While the patient-centered healthcare movement, like traditional medicine movements, aims to deliver quality, affordable, and timely care in a variety of settings, the consumer movement on new technologies is passing it by with emerging technologies and new ways of communicating with others (text, e-mail, Twitter, Facebook). This chapter builds on what we know about e-Mental Health (eMH), technology and communication progress over the past 50 years in maintaining the tenets of “good” quality care, adjusting slightly to telemedicine models, and considering more significant adjustments for use of social media. The areas of challenges include privacy and confidentiality, health and personal practice, having “good” interpersonal/clinical boundaries, awareness of what information is out there about you, and discussing clear expectations about online communication between doctors and patients as part of the informed consent process. Guidelines, strategies, and tips for the clinician are offered.