The engaged patient is ‘the blockbuster drug of the century’ (L. Kish, HL7 Standards, 2012). A reorganisation of healthcare is taking place, with individuals repositioned as partners in their health journey. Patients are being encouraged to monitor their condition; to oversee how their data are being used; to interact directly with their medical record; to be more engaged and share responsibility for the decisions that will shape their outcomes. And technology is being developed apace to facilitate this role. Alongside this trend, the focus on precision medicine is accelerating, to enable personalised solutions to complex health challenges; relying on huge volumes of data to better understand the subtle distinctions in different diseases that might merit tailored treatment. How does this shift in the changing expectations of patients, both as data subjects and as healthcare drivers, affect their experiences of healthcare, and what are the risks associated with this progression? What are the unintended consequences of a more democratic and autonomous approach to healthcare, and what might this mean for different communities? This presentation will explore the progress that has been made in developing the role of the patient, and examine how digital health might influence access to healthcare in the future. It will use precision medicine as a lens through which to examine some of the key issues.