The promise of health information technology (HIT) is comprehensive electronic patient records when and where needed, leading to improved quality of care at reduced cost. However, physician experience and other available evidence suggest that this promise is largely unfulfilled. Serious flaws in current approaches to health information exchanges: (1) complex and expensive; (2) prone to error and insecurity; (3) increase liability; (4) not financially sustainable; (5) unable to protect privacy; (6) unable to ensure stakeholder cooperation; and, (7) unable to facilitate robust data sharing. The good news is that personal health record banks pose a viable alternative that is: (a) simpler; (b) scalable; (c) less expensive; (d) more secure; (e) community oriented to ensure stakeholder participation; and, (e) capable of providing the most comprehensive records. The idea of patient controlled records is not new, but what is new is how personally controlled records can help achieve the HIT vision.