, we concluded that a

common expectation from consumers is obtaining

feedback about AAL solutions, preferably by other

end users, offering personal experiences with

products, services and the platform presenting the

solutions. Information on the person giving feedback

is also an important aspect, for evaluating reliability,

usefulness or trustworthiness (Teles et al., 2017).

In our view, within the scope of an ICT-enabled

environment, a platform must also provide multi-

stakeholders’ interaction, including mechanisms for

consumer-to-organization (C2O) and C2C

interaction. These provide stakeholders with the

opportunity to participate, to create content and to

connect, minimizing the drawbacks from lack of

physical engagement and generating more

“compelling engagement experiences” (Ramaswamy,

2009, p. 11; Montgomery and Smith, 2009).

Interaction among stakeholders, thus, is key to reduce

the risk perceived in decision making and, in general

terms, to foster trust in an online environment.

In summary, the platform analysis has shown that

personalised feedback and advice is not yet common.

We previously concluded that personalization is a key

requirement (Teles et al., 2017), and we can conclude

that it’s central for building up an engagement

platform. It enables, first, the consumer recognition

of her particular needs (Füller and Matzler, 2007);

and, if the online platform manages to provide

personalization mechanisms, it both facilitates the

decision-making process and allows consumers to

tailor-make the offer to their needs. We therefore also

need to emphasize ‘democratization’ in the value

creation as a key principle. Finally, multi-stakeholder

platforms facilitate the interaction, the transfer and

the empowering of actors.

3 USERS IN NEED FOR

SUPPORT: CHALLENGES OF

VIRTUAL AND REAL-LIFE

INTERACTION

As online platforms annul the typical f2f interaction,

the user’s acceptance has to be a priority concern of

developers and promoters. Second, what is possible

from a technological point of view and what is

assumed from the developer side must not necessarily

meet the individual user’s needs. Third, “(F)for a

service to be successful it must be provided under

consideration of these criteria: the right good (product

or service), in the right quantity and quality, at the

right time, and the right place for the right customer

at the right price” (Kriegel et al., 2013, p. 78). Overall,

online platforms only at a first glance ease the

interactions. Insights from the ActiveAdvice project

also put in evidence that, in spite of the fact that care

consultancy is more often sought to be found in the

virtual reality, the use of the internet is often reduced

to a first consultancy rather than an ongoing advice.

Indeed, customer engagement with a platform, on a

regular basis, is context dependent, which is of

importance to understand his/her first experiences

and expectations with a platform. Concerning older

adults, research has shown that a fear of losing social

interaction, thus aggravating loneliness, can be

connected to a minor adhesion to online platforms

(Damodaran and Olphert, 2010; Novitzky et al.,

2015; Olphert et al., 2009; Siegel et al., 2014; Teles

et al, 2017). It has been reported that if technologies

are seen as facilitators of new social interactions

rather than replacing mechanisms of human

interactions, this fear of losing social contact can be

at least minimized (Lewin et al., 2010).

Based on a comprehensive, user-centred view of

the constraints and facilitators for interactions in the

virtual worlds, we argue that older adults can benefit

from the integration of digital and human advice on

AAL solutions, as a system that can capitalize the

benefits of both advice formats. Concerning digital

advice, studies have supported, for example, the

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strong impact of virtual agents in the context of

online-shopping, in addressing age related

navigational needs (Rickel and Johnson, 2000).

Moreover, within the context of the ActiveAdvice

project, business representatives stressed the ‘neutral’

nature of digital advice mechanisms when it comes to

guiding a consumer towards the solution fitting

his/her needs. From a digital-human advisory

integration point of view, a first and already stressed

pragmatic argument relies on the fact that the digital

divide still is a well-known challenge affecting older

age groups, albeit in an unbalanced way across

European countries. Contributing factors are poor

ICT skills, fear of both the technology itself and the

learning process, and a lack of financial resources to

purchase devices and internet access (Doyle et al.,

2013; Finn and Wright, 2011; Lewin et al., 2010;

Marschollek et al., 2007; Sanders et al., 2012).

