MP 942003

(Incorporating Amendment No. 1)

MP 94
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Miscellaneous Publication
Product numbering standards for electronic health supply chains

A1

MP 942003 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 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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Keeping Standards up-to-date Standards are living documents which reflect progress in science, technology and systems. To maintain their currency, all Standards are periodically reviewed, and new editions are published. Between editions, amendments may be issued. Standards may also be withdrawn. It is important that readers assure themselves they are using a current Standard, which should include any amendments which may have been published since the Standard was purchased. Detailed information about Standards can be found by visiting the Standards Web Shop at www.standards.com.au and looking up the relevant Standard in the on-line catalogue. Alternatively, the printed Catalogue provides information current at 1 January each year, and the monthly magazine, The Global Standard, has a full listing of revisions and amendments published each month. Australian StandardsTM and other products and services developed by Standards Australia are published and distributed under contract by SAI Global, which operates the Standards Web Shop. We also welcome suggestions for improvement in our Standards, and especially encourage readers to notify us immediately of any apparent inaccuracies or ambiguities. Contact us via email at mail@standards.org.au, or write to the Chief Executive, Standards Australia International Ltd, GPO Box 5420, Sydney, NSW 2001.

MP 942003
(Incorporating Amendment No. 1)

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

Miscellaneous Publication
Product numbering standards for electronic health supply chains

First published as MP 942003. 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 942003

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 Australias 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.
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Committee IT-014-10-04, Standards Australia and KPMG Consulting would like to acknowledge the support and contribution from those who participated in workshops, 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.

MP 942003

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 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 B C LITERATURE REVIEW........................................................................................... 26 BIBLIOGRAPHY...................................................................................................... 28 INTERVIEWS........................................................................................................... 31

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MP 942003

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 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) (b) (c) (d) messaging for electronic supply chains (IT-014-10-01); finance and billing (IT-014-10-02); standards for a central repository of core product data (IT-014-10-03); and product identification standards (IT-014-10-04).

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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) (b) the adoption of a single standard of European Article Numbering (EAN); or 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)).

MP 942003

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. 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.

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MP 942003

STANDARDS AUSTRALIA Miscellaneous Publication Product numbering standards for electronic health supply chains

SECT ION
1.1 OBJECTIVE

EXECUT I V E

SUMMARY

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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 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) (b) a single standard, using the European Article Numbering (EAN); or 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) (ii) Codification factors. 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.

Standards Australia

www.standards.com.au

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

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