This study provides an in-depth discussion of the various issues, incidents, and next/best-practice models regarding privacy in the outsourcing of services requiring the usage of Protected Health Information (PHI). In addition, a survey of 33 hospital executives within the United States at the Vice-President level and above was conducted, relating their individual attitudes and perceptions of privacy in outsourcing to the actual policies and practices of their organization. Convenience sampling was utilized to identify respondents, who were referred to an electronic version of a 23 question survey. Responses indicate that a link exists between the perceptions of hospital executives and the hospital's policies and procedures. The study also reinforces a number of best practice models and implies a need for executives to stay informed regarding potential issues in choosing outsourcing partners.