Introduction: Undoubtedly, the medical record is one of the most important documents containing the most sensitive information on the public health and treatment. As a matter of fact, protecting the confidentiality of the recorded information and the documents there in should be given top priority. Thus, given the importance of the confidentiality of medical document, and their impact on the better performance of hospitals, this study investigates the access levels and confidentiality of medical documents in Iran and selected countries and makes and effort to identify the existing gap.

Methods: This study is a descriptive - comparative one which uses a cross - sectional style. The research sample includes Canada, Australia, USA, and England. It is because these countries have made considerable progress in the confidentiality of medical documents. The study data were gathered via internet and communication with professionals and relevant

organizations in the countries. In the case of Iran, the data were collected, using library studies.

Results: It is concluded that there is no integrated organization for the management of medical documents and the development of its standards. 1) The status of medical documents, onfidentiality and access levels of medical documents in Iran are far from world standards. 2) The lack of consistency between the performance of medical documents in Iran hospitals and standard activities in developed countries has resulted in the gap between existing activities and stated purposes. 3) The countries under study have made great progress in confidentiality of medical record.

Conclusion: It is evident that due to extended application of medical records for several ntention including medical consultations, authentication in legal cases, third parties and health researches, addressing privacy principles is essential. Meanwhile utilization of records content for above mentioned objective also is important and it must be taking correct action while interference patient privaet and public rights. With studied countries will be useful to develop and correct national health care rules for effective management of vital medical information.