Protecting electronic patient health information is crucial to developing systems and structures that support the exchange of that information among healthcare providers, payers, and consumers using Health Information Exchanges (HIEs).1 As noted in the Summary of the Nationwide Health Information Network (NHIN) report from the Office of the National Coordinator, "An important core competency of the HIE is to maintain a trusting and supportive relationship with the organizations that provide data to, and retrieve data from, one another through the HIE. The trust requirement is met through a combination of legal agreements, advocacy, and technology for ensuring meaningful information interchange in a way that has appropriate protections."