This study explores the organizational, professional and legal challenges posed by new health information technology (HIT) in American healthcare. Although technologies such as electronic health records (EHR) and computerized provider order-entry (CPOE) promise to improve the quality and efficiency of patient care, they also raise the specter of new forms of competition, regulation, surveillance, and inequality. The present study focuses on the “governance mechanisms” -- laws, rules, ethics and norms -- that are emerging to manage this HIT revolution. Of particular interest are the federal privacy, security and data-standardization regulations adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as well as the policies and practices that healthcare organizations have implemented to become “HIPAA-compliant.”

Findings from the HITS project will help policymakers to develop the immense potential of HIT systems, while avoiding the equally immense pitfalls. At the same time, the research will also help social scientists to understand the basic forces that shape innovation, standardization, trust, accountability, and legal compliance in the healthcare arena. The HITS project is yielding important insights into how a diverse set of governance mechanisms intersect with one another, as legal enactments, organizational cultures, and professional ethics combine to determine the fate of HIT initiatives both within particular healthcare organizations and throughout the healthcare sector as a whole.