The records of your healthcare treatment receive less federal legal protection than the records of the movies you rent. Since 1988 there has been a federal law setting rules for the use of video rental records,1 but there is no federal law protecting against the misuse or improper disclosure of most health information. At a time when the healthcare delivery system is changing rapidly because of computerization, cost pressures and healthcare reform, the failure to establish clear rules governing the use and disclosure of health information is a threat to patients, to confidence in the healthcare system and-perhaps surprisingly-to efficiency.