Patient confidentiality is the keystone for the trust necessary for medical care.
The Internet creates new opportunities for medial treatment and medial research. These new opportunities in turn create new vehicles for old evils. Existing medical security protocols neither anticipate behaviors considered normal by computer users nor facilitate these new opportunities while preserving patient confidentiality. This paper will explore parameters for future medial security protocols needed to serve treatment and research environments including Internet access to patient information. This is a thought piece to help scope out a research project which is under funding consideration by the American Board of Radiology.