Int. J. Environ. Res. Public Health 2009, 6 514 could dramatically expand their use of web-based tools, devices and health social networking platforms as their awareness increases, costs drop, financial incentives arise and automated tools proliferate. Current and future self-measurement and self-experimentation projects could be formalized into more structured programs, possibly generating even more value in collaboration with others as consumers develop relationships with health social network peers and propose, lead and participate in self-run patient studies. As data owners and administrators, consumers may be starting to maintain digital files of their medical history either on home computers or by entering the data into available Internet-based electronic medical records (EMRs) to the extent possible given website functionality and personal comfort with online security. The digitized information may include any available documentation from previous doctor visits, a medication history, genomic scans and other biomarker tests, a weight, exercise and sleep history, health journaling information, self-tracking device input and any other relevant information. Eventually, health social networks, health portals (examples: Google Health, Microsoft HealthVault) or other EMR-specific websites such as Shared Care Plan (http://www.sharedcareplan.org) and Keyose (http://www.keyose.com) could be the application front- ends and centralized repositories of quantitative patient data. These websites could orchestrate EMR access permissions to doctors and other parties. The future might be physicians logging in to patient- owned EMRs to type notes into standardized forms and submit online prescriptions that automatically clear through the patient’s insurance company and automatically fill through the patient’s preferred pharmacy. Even being able to review one’s own medical file online would be a big step. One early version of this is MD VIP (http://www.mdvip.com), who offers a service for patients to input an extended online wellness profile for physicians to review prior to office visits. Consumers may be evaluating all of their traditional health interactions, for example, identifying the opportunity to approach employers or health insurers for discounts for being healthy, particularly unified as a health social network buying group. Thus far insurance and other aspects of health care have been a one-way street with penalties for pre-existing and negative conditions but no reward or incentive for healthy behavior. Insurance companies have detailed knowledge of patient costs; U.S.- based Humana’s cost to insure people is $11 per pound more per year for each pound overweight they are and $31 per overweight pound per year for obese people 65 and over [30]. Healthy behavior could be demonstrated easily with regular biometric readings such as weight, cholesterol, BMI, blood pressure and other data points. Examples of this idea in implementation include U.S.-based grocery- retailer Safeway who lowered employee health care costs by 13% after instituting a rebate plan for healthy employees or employees who improved their health [31] and the Healthy Incentives program, due to launch in the U.K., which plans to offer a point system to reward BMI reduction and smoking cessation (http://www.launchpad.youngfoundation.org/fund/hia/portfolio/project/healthy-incentives). 3.3. The Evolving Role of the Physician Just as the role of the patient is evolving, so too is that of the physician. The physician may need to adapt to both changing patient behavior and dramatic industry shifts. In interaction with some patient segments, a physician is starting to become a care consultant, co-creator and collaborator, generating