However, it is also accepted that, to a certain extent,

barriers associated with ICT skills will tend to

decrease in future generations (Reginatto, 2012). In

investigating two age cohorts, the digital natives (the

Millennials), and the digital immigrants (the Baby

Boomers), Bart et al. (2005, in Obal and Kunz, 2013,

p. 47) concluded that age is a critical dimension when

it comes to trust on online interactions. Millennials

value time saving, e.g. navigation enabling a quick

search of information, easy findings and shorter

response times. Baby Boomers prefer security of their

personal data. While Millennials appreciate

information about the product and the seller right on

the site, Baby Boomers don’t trust the sellers’

promotional materials and are more likely to look for

consumer feedback (ibid.). It can be expected that, in

a long run, platforms will become increasingly

important. Millennials in particular are used to

participate in virtual communities and in seeking

consultancy with virtual experts. Yet, as the focus of

AAL is on very specific needs, an AAL platform

always will have to assure the bridge between virtual

and real life. However, even if it is demonstrated that

e-services for older adults need to take the potential

impact of generational differences on online trust into

consideration, we want to argue that the ICT uptake

actually depends on the intersection of multiple

factors. These are related with both technology

features and users’ characteristics (e.g. age, gender,

physical or cognitive skills, expectations,

biographical experience) (Nedopil et al., 2013).

Again, we can find very different profiles and

preferences when it comes to service provision to

older adults in the virtual and physical words.

Here is a second argument: besides idiosyncrasies

regarding older adults’ preferences towards both

digital and physical worlds, growing old and being in

need of support is usually a rather local or regional

experience, even if projects generally are carried out

in an international atmosphere. Thus, an interactive,

highly flexible, approved and continuously updated

platform needs to take that into consideration. This is

to be able to support people with very specific needs

in their regional contexts, as well as to give them

access to an international community and knowledge

base. Such complex logic in an optimal service

provision to older adults is probably only achievable

by using the ‘human touch’. In fact, requirement

interviews for the ActiveAdvice project have shown

that in spite of stakeholders’ recognition of high value

of an online advisory platform, both consumers and

business representatives stated that getting advice

online still competes with the f2f experience. For

customers, it is perceived as more trustworthy, while

for companies it is seen as bedrock for consumers to

engage and build a relation with the company (Teles

et al., 2017).

A third argument summarizes what was stated

earlier: An integration of real and virtual

environments in engagement ecosystems enable C2C

interactions. The co-creation of value is thus

facilitated (Breidbach et al., 2014). This, so our fourth

argument, enhances user trust on the services

provided, both advice services or any others. Trust is,

indeed, one of the most critical user/consumer issues

(Cummins et al., 2014), and one of motives for

supporting investments in digital-physical integration

for service provision. In the digital sphere, consumers

need to trust the website, the communication and,

finally, if products are promoted on the website, in the

products themselves. In AAL, trust was shown as a

key attitudinal factor for solutions’ uptake (Olphert et

al., 2009). From the requirement interviews carried

out within the ActiveAdvice project, we drew similar

conclusions and found that trust is, according to the

stakeholders’ point of view, influenced by: the

communication strategy and web-layout; the

perception of neutrality regarding the information

provided and the individuals providing that

information; the perceived quality of that

information; the access to real users’ feedback; and

the perception that feedbacks are ‘fair’, i.e. not

exclusively guided by negative incentives (Teles et

al., 2017). Indeed, the presence of e.g. provider

advice, privacy cues and community features have a

high influence on trust in online platforms (Obal and

Kunz, 2013, p. 48). Overall, we need to take into

consideration that one obstacle for getting health

information online by older adults is the perception

that information available online has low quality, can

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245

be biased or misleading, is frequently not run

professionally, doesn’t include peer-reviewed

materials by independent actors, and the selection of

the most reliable and suitable information is

constrained by information overload on health issues

Marschollek et al. (2007). Moreover, data security

and data privacy, ethical and cultural issues as well as

market development and legal regulations are crucial

aspects that need to be considered to foment trust.

