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Computer services to patients' homes through their telephones. Application to other disease management efforts.

One way of reducing cost of care and improving quality is through case management. But case management is time consuming. A good example of how case management can improve health of patients and how much time it takes is the recent work of Debusk et al.1 In this study, a nurse called patients and followed specific computer-generated protocols to interact and advise the patients. The intervention included protocols for smoking cessation, nutrition counseling, medication adjustment, and exercise training. This intervention was found to improve the health status of patients with myocardial infarctions at five health maintenance organizations. For each