Systems and techniques are disclosed for trust based access to records via encrypted protocol communications with an authentication system. An example system is configured to authorize and provide selective and secured access to sensitive medical information according to one or more trusted relationships. The system is configured to receive a request for access to a patient's health record from an outside entity. Authentication information associated with the outside entity is determined. Whether the outside entity is authorized to access the requested data is determined. The determination is based on existence of a trust relationship being established between the outside entity and the patient, the trust relationship established by an action of the patient or a patient's representative. Access to the patient's health record is enabled based on a positive determination.