In summary, users are confronted with high

complexity, which they hardly know how to manage.

Therefore, knowing how to build-up trust and

identifying the drivers of online trust are key

responsibilities in service provision.

4 INTEGRATION OF HUMAN &

DIGITAL ADVICE – THE

ACTIVEADVICE APPROACH

The arguments exposed above strongly indicate that

a platform for AAL products and services cannot be

a stand-alone solution. Rather, it has to be part of an

integrated and systematic service logic, incorporating

both virtual and physical service logics and

promoting the integration of different actors with

different interests and contributions. As previously

outlined: “People – whether consumers or service

providers – are complex agents, with highly diverse

cognitive frameworks, values and attitudes, physical

and emotional needs (...) Service systems are thus

complex to model and manage – but they may also be

resilient and innovative. People can be empowered to

act in non-mechanical ways, responding to

unexpected circumstances and collaborating to solve

problems. They can be linked together in new ways

through new information technology” (Cardoso et al.,

2014, p. 417). In the scope of advisory services on

AAL solutions, we argue for the integration of digital

with human advice. In fact, within the ActiveAdvice

project we conceptualized the human advisor as an

assistant for users helping in informed decision-

making – a human addition to the ICT platform.

Active Advisors are then foreseen to assist

individuals in finding the right solution for their

problem or needs. They are trained and follow a five-

step procedure: (i) They listen to the need and

translate it into a search strategy that complements the

digital advisory component; (ii) they identify

solutions and suppliers and assess their pertinence;

(iii) they assist the individual in making the decision;

(iv) they follow-up on satisfaction and stimulate users

to provide a feedback on the platform; and (v) they

feed the platform with professional feedback or

testimonies.

This human advisor workflow was conceived as

being based on the following dimensions: (i)

Assessment of products and services: the product and

service database include a digital advice component

fed by user and expert feedback; (ii) Training:

offering basic as well as advanced training, covering

the use of the platform and the TAALXONOMY

(Leitner et al., 2015), up to the detailed level, for the

different target groups according to their needs.

Finally, the training should cover the decision-

making process and how to enhance the quality of

decisions, as well as how to create a human network

around the digital community of the platform; (iii)

Code of conduct: using a co-designed code of conduct

as a mean to control and manage the quality of the

interaction between offer and demand, i.e. neutrality,

the compliance with minimum ethical standards,

knowledge of the ActiveAdvice platform (achieved

by following a training), acceptance to follow the

code of conduct including the recording and handling

of complaints, knowledge of the local situation (for

the advisors who include this dimension in their

service); (iv) Quality control, which will ideally be

based on two systems: a user feedback on the

platform, including scoring, and the possibility to

leave comments.

The code of conduct and training are the two

central elements of the accreditation of advisors.

Even when the Active Advisors’ role and workflows

are globally well defined, we consider to be crucial to

discuss who actually should provide advice to

consumers. Here again, trust, as well as the

integration of a multi-stakeholder perspective, are

considered main challenges. Interviews with multiple

stakeholders, when doing the requirements analysis,

brought some interesting inputs. First, the need of

neutrality of the Active Advisor is a shared concern

by older adults and their caregivers, business and

government representatives alike. However, for

business actors, a paradoxical position emerged:

while advice is perceived as being best given by those

who sell a product, it can lead to disruptions in the

neutrality condition though. Therefore, the solution

could be the establishment of older adult panels to test

products and services as well as the platform itself.

