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In this paper we describe the development of a novel markerless motion capture system and explore its use in documenting elder exercise routines in a health club. This system uses image contour tracking and swarm intelligence methods to track the location of the spine and shoulders during three exercises - treadmill, exercise bike, and overhead lateral pull-down. Validation results show that our method has a mean error of approximately 2 degrees when measuring the angle of the spine or shoulders relative to the horizontal. Qualitative study results demonstrate that our system is capable of providing important feedback about the posture and stability of elders while they are performing exercises. Study participants indicated that feedback from our system would add value to their exercise routines.

In healthcare, IT Sophistication has been defined as the diversity and maturity of information system hardware and software that support clinical services. Clinical services relevant to this study include resident care management, clinical support and administrative activities in nursing homes. An IT sophistication survey previously validated in acute care settings and adapted for nursing homes was used to develop a state profile of Missouri nursing homes. The IT survey was disseminated via paper and electronic methods as chosen by a selected responder that had IT oversight and knowledge of IT stakeholders. A census of 199 respondents completed the survey, representing a 41% (199/491) response rate. Findings support recent literature indicating a higher percentage of nursing homes are still using technology for administrative purposes; however, there is growing recognition that technologies with greater functionality, is used more extensively for electronic and automated transfer of resident care information.

Clinical information systems are absent in most nursing homes. Therefore, the vast numbers of elderly people who reside in the facilities are not reaping the benefits that these systems are thought to have, including better management of chronic conditions, greater efficiencies, and improved access to information. It is important for early adopters of nursing home information systems to share experiences to foster implementation of other systems and improve design and evaluation of these systems. The purpose of this study is to describe the activity of clinical decision support alerts and associated triggers during an analysis of an information system implemented in three nursing homes. The proportion of triggers used for each active alert in each alert category is described across resident diagnoses within the nursing home decision support system during six months of data collection.

When monitoring elders' daily routines, it is desirable to track significant deviations from a baseline pattern, as consecutive, aberrant days may foreshadow a need for medical attention. However, many traditional, unsupervised methods for pattern classification are ill-suited for this task, as they are incapable for adapting to additive datasets. To surmount this shortcoming, we establish a framework for recognizing temporal trends in feature data extracted from passive sensors.

Few computerized systems have been implemented and evaluated in nursing home systems. The purpose of this descriptive study is twofold: 1) assess the frequency of active alerts occurring in two nursing homes implementing an electronic health record (EHR) with a clinical decision support system; and 2) determine if clinical responses of health care workers are different when a clinical alert is active versus not active. A secondary analysis of de-identified data was performed to derive conclusions about use of alerts to monitor residents' skin conditions in the nursing homes. The percentage of residents who had active skin integrity alerts ranged from 8% to 52%. A total of 118 alerts were analyzed from 59 residents in the analysis of documented clinical responsiveness. No significant difference was found in clinical documentation for responses when alerts were active versus when alerts were not active (N=59, p=1.00).

This article presents qualitative results collected 6 months after implementation of a clinical information system in four nursing homes in the Midwestern USA. Researchers explored initial implementation strategies, discussed employee experiences and analyzed employee satisfaction. Transcript-based analysis and axial coding were completed to illustrate recurring phenomena. Common attributes were identified by two gerontological nurse experts and a researcher with human factors expertise. Common themes emerging from 22 focus groups and direct observation of more than 120 nursing home staff were perception and cognition, change, workable systems, competence, and connectedness. Implementation strategies associated with lower satisfaction were availability of equipment, training resources, and the presence of information technology professionals. Initial clinical information system implementation strategies and employee satisfaction could be enhanced by the inclusion of a system life cycle charter plan, emphasizing change management procedures, improving start-up projections, hiring adequately trained information technology staff, and providing a system support plan. Findings will be useful to administrators and policy makers who are contemplating implementation of a clinical information system.

The development of nursing knowledge should give structure and form to the practice of nursing. The development of Nursing Process Theory resulted from early nursing observations and inferences from nursing practice that resulted in formal data accumulation processes, mutual correspondence between nurses and patients, and exchange of information. The development of the nursing process discipline helped to substantiate the need for professional nursing services. The shifts towards examining the links between processes and outcomes, professional accountability, and classification of distinct nursing functions have influenced the development of information systems. The Nurse-Patient Trajectory Framework described in this paper may be used to show the relationships between the virtual information system and the real world that it affects. The framework is visualized along two separate and distinct nurse and patient trajectories.

Building on work within public administration research, five categories of quality indicators are proposed for evaluating World Wide Web (web) sites belonging to state health professional agencies and associations. The five measures include: transparency, transactions, connectivity, personalization and usability. This project describes the construction of each quality indicator index and a calculation of quality scores. This project applies these methods to state Boards of Nursing and nursing association websites.