The use of information technology to improve health care systems and the provision of tools to help patients become more active participants in their care are recognized as important strategies to more effectively address the nation’s health care needs. Both Electronic Health Records (EHRs) and Personal Health Records (PHRs) are being implemented to leverage technology to address these needs, however careful attention must be given to the crucial interactions between patients, health care professionals, organizational structures, and processes in order to implement and use technology in ways that are optimal. Using the VA health care system as an exemplar, issues and opportunities for PHRs and PHR systems will be further explored to share some lessons learned and highlight important areas that warrant further research.