The emerging US National Healthcare Information Network (NHIN) will improve healthcare's efficacy, efficiency, and safety. The first-generation NHIN being developed has numerous advantages and limitations. One of the most difficult aspects of today's NHIN is ensuring privacy and confidentiality for personal health data, because family and caregivers have multiple complex legal relationships to a patient. A Social Actor framework is suggested to organize and manage these legal roles, but the Social Actor framework would be very difficult to implement in today's NHIN. Social Actor Security Management could, however, be effectively implemented using Service Oriented Architectures (SOAs), which are rapidly becoming accepted for supporting complex information exchange across heterogeneous information systems fabrics. The Department of Defense is applying SOA to all of its enterprises. It is using customized simulation and modeling tools to achieve security and robustness goals and to reduce the intrinsic design and implementation risks for SOA's complex Systems of Systems environment. This paper integrates all of these approaches into a next-generation NHIN-2 design based on a specific Air Force SOA named MCSOA. This NHIN-2 design uses MCSOA to create Security Management, Service Discovery, and Presence Management agents to implement Social Actor support for improved confidentiality and privacy.