Patient Centered Medicine and Technology Adaptation But what we have to remember are lessons from the past. In the early 1900s, a novel me- chanical device to travel from point A to point B was introduced. The automobile, compared to the horse, had constant machinery problems, was noisy, required fuel that was not widely avail- able, and there were no roads smooth enough for them to work! Yet the benefits were realized by the masses and eventually the automobile took its place in the transportation infrastructure; the rest is history. The migration from the hand-written medical record to a digital one faces a rough road as well. But like the automobile compared to the equine, the benefits will outweigh the struggles and a new order will prevail. And it will not just be EMRs that energize this industry; it will be a wide array of technology, interfaces and revised practice regi- ments that will move healthcare out of the Stone Age and into the digital domain. BACKGROUND Primary Care Physicians (PCPs) in the United States feel they are becoming the "repairers of American indiscretion." Patients are poorly educated and pay little attention to details, even critical issues like what type of medications they use. A recent study by Commins (2009) showed that almost half of hospital patients thought they were receiving a medication they were not, and 96% could not remember the name of at least one medication that they had been prescribed during their hospitalization. This is indeed disturbing and a good example of the apathetic attitude people have towards their healthcare. This creates expen- sive problems. In the U.S., healthcare costs are approaching 20% of the gross domestic product. In 2010, the government endorsed controversial, overhauled healthcare legislation that embraces a budget of over $800 billion (U.S.) over ten years (Hitt & Adamy, 2009). Part of the future lies in the past; the American Academy of Pediatrics (AAP) introduced the medical home concept in the late 1960s to assist parents with a child's care at home including a copy of the medical record. The model received more attention in the 1980s and then, in a 2002 policy statement, the AAP revisited the medical home concept and outlined the following charac- teristics: accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective care (American Academy of Pediatrics, 2007). Since then, other medical pro- fessional organizations have begun to embrace patient centered medicine. Within the U.S. healthcare plan, billions of dollars are earmarked for healthcare information technology (HIT). It is not enough that processes and reimbursement mechanism are changed. Technology will play a vital role as it has in count- less other industries. From monolithic electronic medical records to tiny sensors worn on the skin, technology will be integrated into the infrastruc- ture of comprehensive medical programs. Through a combination of operational changes, reimbursement enhancements and technical adop- tion, the system can evolve into an elegant and efficient platform that not only provides better care, but promotes better health. Consumers, armed with tools discussed later, will fuel market forces in exchange for more responsible clinical management. The bi-directional flow of data will be one of the key ingredients to a leaner and more successful healthcare environment. The Patient, Not the Process To characterize the patient flow at an abstract layer we can use a simple circular analogy. In properly administered primary or family care practice models, the PCP is the target location, a focused and narrow point of entry for healthcare. See Figure 1. This is where a person's history is known, uses of current medications are identified, relationships are built, communication is open 3