Translating research into health care practice is a complex, challenging process aimed ultimately at yielding improvements in patient outcomes. Most of the literature in the field has focused on efforts to increase the use of clinical guidelines in hospitals and by physicians (Davis et al. 1995; Bero et al. 1998; Hunt et al. 1998; Grimshaw et al. 2001; 2004). Although such guidelines usually incorporate practices shown in clinical trials and/or judged by experts to produce clinically meaningful benefits for patients, relatively few “translation” studies have attempted to trace the impact of changes in practitioner behavior to actual improvements in patients' self-management of chronic conditions or to patient outcomes (Worrall, Chaulk, and Freake 1997). This study moves out of the hospital setting and beyond physician practice changes to describe the impact and relative cost-effectiveness of a basic and an augmented e-mail reminder intervention designed to help home health nurses improve the self-management skills and outcomes of their heart failure (HF) patients. The interventions, described in a companion article by Murtaugh et al. (2005), delivered evidence-based, condition-specific information to nurses each time they began to care for a new HF patient—“just-in-time” to incorporate the recommended assessment and instruction practices into each patient's individualized plan of care. The interventions, selected for their reported effectiveness in other settings (Oxman et al. 1995; Bero et al. 1998; Grimshaw et al. 2001), were grounded in the “dual task theory of human performance.” This theory suggests that busy, information-overloaded clinicians will be more likely to perform “secondary” management tasks in conjunction with hands-on care when they receive well organized, cogent information for the right patient at the right time (Litzelman et al. 1993). HF—a debilitating chronic condition characterized by symptoms such as severe shortness of breath, edema, and fatigue—is a high frequency, high cost disease that imposes a significant burden on older adults and their families. The leading cause of hospitalization among elders, HF accounted for nearly one million discharges in 1999 (Rich 2003). HF is also one of the major conditions for which older persons receive home health services. In 1999 it accounted for approximately 8.6 percent of Medicare home health discharges, 226,000 cases, and payments of $646 million (HCFA 2001). HF care has benefited over the past 20 years from the completion of several large-scale, randomized clinical trials and the development of authoritative evidence-based guidelines for clinical evaluation and treatment (Konstam, Dracup, and Baker 1994; Hunt et al. 2001; Rich 2003). Yet HF management among older adults has been suboptimal—marked by under use of effective therapies and lack of patient adherence to diet and medication regimens (Rich 2003). To improve HF care and reduce hospital readmission, experts have recommended early discharge planning (Naylor et al. 1999; Phillips et al. 2004) and disease management approaches that entail post hospital follow-up, close monitoring of patient symptoms, and education regarding diet, medication, and exercise (Rich et al. 1995; Naylor et al. 1999; 2004; Stewart, Marley, and Horowitz 1999; Quaglietti et al. 2000; McAlister et al. 2001; Harrison et al. 2002; Weingarten et al. 2002; Rich 2003; Phillips et al. 2004). In theory, if not in practice, the role of a home health nurse encompasses the close patient follow-up that is a key element of disease management programs. Over the course of an HF home care episode—51 days on average (Centers for Disease Control and Prevention 2004)—home health nurses are routinely responsible for ongoing patient assessment, individualized care planning in consultation with the patient's physician, patient instruction in self-care management, monitoring of patient symptoms and support of patient adherence to medications and diet. Thus rather than mounting a new care management program, this study focused on the use of just-in-time, condition-specific information to improve the evidence-based knowledge and practices of home care staff already serving in the community. The interventions capitalized on existing intranet communication channels, so no significant organizational systems changes needed to be made. As an inexpensive and convenient mechanism, e-mail reminders were hypothesized to be an effective new medium for home care agencies and other decentralized health care practices to upgrade and standardize service provision and improve patient self-management and outcomes. The results reported here describe the comparative impact and cost-effectiveness of two variations of the information-based interventions.