User acceptance issues and user-centered design have long been an important theme in information systems research. In the field of health care information systems, much attention has been devoted to user issues in the health care provider domain, e.g. physicians, nurses, medical records. Recent developments toward promoting more consumer-oriented healthcare information systems have opened new questions about how individuals can and should relate to their personal health information in the form of Personal Health Records (PHR) systems. This paper adopts a user-driven perspective toward these new and challenging questions. Drawing upon ideas and discussions from a cross-section of information systems researchers, health care providers, private industry, and government, we examine several of the major issues that will need to be addressed in order to meet a national challenge to adopt PHR for all Americans by 2014.