se technologies to address real world problems. For example, research shows that substituting interactive video sessions for up to half of a visiting nurse's in-home meetings with postsurgical or chronically ill patients can be a cost effective way to provide care. "Video visits are not a complete substitute for in-home nursing care," says Kathryn Dansky, a Penn State University associate professor of health policy and administration. "You are always going to need home visits because patients benefit from the personal touch." Still, a recent study led by Dansky found that, over a typical 60 days of care, savings of $300 per patient could be achieved by substituting video visits for seven in-home visits and $700 per patient was saved if half of the visits were made via advanced communication technology. "As the number of nursing visits increase, you can substitute more and more video visits if the purpose is to monitor the patient's health status," says Dansky. "Substituting an equal number of video and home visits can produce a major difference in the cost of the care." The sources of savings include less travel time and travel costs, fewer travel accidents, less car theft, and the ability to see more patients in the same amount of time. Skilled nursing care in the home requires a registered nurse to drive to the patient's residence, conduct examinations and assessments, provide patient care and education, and then drive to the next patient's house. The process is time consuming, dangerous at times for the nurse, and expensive. To see whether new technology could help both patients and nurses without incur- ring additional costs, the researchers initiated a 24-month evaluation of the use of telecom as a supplement to skilled nursing visits for people with dia- betes. Called the TeleHomecare Project, the effort was a partnership of Penn State, American Telecare Inc., and the Visiting Nurses Association of Greater Philadelphia (VNAGP), a large, urban, home health agency. ON THE MENU-TELECOM SERVICES A group of 171 