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Measuring meaningful use of supply data standards
Who should be held accountable for adoption, implementation? by Rick Dana Barlow
C
harles Dickens could apply the open- ing sentence of his classic novel “A Tale of Two Cities” to the supply data standards movement in healthcare: “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity…”
Clearly, supply data standards momen- tum in healthcare has weathered its share of fits and spurts, ups and downs along the rollercoaster of progress.
Supply data standards represents one of those issues where, post-universal adoption and implementation, healthcare profession- als will step back, scratch their chins and ask with mock disbelief why it took so long to carry out. Pharmaceutical manufacturers and dis- tributors used the “patchwork quilt” of state regulations for pedigree in the early 1970s to motivate the federal creation, adoption and implementation of a single standard, known as the National Drug Code (NDC) for prod- uct identification and the DEA Registration Number (Drug Enforcement Agency) to identify locations for controlled substances. Meanwhile, the grocery, manufacturing and retail industries already were using the Universal Product Code (UPC) for product identification and tracking purposes. Medical device/product manufacturers and distributors, however, skated around supply data standards until the late 1980s with the formalized Common Category Database (CCD). But the CCD faded by the mid 1990s when critical mass wasn’t achieved and key companies withdrew their support of the project. As healthcare organizations relegated the CCD to industry lore they shifted their interests and allegiance next to a new initiative spearheaded by the Department of Defense and being promoted by the then-named Health Industry Bar Coding Council (HIBCC), along with the Health- care EDI Coalition (HEDIC). Both HIBCC and HEDIC picked up the supply data standards baton to rally healthcare sup-
pliers and providers around the Universal Product Number (UPN). With healthcare organizations grap-
pling with President Clinton’s healthcare reform efforts the timing seemed right for a renewed push for supply data standards that could be reinforced by the clinical, financial and operational benefits gleaned from adoption and implementation. The mi- gration to open electronic data interchange formats from proprietary systems only fu- eled the interest as proponents argued for more accurate data flowing through the pipes and not just more data.
By the end of the decade, however, the alluring emergence of online electronic commerce through Internet and Web-based exchanges turned heads. And just like that, HTML and XML entered the lexicon of noteworthy acronyms striving to increase efficiencies, decrease costs and boost rev- enues along the way.
Unfortunately, the Internet bubble burst within several years. Yet as the smoke cleared by mid-decade healthcare organiza- tions acknowledged the ongoing need for supply data standards particularly because the Internet provided a faster way to trans- mit information and transact business. Enter GS1, a global product standards- oriented organization with deep roots in the manufacturing and retail industries. Representatives from several healthcare companies approached GS1’s U.S. division to promote healthcare as a viable industry segment for their standards system. Rec- ognizing opportunity, GS1 U.S. launched its healthcare group more than five years ago with aims to accelerate the momentum toward standards adoption and implemen- tation that has been mired in debate and discussion for more than three decades. Since then, GS1 Healthcare US has signed on scores of healthcare product suppliers and providers to adopt its Global Location Number (GLN) and Global Trade Item Number (GTIN) standards. In fact, GS1 Healthcare US reported solid growth in the number of GLNs and GTINs in use
10 March 2014 • HEALTHCARE PURCHASING NEWS •
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and members added, among other data from 2013, the fifth year of its initiative. (See chart online.) While some will argue that GS1 Health- care US has recruited more organizations to its standard identifiers than earlier ef- forts, others will contend that it may have persevered the longest but still has yet to reach critical mass in that the majority of hospitals and other healthcare facilities and suppliers are using GLNs and GTINs on the majority of the products they buy and sell. In fact, Healthcare Purchasing News annual reader surveys since 2010 have showed that less than half of U.S. hospitals have implemented GLNs and GTINs fully across a majority of product categories. Yet implementation intentions spike around GS1 Healthcare US’ Sunrise dates. (See graphic here or online). “The healthcare industry has moved further and faster than previous initiatives to adopt common data standards in other industries, once the common standard was selected,” said Michael Pheney, Vice Presi- dent, Healthcare, GS1 US. “What took 10 years in the retail industry to achieve with standards adoption is taking only a few years in healthcare. The healthcare industry set clear goals and utilized lessons learned
Michael Pheney
from other industries, which helped health- care to accomplish the results to date.” When the pharmaceutical industry struggled with the myriad state regula- tions drug companies took an aggressive approach by seeking a federal guideline to simplify the process with a unique product identifier. The Drug Listing Act of 1972, which established the NDC, fit the bill. Until last year, the medical device/ product industry took more of a passive aggressive approach. Suppliers and provid- ers understood the need for product data standards, but neither would act before the other and certainly not before the FDA provided a “fair regulation that applied
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