Similarly, volunteers could act as advisors on the

platform. Still, because of the complexity and the

many open questions related to human advice and its

importance for older adults, and due to the fact that

different advisor profiles are probable to emerge in

different local realities, the project is being used to

test various profiles. These could include among

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others e.g. care professionals involved in the process

of assisting older adults and interested in applying

AAL technologies and services; architects with an

interest in adapting houses for special needs;

individuals from all age groups who act as volunteers

to assist their peers in living longer at home; public

administration services in charge of assisting citizens

in adapting their house or promoting active lifestyles;

and, lastly, suppliers of solutions, including retailers

(e.g. alarm systems, hearing aid) who might become

Active Advisors as an advanced service for their

customers.

5 CONCLUSIONS

In the AAL field, engagement platforms not only

would promote AAL products and services but also

empower stakeholders and facilitate the co-creation

of value. Current service platforms promoting AAL

technologies and supply for older adult health care

services lack in most parts to provide either

personalization and/or interaction opportunities

among stakeholders – including C2O and C2C

interaction –, which we consider a strong requirement

for engagement platforms. Moreover, by considering

the complexity characterizing service logics

nowadays, we argue that an engagement ecosystem

for AAL, particularly focusing on advice for AAL

solutions, must integrate both digital and human

advice and physical and virtual engagement

platforms.

Furthermore, we see the shift from a purely online

to an integrated logic as a path to enhance

stakeholders’ trust in advisory services, as well as to

offer those AAL products and services which are at

best suited to the individual context and situation.

With a focus on the ‘human touch’, we

conceptualized the Active Advisors as human agents

providing assistance to users of the ActiveAdvice

platform, in getting familiar with AAL products and

services as well as in becoming part of a respective

AAL online community. Those actors are of utmost

importance due to a lack of personalized information,

noticed when dealing with AAL products and/or

services, and are fundamental for the creation of an

engagement ecosystem. They answer to stakeholders’

preferences for f2f contact, substantiated by the

human interaction role in establishing trusty

consumer-organization relationships. In this

equation, trained and independent human advisors are

required to safeguard trust in advisory services.

Another important issue to take into consideration

is: Are human advisors also capable to reduce the

technology aversion and rejection? The latter is often

linked to the lower experience older adults might

have with technology but also with the idea of

technology substituting human interaction. In linking

technology promoted via an online platform with

human advisory, we in a way oppose the frequently

associated isolation and loneliness fear of older

adults. Human advisors can help to overcome these

fears, can encourage older adults to participate in

digital communities, also with the intent of

minimizing the digital divide, which is still affecting

this age-group. In order to be an adequate

complement to digital advice, those human advisors

will always have to consider the heterogeneous

profiles of older adults. Hence, different requirements

have to be covered in the conceptual approach by

defining tasks, which are adopted by the Active

Advisors, such as the translation of needs into a

search strategy, identification of solutions, decision

support and follow up as well as feedback after the

purchase. Active Advisors must be able to promote

stakeholder involvement, interactivity and trust. In

addition, it definitely is required to define Active

Advisors profiles. For each profile, e.g. for an

architect giving advice or volunteers offering their

help, an understanding of roles, responsibilities and

communication logics need to be further established.

Overall, when it comes to the development of an

integrated system for advice on AAL, we recommend

the promotion of engagement ecosystems where

multiple stakeholders’ profiles evolve together.

Moreover, we favour a symbiotic approach

combining human and digital advisory allowing for

personalised guidance and reduced complexity in

search operations. Feedback and evaluation

mechanisms are a must-have in order to create social

awareness and a sense of community regarding C2O

and C2C interactions. The potentials of human advice

for online engagement platforms on AAL products

and services are, indeed, to be explored and we take

into account different national, if not to say, regional

specifics.

ACKNOWLEDGEMENTS

The authors would like to acknowledge the co-

financing by the European Commission AAL Joint

Programme and the related national agencies in

Austria, Belgium, the Netherlands, Portugal,

Switzerland and the United Kingdom.

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247

REFERENCES

Baldissera, T.A., Camarinha-Matos, L.M., 2016. Towards

a Collaborative Business Ecosystem for Elderly Care.

