a record allows for improved access to patient data at the point where clinical decisions are made (Institute of Medicine, 1997). In addition, telemedicine has demonstrated effectiveness in certain settings, including pulmonary clinics and intensive care units (Pacht et al., 1998; Rosenfeld et al., 2000; Shafazand et al., 2000); home telemonitoring has been shown to be successful as well (Finkelstein et al., 2000; Johnston et al., 2000; Rogers et al., 2001; Shea et al., 2002; Whitlock et al., 2000).

Patient Support

Patient education has demonstrated significant effectiveness in improving control of chronic illnesses (Weingarten et al., 2002). Computer-based patient education in particular has been found to be successful in primary care (Balas et al., 1996). In a 1997 study of 22 clinical trials, interactive educational interventions showed positive results for several major clinical applications, the most frequently targeted of these being diabetes (Krishna et al., 1997). Additionally, as noted earlier, several studies have demonstrated the feasibility of home monitoring by patients (Finkelstein et al., 2000; Johnston et al., 2000; Rogers et al., 2001; Whitlock et al., 2000). In a recent study, for instance, spirometry self-testing by asthma patients during home telemonitoring was found to provide valid results comparable to those of tests collected under the supervision of a clinician (Finkelstein et al., 2000). A multidimensional telehealth system has also demonstrated the ability to decrease stress for some caregivers of patients with Alzheimer’s disease (Bass et al., 1998).

Administrative Processes

Electronic scheduling systems for hospital admissions, inpatient and outpatient procedures, and visits not only increase the efficiency of heath care organizations, but also provide better, more timely service to patients (Everett, 2002; Hancock and Walter, 1986; Woods, 2001). Use of communication and content standards is equally important in the billing and claims management area—close coupling of authorization and prior approvals can, in some cases, eliminate delays and confusion. Additionally, immediate validation of insurance eligibility should add value for both providers and patients through improved access to services, more timely payments and less paperwork.

Moreover, computerized decision support tools are being used in a variety of settings to identify eligible or potentially eligible patients for clinical



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