This is a report of an interdisciplinary team which: (1) examined the literature from medicine and health, law, computing, and social science; (2) conducted interviews with manufacturers, developers, health professionals, consumers, and public interest groups; (3) made site visits to health organizations using computers; (4) corresponded with health organizations; and (5) subjected the initial draft report to review by experts. Findings are in four parts: (1) description of medical data and citizen rights in three areas--primary health care, service payers, and health care reviewers, and social uses of health data; (2) patterns of computerization in health care in the three above areas; (3) profiles of six health-care organizations; and (4) the impact of computerization on health records, including a comparison of American progress in health care automation with experiences of six other democratic nations, and 12 management principles for health care data systems. An extensive bibliography and appendices of supporting documents are included. (Author/DAG)