We studied the effect of telephone-linked computer (TLC) communication in patients being treated with home enteral nutrition. A total of 290 patients were enrolled in the study which compared two groups of patients who were recruited at different times (control: 193, TLC: 97). At baseline there were no significant differences in characteristics or clinical practice between the two groups. Over a three-month period, 823 automatic telephone calls were dialled out to the TLC patients and in 787 of the calls (96%) there were complete responses to all questions. A total of 205 alert messages were generated for the 823 calls. Less than 10% were false alerts. All health outcome measures, the EQ-5D and three components of the SF-36 improved slightly with time in both groups, but there was no significant difference between the groups. The patients' body mass index increased slightly in both groups, but the change was not significant. Home enteral nutrition prevented weight loss and improved some components of the QOL scores. The TLC system detected a high number of abnormal nutritional symptoms.