This chapter presents the evolution of the Swedish patient portal and how it has coevolved with the eHealth architecture and the overall national eHealth infrastructure. It focuses on the period from 2000 to 2015. The patient portal with related e-services give citizens access to for instance e-scheduling, e-pharmacy, e-referrals, telemedicine, access to personal health information, digital self-services around the clock, Internet-Psychiatry, Electronic Health Record (EHR) logs, e-services that

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... visualize planned care procedures including upcoming encounters, pre-visit form submission, e-communication with their physician or nurse, and secure disclosure of their health data (generated in the public health care system) to third party vendor's apps and systems. The case narratives illustrate the role a broadly and timely agreed upon national reference architecture has played during 8 years of distributed, yet harmonized development of a national eHealth infrastructure and the eHealth innovation made possible by that infrastructure. During these 8 years the installed base was organically expanded with new regulations, users, infrastructure components, portals and e-services, proving the importance of the infrastructure as a basis for innovation carried out and utilized by a broad range of stakeholders. The remainder of the chapter is structured as follows: in the next section the Swedish healthcare model is presented, thereafter an overview of the core components building the Swedish eHealth architecture is illustrated. This section is followed by our narrative of the Swedish case. Next we analyze and discuss the core activities and actors that have evolved the installed base supporting innovation and