Zanutto, AlbertoPiras, Enrico Maria2017-06-122017-06-122017Personal Health Record (PHR) projects have been supported in recent years by several health institutions. The aim has been to involve patients, the idea being that patients must become more significant in health infrastructure policy. The paper presents some results concerning a PHR system implemented in a region of North Italy. The system has been active since 2011, and more than 10% of the region’s residents use it. The purpose of this paper is to highlight how an extensive PHR infrastructure planned for everybody has become an interesting ‘‘tool’’ for specific intensive health situations. Drawing on the results of 20 interviews with the most frequent users of the system, we have identified three categories of users: individual or family health controllers, therapy driven managers, and complex illness managers. These diverse ways to adopt the infrastructure only partially meet governance expectations.en10.18420/ihc2017_0142510-2591