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Hawaii and Missouri: health record laws compared
Hawaii and Missouri, side by side on the seven questions, with the laws read October 3, 2026. They give different answers on health information exchange, breach notice and AI in care, and the same answer on everything else.
The seven questions, side by side
"Differs" marks a question where the answers are not the same; "same" marks one where they are. "Can't compare" means at least one answer was not checked; a not-checked answer is not a no. Where a question has a map, the small square shows the color each column has on it. Two squares can match where the answers differ: the maps draw "no law found" and "a law with none of the rules" alike. Each citation opens that state's page, with the law quoted, dated and linked. There is no total and no rank: the questions are on different scales, and some have no best answer.
| Question | Hawaii | Missouri |
|---|---|---|
| Health data outside HIPAADo apps and wearables need your OK before sharing health data?same | No law foundWe searched the official code and found none.How we searched | No law foundWe searched the official code and found none.How we searched |
| Getting a copyDo you get a copy faster or free in some cases?same | NeitherNo. A law is in force, but it adds nothing to HIPAA's terms.HRS 622-57; HRS 622-57(b) | NeitherNo. A law is in force, but it adds nothing to HIPAA's terms.RSMo 191.227 |
| Health information exchangeCan you say no to sharing through a health information exchange (a network that passes records between doctors)?differs | Opt-outOpt-out. Your records go through the exchange unless you say no, and there is a published way to say no.Hawaii HIE Operational Policy HEN-009, section 4.5; Hawaii HIE Operational Policy HEN-007, section 4.2.1 | No general choiceNo general choice. Sharing through the exchange follows HIPAA's rules, and no state rule or exchange policy offers a general choice.RSMo 191.237.2 |
| Are some sensitive records, like mental health or HIV, given extra rules? These answers record whether a rule exists and what it says. They say nothing about whether any care is legal or available. | ||
| Reproductive health recordssame | Has a ruleYes. A law in force has a specific rule on keeping these records confidential or on who may see them.HRS 323J-2, as amended by Act 59, SLH 2026 (HB1875 HD2 SD2), section 3; HRS 323J-2 (L 2023, c 2) | Has a ruleYes. A law in force has a specific rule on keeping these records confidential or on who may see them.RSMo 188.070 |
| Mental health recordssame | Has a ruleYes. A law in force has a specific rule on keeping these records confidential or on who may see them.HRS 334-5 | Has a ruleYes. A law in force has a specific rule on keeping these records confidential or on who may see them.RSMo 630.140 |
| HIV recordssame | Has a ruleYes. A law in force has a specific rule on keeping these records confidential or on who may see them.HRS 325-101 | Has a ruleYes. A law in force has a specific rule on keeping these records confidential or on who may see them.RSMo 191.656 |
| Genetic recordssame | Has a ruleYes. A law in force has a specific rule on keeping these records confidential or on who may see them.HRS 431:10A-118(a)(3) | Has a ruleYes. A law in force has a specific rule on keeping these records confidential or on who may see them.RSMo 375.1309 |
| Right to sueCan you sue if your records are misused?same | Narrow case onlyOnly in a narrow case, such as a data breach or one kind of record. The laws below say which.HRS 487N-3(b); HRS 325-102 | Narrow case onlyOnly in a narrow case, such as a data breach or one kind of record. The laws below say which.RSMo 191.656(6); RSMo 407.1500(4) |
| Breach noticeMust you be told if health data leaks in a breach?differs | NeitherNo. The breach notice law covers neither medical nor health insurance information.HRS 487N-1; HRS 487N-2(a), (f), (g) | Medical and insurance dataYes. The breach notice law covers both medical information and health insurance information.RSMo 407.1500(1)(6), (1)(9)(e); RSMo 407.1500(1)(5), (1)(9)(f) |
| AI in careAre there rules for AI used in your care?differs | No rulesNo. A law is in force, but it has none of the three rules.Act 248, SLH 2026 (SB3001 SD2 HD3 CD1), new section in HRS chapter 481B | No law foundWe searched the official code and found none.How we searched |
Not legal advice. This records what each law said on the date we read it. Laws and court orders change. State laws add to the federal floor. The United States score in the world index rates only federal law and national systems, so these state profiles do not change it.
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Health Record Rights Index by SuperTruth. Research tool, not legal advice. Text CC BY 4.0.