BACKGROUND The use of personal health records (PHRs) can help people make better health decisions and improves the quality of care by allowing access to and use of the information needed to communicate effectively with others concerning their health care. OBJECTIVE This work presents the lifelong PHR system of the Lombardy region as an example of the implementation of an e-health solution that is capable of providing personal clinical documents from a lifelong perspective, integrating different healthcare providers over a large territory. METHODS The lifelong PHR is embedded in the regional healthcare information system of Lombardy, which is characterised by a large and heterogeneous territory, a large number of different healthcare providers and organisations, and a significant population. RESULTS The lifelong PHR makes clinical documents available to healthcare professionals and citizens when needed, and it is automatically updated with all of the documents regarding a clinical event regardless of which healthcare provider is currently taking care of the patient. Present statistics show that the lifelong PHR has experienced a wide diffusion in a short period of time, and at the end of 2010, it was active for more than five million Lombardy citizens. Digital reports and e-prescription transactions have almost doubled since 2007 and have reached a coverage of almost 100%. CONCLUSIONS The qualified and exhaustive collection of patient clinical data and documents should impact daily medical practice, as well as the care pathways and services provided to patients, and should help in the renewal of health assistance and the simplification of patients' access to care.