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We describe a distributed falls management system capable of real-time falls detection in an unsupervised living context and remote longitudinal tracking of falls risk parameters using a waist-mounted triaxial accelerometer. A self-administrable falls risk assessment is used to facilitate falls prevention. A web-interface allows clinicians to monitor the status of individuals and track their compliance with exercise interventions. Early identification of increased falls risk allows targeted interventions to be promptly administered. Real-time detection of falls allows immediate emergency response protocols to be deployed, reducing morbidity and increasing the independence of the community-dwelling elderly community.

In response to an extended user needs analysis, a home telecare system designed for the management of patients with chronic disease was adapted for use in residential aged care facilities (RACFs). The system architecture and hardware and software components are described for both the client- and server-side. The client-side includes medication dispensing, scheduled clinical measurements and questionnaire delivery. The server-side supports Web-based administrative tools for scheduling and medications management, as well as automated reporting functions. A brief discussion on a trial of the system in five different RACFs focuses on how clinical information technology can support and improve care standards and deliver better health outcomes for residents in Australian aged care homes.

This study assessed the management of delirium in the Acute Care of the Elderly unit (ACE) at a tertiary referral hospital as a case study of the application of clinical governance principles. The environment was found to be supportive of ongoing clinical governance activities, both in clinical organisation of work processes and orientation of management. However, patient involvement, dissemination and use of clinical pathways, performance measurement and feedback, and maintaining stability of care are areas requiring further development. Although there is a clinical governance strategy in place at the policy level, this has not always filtered through to the level of clinical work.