Int. J. Environ. Res. Public Health 2009, 6 513 (http://www.americanwell.com) and the Carol Care Marketplace’s online scheduling and consumer cost management platform (http://www.carol.com) [24]. A second dynamic in the evolving health care delivery model is that large health care institutions and insurance systems may need to change to incorporate the possible coming shift to genomic-based and patient-driven medicine. Physicians are generally not fluent in the new tests and tools of health management such as genomic scans [25], detailed ongoing biomarker analysis, environmental analysis and self-experimentation projects, nor trained to advise on the adjusted concept of health as enhancement rather than cure. There could be substantial reeducation and retraining as institutional medicine adopts the new health care models. New careers in collaborative medicine are already emerging, for example the genetic counselor is one of the fastest growing job categories in any field [26]. A third dynamic in the evolving health care delivery model is managing the information explosion, both for individuals and medical professionals, as the amount and availability of information is increasing. Even specialist physicians may not have time to keep up with every aspect of new research in the fields they cover and certainly general practitioners do not. Some patients have the time and ability to review all available research and information themselves, but there is ample room for other value-chain participants to help consumers navigate and interpret the available information stream. Examples of new value-chain participants that may arise are in-office physician research associates, new categories of medical information providers and expert patients who have developed reputations on health social networks just as community forum leaders and PowerSellers did on other Internet platforms with social dimensions like eBay. Health delivery models are expanding as consumers are using the heightened information flow and interpretation tools to inform their personal health actions. A fourth dynamic in the evolving health care delivery model is the patient-driven relaxation of privacy. Individuals are not hampered by HIPAA (U.S.-based health privacy legislation), and those that feel comfortable doing so are starting to open source their health information on health social networks. This is creating the significant resource of large public health databases. The privacy convention is opt-in; nothing is compulsory, individuals that would like to share do so. This could lead to more people from different fields looking at health data in new ways, both medically-trained professionals and others, to the possible benefit of all. An example of this is when the Goldcorp company published their proprietary gold mining data on the Internet and had 1,000 virtual prospectors from over 50 countries find 110 targets, 50% of which had not been previously identified by the company and 80% of which yielded new gold reserves [27]. More rigorous large-scale quantitative analysis could possibly inform the discovery and delivery of health care services. 3.2. The Evolving Role of the Patient The role of the patient is starting to shift from being a minimally-informed advice recipient to an active participant, instigating collaborator, information sharer, peer leader and self-tracker engaged in participative medicine; a transition is underway from paternalistic health care to partnership models [28,29]. The small but growing consumer health communities examined in this paper suggest that individuals are becoming more engaged in a variety of self-testing and self-management of conditions, symptoms, genomics and blood biomarkers, behaviors and personal environmental factors. Individuals