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Competing interests: None. Ethics approval: This study was approved by the Institutional Review Board at Washington University. Provenance and peer review: [http://www.selleckchem.com/products/gsk1120212-jtp-74057.html GSK1120212 clinical trial] Not commissioned; externally peer reviewed. Data sharing statement: No additional are data available.Self-management support and patient education are core components of best-practice care for many conditions. Engaging people in keeping healthy and supported self-management are two of the eight priorities set out by The Kings Fund to transform individual involvement in health and care.1 However, interventions to support self-management often fail to show significant improvements in care.2 Indeed, after a pragmatic intervention failed to achieve significantly positive results due to lack of adoption of self-management resources into routine care, Kennedy et al3 suggested that ��effective interventions are often not feasible and feasible interventions are often not effective.�� This indicates that for new service delivery models to be effective, they have to be easy for primary care teams to adopt and create minimal change in practice workload and ideally, a net reduction. Mobile technology was suggested as a conduit through which self-management behaviours may be integrated into patients�� lives.3 Although evidence to date indicates that satisfaction with telehealth services can sometimes be good, substantive evidence that telehealth produces tangible outcomes, such as reduced hospital admissions, is lacking.4 However, it may be that such healthcare usage outcomes do not reflect the potential breadth [http://www.selleckchem.com/products/Bortezomib.html PS-341 datasheet] of the value of telehealth services. Applications of such technology are wide, often with broader and less tangible value than simply preventing hospital admissions or reducing mortality/morbidity. For example, if used as an alternative mode of delivery of care to minimise [https://en.wikipedia.org/wiki/Lazabemide lazabemide] barriers to seeking traditional methods of care (eg, the shift worker who cannot access the general practitioner (GP) to get their blood pressure (BP) measured), significant improvements in clinical outcomes of a population may not be observed but the intervention may reach patients who would otherwise not have been attended to. The involvement and enhanced responsibility patients experience through this type of service delivery may have longer term gains for the patient's health, well-being and future healthcare usage; for example, reassurance to carers and relatives may impact on health and social care use over time.4 ��Florence�� (or ��Flo��) is a simple telehealth service that enables a patient to use their mobile phone to submit responses via text messages to a server that is periodically reviewed by their responsible clinician. This service was designed to support self-management and education using technology with which patients are already familiar; 92% of the population use a mobile phone, including 57% of people aged 75?years and older.