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Although researchers have developed robust approaches for estimating, location, and user identity, estimating user activities has proven much more challenging. Human activities are so complex and dynamic that it's often unclear what information is even relevant for modeling activities. Robust approaches to recognize user activities requires identifying the relevant information to be sensed and the appropriate sensing technologies. In our effort to develop an approach for automatically estimating hospital-staff activities, we trained a discrete hidden Markov model (HMM) to map contextual information to a user activity. We trained the model and evaluated it using data captured from almost 200 hours of detailed observation and documentation of hospital workers. In this article, we discuss our approach, the results, and how activity recognition could empower our vision of the hospital as a smart environment.