While e-health tools have been designed for patient/consumer empowerment and for decision support focusing on healthcare providers, they have had only modest success in primary care settings. Creating complementary e-health tools that provide patient activation and decision support for a common clinical problem such as hyperlipidemia using a behaviorally oriented risk communication strategy has not been previously described. This paper presents the details regarding the development of two complementary software programs: HeartAge, an interactive risk communication program focusing on patient activation placed on a laptop computer in the doctor's waiting room, and a PDA-based, clinical decision support program for lipid management utilizing algorithms recommended by the National Cholesterol Education Program. The efficacy of these programs in improving cholesterol management in five primary care practices is described.