Home based e-health applications use telecommunication and video-conferencing technologies to enable a healthcare provider at the clinical site to communicate with patients at their home. Such an interaction is called a ‘virtual visit’. Numerous applications are utilizing commercially available monitoring devices and the Internet to enable home based disease management and monitoring. The aim to meet older adults' desire to remain independent at home while controlling home health care costs has also led to the development of “smart home” technologies. A smart home is a residence equipped with technology that enhances safety of patients at home and monitors their health conditions. Therefore, the devices and sensors chosen to be installed and maintained in the older adults' residences need to address functional limitations and social and health care needs. This paper provides an overview of home based e-health applications and discusses the challenges of implementing and evaluating e-health applications.