In: Camarinha-Matos L.M., Falcão A.J., Vafaei N.,

Najdi S. (eds), Technological Innovation for Cyber-

Physical Systems. DoCEIS 2016. IFIP Advances in

Information and Communication Technology, 470.

Springer.

Blasco-Arcas, L., Blasco-Arcas, L., Hernandez-Ortega, B.

I., Hernandez-Ortega, B. I., Jimenez-Martinez, J.,

Jimenez-Martinez, J., 2016. Engagement platforms:

The role of emotions in fostering customer engagement

and brand image in interactive media. Journal of

Service Theory and Practice, 26(5), 559–589.

Breidbach, C.F., Maglio, P.P., 2015. A Service Science

Perspective on the Role of ICT in Service Innovation.

ECIS.

Breidbach, Ch. F., Brodie, R., Hollebeek, l., 2014. Beyond

virtuality: from engagement platforms to engagement

ecosystems. Managing Service Quality, 24(6), 592–

611.

Brodie, R.J., Hollebeek, L.D. Jurić, B., Ilić, A., 2011,

Customer Engagement: Conceptual Domain,

Fundamental Propositions and Implications for

Research. Journal of Service Research, 14(3), 252–271

Cardoso, C., Llerena Rodriguez, Y., Grade, M., Augusto,

F., Queiros, A., Quintas J., Pacheco Rocha, N., 2014.

Platform to Support the Development of Information

Services for Informal and Formal Care. Proceedings of

the International Conference on Health Informatics,

417–421.

Cummins, Sh., Peltier, J., Schibrowsky, J., Nill, A., 2014.

Consumer behavior in the online context. Journal of

Research in Interactive Marketing, 8(3), 169–202.

Damodaran, L., Olphert, W., 2010. User Responses to

Assisted Living Technologies (ALTs) – A Review of

the Literature. Journal of Integrated Care, 18(2), 25–

32. doi:10.5042/jic.2010.0133

Doyle, J., Bailey, C., Ni Scanaill, C., van den Berg, F., 2013.

Lessons learned in deploying independent living

technologies to older adults’ homes. Universal Access in

the Information Society. doi:10.1007/s10209-013- 0308-

Finn, R.L., Wright, D., 2011. Mechanisms for stakeholder

coordination in ICT and ageing. Journal of Information,

Communication and Ethics in Society, 9(4), 265–286.

doi:10.1108/14779961111191066

Füller, J., Matzler, K., 2007. Virtual product experience and

customer participation – a chance for customer-centred,

really new products. Technovation, 27(6-7), 378–387.

Kofler, A.Ch., Awuku-Sao, G., Schmitter, P., 2016.

Baseline report on AAL advice, decision and

authorization. D2.1, ActiveAdvice AAL Programme

Project No. 851908.

Kriegel, J., Schmitt-Rüth, S., Güntert, B., Mallory, P. 2013.

New service development in German and Austrian

health care – bringing e-health services into the market.

International Journal of Healthcare Management, 6(2),

77–86. doi:10.1179/2047971913y.0000000034

Leitner, P., Neuschmid, J., Ruscher, S., Kofler, M., Ates,

N., Vigl, S., Decarli, P., 2015. TAALXONOMY.

Entwicklung einer praktikablen Taxonomie zur

effektiven Klassifizierung von AAL-Produkten und

Dienstleitungen. Studienbericht.

Lewin, D., Adshead, S., Glennon, B., Williamson, B.,

Moore, T., Damodaran, L., Hansell, P., 2010. Assisted

living technologies for older and disabled people in

2030. Annexes to a draft final report to Ofcom. Plum

Consulting, London. Retrieved from: https://www

.ofcom.org.uk/__data/assets/pdf_file/0033/44889/assis

tedannexes.pdf

Marschollek, M., Mix, S., Wolf, K.-H., Effertz, B., Haux,

R., Steinhagen-Thiessen, E., 2007. ICT-based health

information services for elderly people: Past

experiences, current trends, and future strategies.

