Background: Lung transplant recipients use a telemedicine device known as the electronic home spirometer to gauge the function of their lungs when they are away from the hospital or clinic setting. Health care providers review transmitted spirometry tests and user's symptom responses to detect early signs of infection and or rejection. Current home spirometry users have questions, concerns, and preferences about spirometry that may influence their daily adherence. A spirometer with two-way electronic messaging has the capability to deliver feedback messages to potentially address these questions and concerns. Objectives: The purpose of this study was to identify the type of messaging content users prefer to receive and recognize as positively influencing their spirometry use. Methods: The study design followed a qualitative approach investigating the experiences, perceptions, preferences, and realities of home spirometry. Three focus group sessions were used to generate opinions and interests about automatic messaging content. Results: The focus group approach revealed the nature of six categories and five subcategories for feedback messaging content. These include education (general, lifestyle, and infection), goals, timing, technique, monitoring, and reminders (time sensitive, positive). Messages were created according to length, feasibility, past experience, and neutrality for electronic implementation. Conclusion: The narrative content served as the primary source of electronic feedback messages. Actual quotes were used when applicable. It is believed that pertinent automated electronic feedback messages will enhance home spirometry connection, raise confidence in spirometry use, and influence daily adherence to the spirometry protocol. The content also serves as a foundation for establishing a plan of care individualized to each home spirometry user. © 2008 Mosby, Inc. All rights reserved.