This study aims to assess the value of a help desk in a Personal Health Record (PHR) for monitoring and improving PHR functionalities and processes. Through analysis of 327 help desk tickets categorized by users as telemedicine and PHR requests, we identified four main gaps: information and feedback, access to clinical documents, usability, and ubiquity. The tickets highlighted end users’ needs such as timely feedback, contextual information, effective communication, and ease of access to clinical documentation. These findings were crucial for initiating improvement cycles for various functionalities and processes within the PHR.