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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for this report were chosen for their special competencies and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine

Support for this project was provided by the John A. Hartford Foundation, the American Health Information Management Association, Electronic Data Systems Corporation, and Science Applications International Corporation.

Library of Congress Cataloging-in-Publication Data

Institute of Medicine (U.S.). Committee on Regional Health Data Networks.

Health data in the information age : use, disclosure, and privacy / Molla S. Donaldson and Kathleen N. Lohr, editors ; Committee on Regional Health Data Networks, Division of Health Care Services, Institute of Medicine.

p. cm.

Includes bibliographical references and index.

ISBN 0-309-04995-4

1. Medical records—Access control. 2. Confidential communications—Physicians. 3. Medical informatics. I. Donaldson, Molla S. II. Lohr, Kathleen N., 1941- . III. Title.

RA976.148 1994

651.5′04261—dc20 94-2613


Copyright 1994 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatlichemuseen in Berlin.

Cover art: Woodcut of Galen, flanked by Hippocrates and Avicenna. Source: Galen, Opera, Lyon, 1528, vignette on title page. Courtesy of National Library of Medicine, Bethesda, Maryland.

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