MP 94-2003 Product numbering standards for electronic health supply chains by SAIGlobalAPAC

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									                                                                                                                         MP 94—2003
                                                                                                                         (Incorporating Amendment No. 1)
                                                                                           MP 94




                                                                                                   Miscellaneous Publication
This is a free 8 page sample. Access the full version at http://infostore.saiglobal.com.




                                                                                                   Product numbering standards for
                                                                                                   electronic health supply chains
                                                                                                MP 94—2003
                                                                                           A1   This Miscellaneous Publication was prepared by Joint Technical Committee IT-014,
                                                                                                Health Informatics. It was published on 12 May 2003.



                                                                                                The following are represented on Committee IT-014:
                                                                                                Australian Association of Pathology Practices
                                                                                                Australian Health Insurance Association
                                                                                                Australian Information Industry Association
                                                                                                Australian Institute of Health and Welfare
                                                                                                Australian Institute of Radiography
                                                                                                Australian Medical Association
                                                                                                Australian Private Hospitals Association
                                                                                                Australian and New Zealand College of Anaesthetists
                                                                                                Central Queensland University
                                                                                                Commonwealth Department of Health and Aged Care
                                                                                                Consumers’ Federation of Australia
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                                                                                                Consumers’ Health Forum of Australia
                                                                                                Department of Human Services, South Australia
                                                                                                Department of Human Services, Victoria
                                                                                                General Practice Computing Group
                                                                                                Health Department of Western Australia
                                                                                                Health Information Management Association of Australia
                                                                                                Health Insurance Commission
                                                                                                Health Professions Council of Australia
                                                                                                Institution of Engineers Australia
                                                                                                Medical Software Industry Association
                                                                                                New South Wales Health Department
                                                                                                National Health Information Management Group
                                                                                                Pharmaceutical Society of Australia
                                                                                                Queensland Health
                                                                                                Royal Australian College of Medical Administrators
                                                                                                Royal College of Nursing, Australia
                                                                                                Royal College of Pathologists of Australasia
                                                                                                Society of Hospital Pharmacists of Australia
                                                                                                The Pharmacy Guild of Australia
                                                                                                The Royal Australian and New Zealand College of Radiologists
                                                                                                The University of Sydney



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                                                                                                                                                 MP 94—2003
                                                                                                                                                 (Incorporating Amendment No. 1)




                                                                                           Miscellaneous Publication
This is a free 8 page sample. Access the full version at http://infostore.saiglobal.com.




                                                                                           Product numbering standards for
                                                                                           electronic health supply chains




                                                                                           First published as MP 94—2003.
                                                                                           Reissued and incorporating Amdt No. 1 (March 2004)




                                                                                           COPYRIGHT
                                                                                           © Standards Australia International
                                                                                           All rights are reserved. No part of this work may be reproduced or copied in any form or by any
                                                                                           means, electronic or mechanical, including photocopying, without the written permission of the
                                                                                           publisher.
                                                                                           Published by Standards Australia International Ltd
                                                                                           GPO Box 5420, Sydney, NSW 2001, Australia
                                                                                           ISBN 0 7337 5219 5
                                                                                           MP 94—2003                                         2




                                                                                                                                         PREFACE
                                                                                                This document was prepared by KPMG Consulting on behalf of the Standards Australia
                                                                                                Committee, IT-014-10-04, Health Informatics, Product Identification, for Standards
                                                                                                Australia’s Health Informatics Committee, IT-014.
                                                                                                This Standard incorporates Amendment No. 1 (March 2004). The changes required by the
                                                                                                Amendment are indicated in the text by a marginal bar and amendment number against the clause,
                                                                                                note, table, figure or part thereof affected.
                                                                                                The aim of considering product numbering standards for electronic health supply chains
                                                                                                project was to deliver a clear recommendation on a national product numbering standard to
                                                                                                be used across the Australian hospital supply chain.
                                                                                                Committee IT-014-10-04, Standards Australia and KPMG Consulting would like to
                                                                                                acknowledge the support and contribution from those who participated in workshops,
This is a free 8 page sample. Access the full version at http://infostore.saiglobal.com.




                                                                                                interviews and responded to questions regarding this document. Gratitude goes to Central
                                                                                                Sydney Area Health Service for providing the opportunity to visit Concord Hospital.
                                                                                                Sincere thanks are extended to all who have contributed for their time and discussion.
                                                                                                It is to be noted that in publishing this document Standards Australia International does not
                                                                                                endorse the contents in any way shape or form and that it is being published for the
                                                                                                information of the industry or anyone else interested in the debate surrounding product
                                                                                                identification within the health industry.
                                                                                                                                                              3                                                            MP 94—2003



                                                                                                                                                     CONTENTS

                                                                                                                                                                                                                           Page

                                                                                           FOREWORD.............................................................................................................................. 4

