The obligation to keep patient records has developed over a long period of time. This paper deals with three crucial legislative measures in the Swedish context. The general instruction for medicinal doctors (1963:342) introduced a general duty to keep patient records and was mainly an adjustment to current changes in the legislation regarding public archives. The Patient Record Act (1985:562) extended the obligation to include all licensed health care professionals and here a focus on the patients right to integrity was introduced. Finally, The Patient Data Act (2008:355) transferred the obligation from an analog to a digital setting. The discussions before the introduction and the actual content of these three acts reflect different interests, power relations, and societal concerns. The legal position of the patient has changed considerably over time, but the greatest difference may still be those that concerns organizational transformation and the role of the health care professionals.