Comprehensive Health Enhancement Support System - CHESS

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Comprehensive Health Enhancement Support System (CHESS) is a computer-based system of integrated services designed to help patients suffering from a life-threatening disease such as breast cancer, HIV infection, heart disease, Alzheimer's disease, or alcoholism [1,2]. It provides information, referral to service providers, helps in making tough decisions and provides network with the expert and those who are facing the same concern [3]. “It is designed to improve access to health and human services for people who would otherwise face psychological, social, economic or geographic barriers to receiving services. [3]” It was designed to help them improve their health through education at home via personal computer. This support system was developed at the University of Wisconsin-Madison. An AHRQ study of HIV patients who used CHESS showed that they had fewer hospitalizations and a higher quality of life than patients who received only standard medical treatment.

Although CHESS was primarily a support system developed to improve life quality of patients suffering from life-threatening diseases, other CHESS-like applications such as Stomp Out Smokes (SOS) have been proven to stimulate a desire to quit smoking of over 70% of users participant of interactive cessions. In contrast to CHESS targeting adults, SOS focussed on adolescent health behavior change [4].

One of the problems with CHESS is that each component of the system stands individually, which means that only one tool can be used at a time. All patients receive the same information, so there is no way to individualize the information received. Information entered by the user cannot be shared with other parts of the system [5].


In 1987, Dr. David Gustafson garnered a team to start building the Comprehensive Health Enhancement Support System (CHESS). The team took valuable lessons from their previous Body Awareness Resource Network (BARN) experience (1981). Before developing CHESS, the researchers had thoroughly studied what patients in health crises struggled with, and sought to understand their unmet needs were. They conducted extensive needs assessments among patients and their families [2].


1. Gustafson DH, Hawkins R, Boberg E, et al. Impact of a patient-centered, computer-based health information/support system. Am J Prev Med 1999; 16(1):1-9.


3. Nolte E, Mckee M. Caring for People with Chronic Conditions: A Health System Perspective.

4. Patten A.C, Rock E., Meis T. Frequency and Type of Use of a Home-Based, Internet Intervention for Adolescent Smoking Cessation. J Adolesc Health.2007 November ;41(5): 437–443.

5. Susan W. McRoy, Alfredo Liu-Perez, Syed S. Ali. Interactive Computerized Health Care Education. J Am Med Inform Assoc. 1998 Jul–Aug; 5(4): 347–356.