The HHS Security Series notes, “When the final Security Rule was published, the security standards were designed to be “technology neutral” to accommodate changes. The rule does not prescribe using specific technologies so that the health care community will not be bound by specific systems and/or software that may become obsolete.”
The concept of technology neutrality within the Security Rule is a way for healthcare entities to explore a variety of technological solutions without being restricted to specific tools or systems. An example of this is while encryption is recommended as a best practice for protecting electronic protected health information (ePHI), organizations are not confined to a single method of implementing encryption. The flexibility allows organizations of different sizes to implement security measures that are reasonable and appropriate for their size and available resources.
Defining technology neutrality standards
Technology neutrality means that standards or regulations specify the performance or outcome to be achieved rather than mandating the use of any particular technology or method. In the U.S. healthcare sector, technology-neutral standards for health information exchange set interoperability goals that do not dictate which software or hardware must be used to achieve them.
An example of this is illustrated in a Journal of the American Medical Informatics Association study on the classification of technological readiness, “The American Recovery and Reinvestment Act (ARRA) of 2009 clearly articulated the central role that health information technology (HIT) standards…for enabling technical, semantic, and operational interoperability so that healthcare information could be privately and securely exchanged.”
The concept is intertwined with the idea that technology itself is value-neutral, meaning it is not inherently biased or value-laden before its application. However, while technology may be designed to be neutral in form, its development and use are always embedded in social contexts that can introduce biases. For example, algorithms or technologies designed by specific individuals carry implicit biases based on those designers’ perspectives and experiences, challenging the practical realization of true technological neutrality.
Why technology-neutrality is a policy goal
One of the reasons technology neutrality is a policy goal is its ability to encourage innovation. When organizations or regulators specify only the goals or outcomes to be achieved, rather than locking in a particular technology, it provides the freedom for multiple technological solutions to compete and evolve. The flexibility is needed because technology landscapes change rapidly; what is advanced and relevant today can quickly become obsolete tomorrow.
According to a study on the role of digital technology in organizational structure published in Frontiers in Psychology study titled, ‘Role of Digital Technology in Transforming Organizational Competencies Influencing Green Economy: Moderating Role of Product Knowledge Hiding’, “Digital technology has led to many benefits for organizations like centralization, access to new markets, and transparency, which have been made possible remotely only because of the use of digital technology in business operations.”
Organizations gain the freedom to select or develop solutions most suited to their unique operational needs without being constrained by outdated regulatory requirements. In information and communications technology (ICT), technology-neutral standards enable systems to interoperate and evolve even as new protocols or platforms emerge. It promotes speedier adoption of new technologies and services, thus enhancing organizational competitiveness and responsiveness to market demands.
Technology neutrality also helps avoid market distortions and vendor lock-in, which is another organizational benefit. By not favoring one technology or vendor, organizations maintain a level playing field, promoting fair competition. The openness lowers barriers to entry for startups and new players, helping stimulate diverse innovation ecosystems rather than allowing dominant firms to entrench their market positions through regulatory capture.
Why these standards benefit healthcare organizations
The areas requiring standardization are noted in an International Journal of Environmental Research and Public Health study, “Digital technologies include a wide range of domains: AI, automation technologies... electronic health records, mobile health, telemedicine, personalized healthcare... all entail potential benefits and pose challenges.” By defining what outcomes or functional capabilities are required, rather than how to achieve them technologically, these standards enable healthcare organizations to incorporate novel, sometimes heterogeneous technologies seamlessly into their ecosystems without costly or disruptive infrastructure overhauls.
If standards locked organizations into specific technologies, they would risk obsolescence and face barriers to adopting breakthrough tools. Instead, technology-neutral standards allow healthcare providers and technology developers to compete and innovate on equal footing, accelerating the adoption of cutting-edge, effective solutions.
Healthcare organizations bear substantial costs in technology acquisition, integration, and maintenance. Neutral standards create a competitive environment where multiple vendors can provide interoperable and compliant solutions, reducing dependence on proprietary systems and enabling better procurement choices. This competition can lower costs while enabling scalability and sustainability, necessary in a sector where resources are often constrained and healthcare demands are rising.
Patient safety and care quality also benefit substantially. Technology-neutral standards set clear, measurable performance requirements, like accuracy, reliability, and security, without limiting available technological pathways. It ensures healthcare organizations implement tools that meet rigorous safety and efficacy thresholds appropriate for their patient populations.
How healthcare organizations can implement technology neutral standards
- Organizations should start by conducting risk assessments to identify vulnerabilities in their systems and determine the appropriate safeguards for the protection of ePHI.
- The next step is the development of policies and procedures that reflect their chosen technologies and security measures. Every process involved in this step should be documented.
- When using third-party services like HIPAA compliant email platforms or telehealth services, a business associate agreement (BAA) should be in place.
FAQs
How would healthcare organizations benefit from more targeted technological standards?
Targeted technological standards provide clear guidelines that help organizations implement technology that aligns with specific compliance requirements instead of the uncertainty of neutrality standards.
How can the process and procedures related to HIPAA compliance be documented?
Policies are documented by creating written records outlining how ePHI is handled and making use of resources like email that create a comprehensive document trail.
What is the consequence of the removal of addressable and required implementations?
Without clear distinctions between addressable and required implementation when accompanied by targeted standards takes away some uncertainty in the context of compliance.
Kirsten Peremore
