The authors explore the role of technology in supporting collaboration between health care providers and older adults. They focus on two technologies that help link patients to their providers by giving them access to health information and services: 1) patient portals to Electronic Health Records, and 2) Personal Health Record systems. Theories of distributed cognition and common ground are used to frame a review of the small but growing body of research that investigates which older adults use or do not use these technologies, and why. The findings, while sparse, suggest that older adults with lower levels of health literacy stand to benefit the most from this technology, but they tend to have fewer cognitive, literacy, and other psychosocial resources needed to take advantage of the technology. This discrepancy is due in part to systems that are not designed with older adults’ needs and abilities in mind. The authors conclude with recommendations for improving the use of these tools to support patient/provider col- laboration by making them easier to use, and by integrating them with other communication media to support the broader context of the patient/provider relationship.