Our healthcare systems are currently going through vast changes. Possibly some of the most significant transformations since Enlightenment. The medical establishment, the technology industry and patients are integrating in a manner which has not been witnessed before. The technological changes in patient online access to Electronic Patient Health Records (EPHRs) is potentially more convenient for patients, empowers and enables them to take better control of their health and health behaviour, helps them to navigate a complex system, and may make services more efficient and cost effective. But there is also the possibility for unintended harm, particularly related to privacy and confidentiality, and patients with complex needs or potential vulnerabilities could potentially experience significant impacts to their healthcare and relationship with their providers.