The same levels of physician and staff responsibility for patient confidentiality and protection apply to electronic records as apply to a paper record: All patient information is sensitive Every patient needs protection Access patient information on a need-to-know basis only Systematic tracking of every entry, look-up, and printing of patient information using unique and confidential signature computer keys (or passwords) is advocated as the best safeguard. Ideally, patients should be able to find out who accessed their record and whyWhile e-mail has become an efficient way to impart patient information, clinicians must consider any patient-specific e-mail messages to be part of the medical record.