Tracing the origins of the HIPAA regime, Mark C. Suchman considers how new technologies are “domesticated” by law, organizations, and professions.
In the late 1990s and early 2000s, advances in health information technology (also known as HIT) promised to simplify the process of receiving health care and paying for it. Inspired by this vision, Congress incorporated a set of “administrative simplification” provisions into the Health Insurance Portability and Accountability Act in 1996, aiming to ease the transmission of electronic health records while also protecting patient privacy.
Despite coming on the heels of bitterly partisan battles over the Clinton health reform plan, the Act, better known as HIPAA, received broad political support, including unanimous passage by the Senate in April 1996. Nevertheless, the path from HIPAA’s broad legislative language to detailed regulations was long and arduous, and many of the promised benefits proved slow to materialize. How could it be that steady consensus among lawmakers became turbulent in practice?
A new project from ABF Research Professor Mark Suchman will examine how law, organizations and professions “domesticate” technological change, and consider how intersecting institutional agendas shape the resulting governance architecture.
Suchman is a Research Professor at the American Bar Foundation and a Professor of Sociology at Purdue University. He served as Executive Director of the ABF from 2023 to 2025. Before joining the ABF, Suchman was a Professor of Sociology at Brown University, where he led the Sociology Department’s Work, Organizations, and Economy faculty.
Suchman’s research focuses on the impact of law and legal institutions on organizational and economic life, with a particular interest in the ways in which legal conditions can create—or foreclose—opportunities for innovation, entrepreneurship, and technological change.
In his new project, Constructing the HIPAA Regime: Legislation, Regulation, and Institutional Entrepreneurship in the Half-Hearted Stampede Toward Health IT, Suchman aims to answer two questions: What sociolegal and sociotechnical processes gave rise to the HIPAA regime, and how did various actors in industry, the patients’ rights movement, the health policy community, Congress, and the Department of Health and Human Services seek to insert their perspectives and agendas into the emerging legal structure?
Through interviews, this project aims to foreground an oral history of the key players who shaped HIPAA’s implementation. This project will build a deeper understanding of the role of these actors in influencing what HIPAA became as the policy agenda moved through the legislative and regulatory process.
In addition to academic articles, this project will produce a curated set of interview transcripts and historical documents. The archive of these additional materials will be maintained and used in continuing research about the governance of technology, privacy, and organizational compliance.
While the project aims to examine HIPAA specifically, the lessons learned from this project will be an aid to sociolegal scholars of regulation and legal institutions who want to understand the relationship between legislative and administrative processes and the governance frameworks they produce. Policymakers, practitioners in health information policy, and those interested in digital privacy can also draw on the project’s insights.
New technology and its regulation are increasingly key determinants of how we live and work. Understanding how people interact with, resist, and respond to technological progress will be invaluable to those seeking to regulate technology or more deeply understand our relationship with it.