The Health Insurance Portability and Accountability Act (HIPAA, Public Law104-191), signed by President Clinton on 21 August 1996, is definitely providing a strong push for the US health care sector to embrace various e-commerce initiatives. The Act aims to improve productivity of the American Health Care System by encouraging the development of information systems based on the exchange of standard management and financial data using EDI. It also requires organizations exchanging transactions for health care to follow national implementation guidelines for EDI established for this purpose. It is clear that such an Act is attempting to encourage the adoption of various forms of IS/IT by respective players in the health care arena. This paper presents the case of Kaiser Permanente-Ohio and their development and use of MARS (medical automated record system); an e-knowledge management system in health care. From case study data we show that MARS has not only enabled Kaiser to provide high quality cost effective service to its enrollees but it also enables Kaiser to enjoy a position of strategic advantage in terms of the directives of this Health Insurance Portability and Accountability Act. We strongly urge for an e-knowledge focus as a strategic imperative in today's health care environment. Further, we believe it is only when the automated medical record system is viewed as an e-KMS that its full potential and power can be realised.