Since centuries health record has been one of main instruments of physicians, used to keep track of clinical process and to testify it. In the last 40 years, diffusion of Information and Communication Technologies (ICT) produced dramatic changes in the way clinical information are managed. Furthermore, in Italy in the last 6 years relevant rules have been introduced, which depicts in details the context for e-Health. The goal of this paper is to summarize the evolution of Health Records, also in considering the most relevant international literature and to describe the expected characteristics that nowadays an Electronic Health Record (EHR) system should have, to fully deploy the technological possibilities and to be coherent with Italian national development guidelines.