Confidentiality and telemedicine: the need for a federal legislative solution

Legal and ethical rules for the confidentiality of health records are incomplete, unclear, and inadequate. Structural and technological changes in the health care industry are resulting in increased uses and disclosures of patient records without adequate guidance to recordkeepers or protections for patients. Because of the interstate nature of medical practice, especially telemedicine, federal legislation based on a code of fair information practices is the best solution.