Abstract
Trust among participants is the cornerstone to any successful health information exchange (HIE) initiative, because sensitive data and information are involved in HIE transactions. The concepts of privacy, security, and confidentiality as implemented through laws, rules, regulations, and contracts foster trust among HIE participants. Primary federal law applicable to HIE in the United States is Health Insurance Portability and Accountability Act (HIPAA), which was later enhanced by the Health Information Technology for Economic and Clinical Health Act. HIPAA and its enhanced privacy and security rules establish the federal floor upon which states can, and often do, enact more stringent laws. In addition to abiding by federal and state laws, HIE participants further build trust with each other through contractual arrangements that can take the form of point-to-point, two party, or multiparty agreements. This chapter explores the legal aspects of HIE, explaining how laws, rules, regulations, and contracts foster trust and establish a framework for safe and secure electronic exchange of protected health information.
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