In order for health information exchange and Health Information Technology (HIT) to be successful, consumers must trust that their health information will be kept confidential and secure.  Likewise, participants in the exchange must feel confident that they are not exposing their organizations to risk or violations of law. Thus there is a critical need to review federal and state laws affecting health information exchange and HIT, particularly related to confidentiality, the use and disclosure of health information, and to anticipate new issues that may arise through health data exchange and HIT across multiple environments.