                                                                                           SECTION 1 EXECUTIVE SUMMARY
                                                                                             1.1 OBJECTIVE................................................................................................................ 6
                                                                                             1.2 KEY RECOMMENDATIONS .................................................................................... 7
                                                                                             1.3 SUPPORTING REASONING ..................................................................................... 7

                                                                                           SECTION 2 INTRODUCTION
                                                                                             2.1 CURRENT SITUATION............................................................................................. 8
                                                                                             2.2 PROJECT BACKGROUND........................................................................................ 9
                                                                                             2.3 STANDARDS DESCRIPTIONS ............................................................................... 10
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                                                                                             2.4 QUALITATIVE DIFFERENCES AND SIMILARITIES BETWEEN
                                                                                                 EAN AND HIBC CODING....................................................................................... 11
                                                                                             2.5 STAKEHOLDERS .................................................................................................... 13

                                                                                           SECTION 3 ASSESSMENT FRAMEWORK
                                                                                             3.1 PRODUCT CODING STANDARD ASSESSMENT PROCESS............................... 14
                                                                                             3.2 FRAMEWORK CRITERIA DEFINITIONS FOR THE PRODUCT
                                                                                                 CODING STANDARD ............................................................................................. 14
                                                                                             3.3 ASSESSMENT OUTCOME...................................................................................... 17

                                                                                           SECTION 4 CRITICAL ISSUE ANALYSIS
                                                                                             4.1 GENERAL ................................................................................................................ 18
                                                                                             4.2 INTERNATIONAL HEALTHCARE PRODUCT CODING TRENDS ..................... 22

                                                                                           APPENDICES

                                                                                               A        LITERATURE REVIEW........................................................................................... 26
                                                                                               B        BIBLIOGRAPHY...................................................................................................... 28
                                                                                               C        INTERVIEWS........................................................................................................... 31
                                                                                           MP 94—2003                                          4




                                                                                                                                        FOREWORD
                                                                                                Background
                                                                                                In July 2000, the National Health Information Management Advisory Committee (NHISAC)
                                                                                                established a National Supply Chain Reform Task Force, comprising broad representation
                                                                                                from hospitals, suppliers and government sectors to develop a national action plan for
                                                                                                establishing e-commerce in the Australian hospital sector.
                                                                                                A key objective for the Task Force is to establish robust national electronic hospital supply
                                                                                                chain open standards to support the formal collection, storage and transmission of data
                                                                                                within hospital electronic supply chains. Robust standards will reduce the number of
                                                                                                different systems needed to transact business, providing a framework for trading partners to
                                                                                                share information, irrespective of organizational changes or differences. This in turn will
                                                                                                reduce administrative costs related to business transactions. Decisions on standards are
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                                                                                                needed early to inform investment by States and Territories, hospitals and suppliers of
                                                                                                information systems.
                                                                                                The issue of standards development was considered at the Supply Chain Reform Task Force
                                                                                                Summit held in Sydney in December 2000. The Working Group recommended that the Task
                                                                                                Force approach IT-014 to work with stakeholders to agree on technical standards for
                                                                                                electronic supply chains in the hospital sector.
                                                                                                IT-014 subsequently agreed to establish a sub-committee (IT-14-10) dedicated to standards
                                                                                                for electronic supply chains and four working groups, covering—
                                                                                                (a)     messaging for electronic supply chains (IT-014-10-01);
                                                                                                (b)     finance and billing (IT-014-10-02);
                                                                                                (c)     standards for a central repository of core product data (IT-014-10-03); and
                                                                                                (d)     product identification standards (IT-014-10-04).
                                                                                                The work of these groups extends beyond hospital supply chains, to encompass all of
                                                                                                health.
                                                                                                Issues
                                                                                                The working group IT-014-10-4 agrees that standards for product descriptions and product
                                                                                                numbering are critical to enable automation of health supply chains and to support
                                                                                                electronic product sourcing. Standardised product descriptions will help buyers to search
                                                                                                for products on electronic catalogues. Standardising product numbering will help to reduce
                                                                                                errors in ordering and delivery processes. Standardised product numbering will support
                                                                                                standardised barcoding which has the potential to significantly reduce both the need to
                                                                                                re-key data and opportunities for human error.
                                                                                                The working group considered the following options in order to reach a consensus position
                                                                                                on product numbering—
                                                                                                (a)     the adoption of a single standard of European Article Numbering (EAN); or
                                                                                                (b)     the adoption of both EAN and the Health Industry Business Communications Council
                                                                                                        numbering system (HIBC) as the primary identifier of products (the universal product
                                                                                                        numbering standard (UPN)).
                                                                                                                                         5                                        MP 94—2003


