Real-Time Communication Infrastructure for Mixed Reality in Home Care: A Comparative Case Report of Three Approaches

Abstract

Background: Europe's ageing society faces a growing gap in long-term care (LTC) resources. The Care about Care project developed a Remote Care Assist (RCA) system to support LTC staff. Objectives: The project aimed to develop and evaluate a robust, mixed-reality-capable communication infrastructure for home care workers. This case report (a) details requirements for a communications infrastructure, (b) examines challenges in field testing, and (c) describes the transition to an alternative approach. It also provides a glimpse into a new solution used in a follow-up project. Methods: User requirements were gathered through co-creation workshops across three countries. Technical requirements focused on modularity, security, integration, and cross-platform usability. The initial implementation used Asterisk and was tested with ~300 participants. Results: The field test revealed persistent video quality issues with Asterisk, attributed to its WebRTC implementation. A switch to Kamailio resolved these issues, improving video quality but sacrificing group call capabilities. Conclusion: Pre-testing is limited, highlighting the necessity of field testing. Emerging frameworks like LiveKit could be an alternative for follow-up projects.