My father is awakened every morning at 7am with a voice “of a sweet young nurse” telling him enthusiastically “Good morning! It’s time to take your vital signs!” This sweet young nurse is a virtual nurse, an electronic tele-health nurse complete with a weight scale, a blood pressure cuff and a finger monitor for blood oxygen level. My father dutifully wakes up and steps on the scale, then sits down in a chair and puts the blood pressure cuff on and the oxygen monitor while the voice of the nurse barks directions. After that is done, the nurse asks him a series of yes/no questions, such as “Since yesterday, have you had any increased breathing difficulties?” and he pushes the appropriate button. She finishes with an admonishment to take his medications as prescribed by his doctor and to follow his diet. My father is a model patient and complies. He likes this in-home monitor because it gives him a sense of control over his health. He likes numbers and knowing that his weight, blood pressure and oxygen level are all stable. He liked the day the monitor went nuts and recorded a weight of 10 pounds and a blood pressure of 250/180. His family doctor’s office called him that same morning to make sure he was OK, so he knows the system works for monitoring his status. This machine now costs him $130 per month, including the remote monitoring/connection with his physician. A one-hour home nurse visit by the same agency costs him $180. Both of these are now self-pay ‘real’ costs, as he was kicked off Medicare home care payments because of his trip to Florida in a wheelchair/via airplane. I find it particularly ironic that they decided this based on how onerous airport security and the hassles with TSA folk are now—that anyone who can survive TSA is too healthy to be on home care. My father wants to pay for the home vital sign monitor, but doesn’t see the value of the home nurse visits. So far I have convinced him to pay for at least one monthly home nurse visit, but I’m wondering if I’m doing this more out of some misplaced loyalty to ‘live’ nursing. He may be right and the sweet young virtual nurse is doing more for his health.