As the Veterans Health Administration (VHA) expands the capabilities of its personal health record system, My HealtheVet (MHV), and places greater emphasis on encouraging its use, it is interested in understanding how best to prioritize different functionalities and which of them will provide the greatest benefits to Veterans. This systematic review was designed to evaluate the literature surrounding secure messaging systems and electronic applications that give patients access to their own medical records, specifically investigating the outcomes, patient satisfaction, healthcare utilization and efficiency, and adherence. Additionally, the review examined studies that evaluated attitudes, particularly regarding patients having online access to their own medical information. The review distinguished between electronic systems that were “tethered” or tied to existing healthcare institution systems similar to how MHV is tethered to VHA’s electronic health record systems (EHR), versus those that were “stand-alone.”