                                                                                           The EAN system is broadly used in retail and grocery sectors and is the predominant coding
                                                                                           system used by the pharmaceutical sector. EAN numbering has been recommended by the
                                                                                           Medicines Coding Council, for example, to provide a primary identifier for medications in
                                                                                           the Better Medication Management System. The HIBC system is the predominant code used
                                                                                           by the medical/surgical sector, particularly in the United States.
                                                                                           Approximately $1.5 billion is spent on both pharmaceutical and medical/surgical products
                                                                                           in Australia each year. When all products consumed by a hospital are taken into account,
                                                                                           the use of EAN barcodes predominates. However, it is important to note that
                                                                                           medical/surgical devices are high risk items. A decision to re-label products in Australia
                                                                                           could have safety implications and may give rise to additional legal liability for Australian
                                                                                           distributors. Furthermore, Australia imports the vast majority of its medical/surgical and
                                                                                           pharmaceutical stock. This creates challenges for the Australian market to influence
                                                                                           behaviours of international parent companies. It will therefore be important for the
                                                                                           Australian market to have regard to international trends, both in terms of larger markets
                                                                                           (Europe and the United States) and also aggregated trends in smaller markets.
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                                                                                           In reaching a decision, the working group is also cognisant of linkages between standards
                                                                                           for electronic supply chains in health and other health information management initiatives.
                                                                                           Ultimately the goal is to facilitate tracking of products to the patient. In considering the
                                                                                           appropriateness of product numbering for health, it will therefore be important to ensure
                                                                                           that products can be identified down to unit dosage and component levels. There will be
                                                                                           benefits in linking the numbering standard to other clinical applications, for example to
                                                                                           provide the ability to incorporate and link codes to therapeutic guidelines databases,
                                                                                           incorporation of diagnosis codes and any other applications.
                                                                                           There is no global standard for product numbering. A considerable volume of literature is
                                                                                           available on the relative merits of available product numbering systems. The two numbering
                                                                                           companies have produced much of this information and inconsistent assertions appear.
                                                                                           There is considerable sensitivity about product numbering standards within the
                                                                                           medical/surgical sector. The New South Wales government announced it will give
                                                                                           preference to companies using EAN numbering, but has subsequently agreed to delay
                                                                                           implementation of this policy to take account of the recommendations of the Standards
                                                                                           Australia Working Group.
                                                                                           Given the extent of sensitivities and the lack of industry consensus, the working group is
                                                                                           seeking advice from a consultant on international trends about whether there are qualitative
                                                                                           differences between the two codes for e-commerce and e-health purposes.
                                                                                           MP 94—2003                                          6




                                                                                                                                 STANDARDS AUSTRALIA

                                                                                                                                 Miscellaneous Publication
                                                                                                        Product numbering standards for electronic health supply chains



                                                                                                            SECT ION             1    EXECUT I V E            SUMMARY

                                                                                                 1.1 OBJECTIVE
                                                                                                 A key objective of the National Supply Chain Reform Task Force (a sub-group of the
                                                                                                 Australian Health Ministers Advisory Committee) is the establishment of a robust national
                                                                                                 electronic hospital supply chain open standard to support the formal collection, storage and
This is a free 8 page sample. Access the full version at http://infostore.saiglobal.com.




                                                                                                 transmission of data within hospital supply chains.
                                                                                                 Robust standards will reduce the number of different systems needed to transact business
                                                                                                 and provide a framework for trading partners to share information, and enable the effective
                                                                                                 implementation of e-commerce in the hospital supply chain.
                                                                                                 To date, two key product numbering standards have been used in Australia and
                                                                                                 internationally, namely EAN and HIBC. This has hindered the establishment of a single,
                                                                                                 efficient and consistent approach to product numbering across the multiple supply chains
                                                                                                 that feed into the hospital sector in Australia.
                                                                                                 The aim of this project was to hand down a clear recommendation on a national product
                                                                                                 numbering standard to be used across the Australian hospital supply chain. Key options
                                                                                                 which were evaluated during the assessment process included—
                                                                                                 (a)     a single standard, using the European Article Numbering (EAN); or
                                                                                                 (b)     dual standards using both EAN and the Health Industry Business Communication
                                                                                                         Council numbering system (HIBC) as the primary identifier of products, thus
                                                                                                         achieving a universal product numbering standard (UPN).
                                                                                                 Following broad industry consultation across a range of interested stakeholders and a
                                                                                                 detailed assessment of published materials, a range of key assessment criteria categories
                                                                                                 and sub-elements were developed as follows:
                                                                                                 (i)     Codification factors.
                                                                                                 (ii)    Coding standard factors.
                                                                                                 (iii) User requirements.
                                                                                                 (iv)    System factors.
                                                                                                 These were used to assess options (a) and (b). The assessment was also supported by an
                                                                                                 international market review to develop a deeper understanding of the direction and key
                                                                                                 trends emerging in other relevant markets with hospital supply chains.
                                                                                                 As a result of the consultation process supporting secondary research and structured
                                                                                                 analysis, a range of clear recommendations have been developed which are outlined in
                                                                                                 Clause 1.2.




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                                                                                                             MP 94-2003, Product numbering standards for
                                                                                                             electronic health supply chains
This is a free 8 page sample. Access the full version at http://infostore.saiglobal.com.




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