Medical Informatics and the Internet in Medicine,

32(4), 251–261. doi:10.1080/14639230701692736

Miceli, G., Ricotta, F., Costabile, M., 2007. Customizing

customization: a conceptual framework for interactive

personalization. Journal of Interactive Marketing,

21(2), 6–25.

Montgomery, A.L., Smith, M.D., 2009. Prospects for

Personalization on the Internet. Journal of Interactive

Marketing, 23(2), 130–137.

Nedopil, C., Schauber, C., Glende I., 2013. AAL

stakeholders and their requirement. Report by the

Ambient and Assisted Living Association.

Novitzky, P., Smeaton, A.F., Chen, C., Irving, K.,

Jacquemard, T., O’Brolcháin, F., Gordijn, B., 2015. A

Review of Contemporary Work on the Ethics of

Ambient Assisted Living Technologies for People with

Dementia. Science and Engineering Ethics, 21(3), 707–

765. doi:10.1007/s11948-014-9552-x

Obal, M., Kunz, W., 2013. Trust development in e-services:

a cohort analysis of Millennials and Baby Boomers.

Journal of Service Management, 24(1), 45–63.

Olphert, W., Damodaran, L., Balatsoukas, P., Parkinson,

C., 2009. Process requirements for building sustainable

digital assistive technology for older people. Journal of

Assistive Technologies, 3(3), 4–13

Peters, Ch., Blohm, I., Leimeister, J.M., 2015. Anatomy of

Successful Business Models for Complex Services:

Insights from the Telemedicine Field. Journal of

Management Information Systems, 32(3), 75–104.

Ramaswamy, V., 2009. Co-creation of value: towards an

expanded paradigm of value creation. Marketing

Review St Gallen, 26(6), 11–17.

Ramaswamy, V., Gouillart, F., 2010. Building the co-

creative enterprise. Harvard business review, 88(10),

100–109.

Reginatto B.M.B., 2012. Understanding barriers to wider

telehealth adoption in the home environment of older

people: An exploratory study in the Irish context.

Journal of Advanced Life Science, 4(3,4), 63–76.

Rickel, J., Johnson, W.L., 2000. Task-oriented

collaboration with embodied agents in virtual worlds.

In: Cassell, J., Cassell, J., Sullivan, J., Prevost, S.,

Churchill, E.F. (Eds.), Embodied Conversational

Agents, MIT Press, Boston, 95–122.

ICT4AWE 2018 - 4th International Conference on Information and Communication Technologies for Ageing Well and e-Health

248

Roy, S., 2016. Will technology eventually replace human

financial advisors? Retrieved from: https://www

.blog.invesco.us.com/will-robo-advisor-replace-

human-financial-advisors/

Sheng, X., Zolfagharian, M., 2014. Consumer participation

in online product recommendation services:

augmenting the technology acceptance model. Journal

of Services Marketing, 28(6), 460–470.

Sanders, C., Rogers, A., Bowen, R., Bower, P., Hirani, S.,

Cartwright, M., Newman, S.P., 2012. Exploring

barriers to participation and adoption of telehealth and

telecare within the Whole System Demonstrator trial: a

qualitative study. BMC Health Services Research,

12(1). doi:10.1186/1472-6963-12-220

Siegel, C., Hochgatterer, A., Dorner, T.E., 2014.

Contributions of ambient assisted living for health and

quality of life in the elderly and care services – a

qualitative analysis from the experts’ perspective of

care service professionals. BMC Geriatrics, 14(1).

doi:10.1186/1471-2318-14-112

Teles, S., Bertel, D., Kofler, A. Ch., Ruscher S.H., Paúl, C.,

2017. A Multi-Perspective View on AAL Stakeholders’

Needs. A User-centred Requirement Analysis for the

ActiveAdvice European Project. 2017 International

Conference on Information and Communication

Technologies for Ageing Well and e-Health

(ICT4AWE).

High Tech, High Touch: Integrating Digital and Human AAL Advisory Services for Older Adults

249