Hypertension (high blood pressure) affects more than 65 million people in the US with African Americans disproportionably affected. Untreated hypertension is associated with an increased risk for myocardial infractions, sudden death, stroke, and renal failure. This study will test the effectiveness of an Internet based telemedicine system to strengthen the patient-provider relationship and to educate and empower individuals with hypertension to take a more active role in their own health care.

The Institute of Medicine has made prevention of birth defects one of six priorities for the nation's health because each year, 150,000 infants (1% - 3% of all U.S. births) are born with some form of physical or mental birth defect. This project will evaluate ways computers may be able to help doctors counsel women about how to prevent birth defects caused by use of certain medications during pregnancy.

The proposed intervention will markedly improve the quality of care for children with otitis media, the second most common disease in childhood. The intervention will reduce unnecessary use of antibiotics, excess surgery, and improve the management of children's pain.