it and transmits it through the internal network 24 to web server 21 through firewall 20 to the internet the encrypted file is received through the firewall 2 by web server 3 and stored in conjunction with index server 5 in the entrusted medical information database 6 a set of access rules is associated with each record or discrete portion thereof medical transaction record along with the patient identifier and location of the encrypted medical transaction record in the index server 5 the access rules may be a default set of rules for example based on a recipient role context of request and or rules defined by the patient or custodian institution as is noted above a trustee may act on behalf of the patient to authorize access and use and to implement financial transactions with respect to the records during each access to the custodian database 23 an entry is made with the audit log server 25 in the custodian system likewise during each access of the index server 5 and or entrusted medical information database 6 an entry is made with the audit log server 7 in the trustee system a further aspect of the present invention provides a financial accounting server 8 allocating an expense for use of the trustee system resources a user of the trustee system typically seeks medical records belonging to a patient although certain other uses of the system are permitted in accordance with strictly enforced access audit and accounting rules.