Figure 1: Conceptual representation of the text message-based chronic care program. 1Health plan care managers enroll eligible member with type 1 or type 2 diabetes over the phone. 2Patient receives self-management support via automated text messages and respond to queries via text message. 3Patient's responses help to dynamically tailor content. 4The CareSmarts system collects patient data from the text message responses and 5alerts the care manager when exceptions require attention. 6Using protocols, the care manager provides telephone-based support to the patient and 7coordinates care with the provider. 8 The provider follows up with the patient for any necessary care.