Sherri Massey, 40, of Akron had been in and out of the hospital since she developed congestive heart failure after her last pregnancy in 1986. After her last discharge in December 2000. Sherri was enrolled in a new program at Akron General to monitor her heart health at home using a special "smart scale" called the Cardiocom Telescale and a telephonic case management program.

Sherri is one of more than 4 million Americans who suffer from congestive heart failure (CHF), which is the most common reason for admission to hospitals among senior citizens. With CHF, the heart can't pump enough blood to meet the body's oxygen and nutrient needs.

In response, the body retains water to increase the volume of blood in circulation to improve the heart's performance. But as the heart deteriorates, the excess fluid escapes from circulation and gathers in various parts of the body, such as the lungs, causing swelling and sudden weight gain.

People with CHF need to closely monitor their weight so their medications can be adjusted when they begin to retain water. Many of these people, however, have difficulty following doctor's orders to limit salt or properly take medications. Akron General's Cardiocom program takes care of that.

Sherri, like other participants, simply steps on the telescale each morning, which is connected to a computer system at Akron General using a telephone line. A computerized voice on the telescale asks her a series of questions that alert to potential problems such as shortness of breath or swelling in the feet or ankles. She simply pushes a "yes" or "no" button on the scale to reply. A weight gain of three pounds overnight or a worrisome answer to one of the questions prompts an immediate call from the clinical nurse specialist mon-itoring the computer system. The nurse also calls patients who forget to get on the scale to remind them and to check in on them to assure they are okay.

Other CHF patients not meeting criteria for the Cardiocom Telescale program are entered into a program in which the CHF nurse calls them at regular intervals for health updates. In both programs, the nurse works with patients' physicians on weight and symptom issues and makes interventions based on physicians' orders.

"It's very helpful for patients who don't understand their situation or who have trouble complying with therapy," says Akron General's Chief of Cardiology George Litman, MD. "Having this device and having the ability to talk to these people on a daily basis seems to help." In fact, of the 160 patients enrolled in the program since July 2000, only five have been readmitted for problems related to CHF.