The appropriateness of secrets and lies
for socially intelligent tele-healthcare
William Green Abstract
Philips Research Europe, This position paper describes the Marie Curie project
Marie Curie Research Fellow, ‘Social Intelligence for Tele-health’ (SIFT) and the
Media Interaction Department, relevance to the CHI2008 Workshop ‘Secrets and Lies’.
High Tech Campus 34 (5.014), The SIFT project aims to support socially appropriate
5656 GE Eindhoven, (socially intelligent) tele-healthcare systems. All
The Netherlands healthcare systems with access to an individual’s
William.Green@Philips.com medical profile are subject to questions of ethics,
privacy and trust. When the consequence of a system
withholding medical information could be grave, one
must consider when and what information should be
maintained secret or passed on to healthcare
professionals, family and friends.
Appropriateness, social intelligence, socially intelligent,
interaction design, healthcare, home, secrets and lies.
ACM Classification Keywords
H.1.2. User/Machine Systems---Human Factors, J.3.
Life and medical sciences---Medical Information and
Copyright is held by the author/owner(s). Introduction
CHI 2008, April 5 – April 10, 2008, Florence, Italy A brief description of the relevant areas of research for
ACM 1-xxxxxxxxxxxxxxxxxx. the SIFT project and the Secrets and Lies Workshop are
Tele-healthcare Social intelligence
Tele-healthcare systems aim to support and maintain Attributes of an individual’s social ability can be
an individual’s independence by supplementing grouped under the term ‘social intelligence’. In its
healthcare with the provision of direct computer- broadest sense, this is an individual’s “ability to get
mediated human interaction in the home. Hitherto along with people in general” . However, social
tele-healthcare systems have focused on the medical intelligence has a mixed history within psychology with
model of healthcare. There have been three broad research neither concurring in the nature nor definition
beneficial applications for tele-healthcare systems for of social intelligence. Social intelligence is therefore an
older adults and people with chronic conditions, these ambiguous term. For example,  more recently
are: safety and security monitoring in the home, for described it as either, “the intelligence that an
example, fall detectors; monitoring of vital signs; and individual needs to effectively participate in society, or
information and support provided via telephone and the the intelligence that a society as a whole can exhibit.”
Recent research focusing on the former of the
With formal healthcare, the tele-healthcare systems differentiation by  suggests that an individual’s
facilitate computer-mediated interaction (CMI) between social intelligence required for human-human
a health professional (doctor, nurse, physiotherapist, interaction has multiple dimensions, i.e. social
psychologist, occupational therapist) and the service understanding, memory and knowledge . Not only
user. To improve people’s lifestyle and well being, is it difficult to measure these dimensions ordinarily,
Quality of Life (QoL) has increasingly become a focus but these dimensions are also situated in the nature of
for research. This research has found that health is not social interaction and the influence, dependence and
the only important factor to QoL. For example,  and the diversity of context and real life situations. 
 found that social relations, functional abilities and have suggested overcoming this difficulty by using real-
activities influence QoL as much as health. Family and life scenarios and new digital media.
friends are a major part of these social relations.
An attribute that could be incorporated within the
It is proposed that future tele-healthcare systems definition of social intelligence is an individual’s ability
support informal health care provision (family and to understand the appropriateness of deception and
friends) in addition to the formal, medical model of secrecy/self-disclosure. These traits are not widely
health to really improve people’s QoL. In addition, it is discussed in the social intelligence literature.
envisaged that tele-healthcare systems will be more Nonetheless, the difficulties of the methods used to
advanced than existing systems with perceptive and study deception and secrecy/self-disclosure are similar
reasoning capabilities. to those experienced by researchers seeking to
measure social intelligence.
Appropriate socially intelligent tele-healthcare interaction barriers and encourage individuals to share
There are many facts about an individual’s past and health related troubles. Nonetheless, when a tele-
present health condition that are private and healthcare system is supporting formal and informal
confidential. An individual may choose to maintain healthcare there is a clear requirement for the system
personal information as a secret from their friends, to be aware of social intelligent rules in relation to
family members or even spouse. The reasons for deception and secrecy/self-disclosure.
maintaining ones health a secret are numerous, and
may include masking age-related deteriorating health Research approach
in an effort to prolong independence and to ‘protect’ The SIFT research project aims to support socially
family and friends from the truth. In another appropriate (socially intelligent) interactive systems for
application, a draconian employer may utilize the user-system interaction, with the application of tele-
access of a home monitoring system to assess whether healthcare. Following field studies, a literature review
or not an employee really is ill. The employee on the and workshops, it is intended that a tele-healthcare
other hand may wish to use such a system to send fake system will be developed as a research tool to capture
health information if they are actually merely suffering and build upon the most important attributes of socially
from a ‘hangover’. One could argue that the intelligent tele-healthcare. These research methods
prevalence of ‘masking the truth’ with regard to health and challenges are identical to research projects with a
is evidence that it is a necessary human trait and more specific focus of deception and secrecy/self-
therefore an essential element for any tele-healthcare disclosure. It is envisaged that deception and
or similar system. It may then be an integral part of an secrecy/self-disclosure will form a part of the research
individual’s perceived self-efficacy . focus.
In the future, tele-healthcare systems for formal and Contribution to the workshop
informal care will facilitate computer-mediated When the CHI2008 workshop is held the research for
interaction (CMI) between an individual and health the SIFT project will have preliminary research findings.
professionals, their family and friends. Attributes of a The author hopes to discuss and suggest appropriate
tele-healthcare system could assist the diagnoses of methods for this research.
the well being of an individual. For example, a system
could understand the truthfulness of replies in Questions pertinent to the topic of this workshop
discourse between a health professional and a service include: When or is it appropriate for a tele-healthcare
user, or monitor activities of daily living (ADL’s), for system to share ordinarily overlooked, masked and
example a system could explicitly monitor an secret information with health professionals, family and
individual’s drinking habits and inexplicitly assess the friends? Should a tele-healthcare system facilitate the
amount of liquid entering the body in comparison to the wish of the service user, with potentially grave or
amount of liquid leaving the body (i.e. using the toilet). unhealthy consequences?
It may be that healthcare CMI will break down social
Acknowledgements  Gabriel, Z., & Bowling, A. N. N. Quality of life from
I would like to thank Boris de Ruyter and Peter Lutz for the perspectives of older people. Ageing & Society, 24
discussions within the SIFT project.
 Vernon, P.E. Some characteristics of the good
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