Patient Centered Medicine and Technology Adaptation care to including persistent asynchronous care will persevere. This asynchronous care powered by a new generation of home healthcare devices, affordable computing, available networks and interoperable EMRs will give doctors a much more accurate portrayal of a patient's health, and how to manage it. Doctors will begin to advertise their PCMH much like the cosmetic surgery industry has done for years. Price lists will show up on their websites, emphasizing healthcare services as a commodity. Initially, many will frown on this practice but, in an age of consumerism, it will happen. As men- tioned earlier, social media will drive traffic to sites that offer certain services that are perhaps better at Doctor A versus Doctor B. What about my medical home - the place where I have built a personal and trusting relationship with my doctor and her team? The 21 st century medical home will have to be adaptable to market pressures like any appear not only though the portal but in the form of email, text messaging and voice prompts. The healthcare industry can learn from another existing medical community for guidance: the cli- nicians that care for our pets in veterinary offices. The ones that care for your canine companion are more likely to have digital documentation, to send reminders, and to follow-up about a procedure than the average PCP's office. True, animals do not have the complexity, interoperability and legal issues associated with humans, but it was recognized years ago that efficient processes were needed to compete effectively and to maximize profits. What was once a political construct will be- come a thriving industry based on health, but deal- ing with illness. Things will continue to improve. Best practices will be shared, and the market will lean on the practices to be efficient and effective. It will take much more than hardware and soft- ware to culturally shift the industry, it will require