The long term goal of the proposed project by Smart Activities of Daily Living, LLC (Smart ADLs) is to develop a device (the Smart Cup) that will improve the health of older adults by managing nutrition using smart health technology. Malnutrition (under nutrition) is a common geriatric syndrome found in older adults across the care continuum. Older adults accounted for 34 percent of the 39 million hospital discharges in 2010 with 56 percent readmitted within one year. Malnutrition is associated with adverse health outcomes that increase the cost of care, including hospital readmissions and institutionalization. Oral liquid nutrition supplements (ONS) are used to treat malnutrition. However, their effectiveness is limited by the difficulty in accurately determining individual consumption. The only way to currently measure and document ONS intake is to record the amount (in cc) of liquid provided, and the amount discarded at the end of a treatment period. This is highly unreliable when relying on self-report, and is time-consuming and labor-intensive if nurse-recorded. As a result, clinicians managing nutrition in vulnerable individuals are left with unreliable nutritiona intake data, making the evaluation of interventions and further adjustments to the treatment plan ineffective and difficult. There is an unmet need for a technology to unobtrusively record and monitor dietary intake of ONS to improve nutrition status in vulnerable adults. The founders of Smart ADLs have manufactured a Smart Cup prototype to meet such a need. The Smart Cup combines sensors, wireless data handling, and analysis technologies (the cost of which have decreased sufficiently in recent years to facilitate commercial development) enabling continuous, real-time monitoring of liquid intake. When integrated into a clinical (institutional o at-home) management plan, the Smart Cup has the potential to impact outcomes for nutritionally-vulnerable older adults by documenting consumption of prescribed ONS, and alerting users (patients) and/or caregivers, triggering alternative treatment recommendations if necessary. In this Phase I STTR project, the robustness and usability of the Smart Cup will be tested and validated in proof-of-feasibility field tests in nutritionally at risk hospitalized olde adults and clinicians. Health, function, and quality of life are important Healthy People 2020 goals for older adults, for which healthy nutrition plays a vital role. This project is significant because it responds to a call for healthcare reform from reactive models to preventive models made possible by integrating e-health (electronic communication and information technology) and m-health (mobile and wireless devices to improve health).