Health care standards have been evolving over time. A plethora of processes and forces take part in igniting the developments. These changes could be ad hoc, systematic or even consensual. At the bottom lurks a well-established organizational structure whose object is to review the performance of the standards and propose advancement where circumstances so require. However, certain areas lag, occasioning serious inefficiencies to the system. Often, the legal framework is a serious undoing and affects the realization of these standards. Besides, diverse standards contain varying recommendations, and this tends to atrophy the efforts therewith. Perhaps a biggest of all is the apparent lack a fully centralized integrated system to reconcile the differences. The world is evolving in all spheres such as technology, legal framework, and nature of diseases. The changes imply a need for these standards to keep in phase and updated. This requires the engineers of the standards to keep au fait with the current developments. The modern society boasts of a multitude of standards. It is important to have a look on a few of these standards to understand how they operate, and current issues affecting them.
National Council for Prescription Drug Program (NCPDP)
NCPDP is a US based standard. Its advent dates back in 1977 as a part of an extension of Drug Ad Hoc Committee that could make recommendations to the US National Drug Code of at the time (Choi et al., 2006). It doubles as an organization but a nonprofit-oriented one for that purpose. This organization wins its credibility through ANSI accreditation, a standards development body composed of over 1575 members across all the pharmaceutical industry. Its membership constitutes an important resource by providing solutions through development of standards and field excursions.
NCPDP is legally recognized in the US. Legal instruments such as Health Insurance Portability and Accountability Act take cognizance of its functions in setting up standards for data transmission (McGraw, 2013). Its major focus is on development of an efficient data sharing system across private and public health care facilities. NCPDP takes plaudits for keeping in phase with most modern technologies for optimal user experience. A bigger fraction of its standards features technological element in them. Such standards such as telecommunication standard, batch standard, manufacturer rebate and SCRIPT standard epitomizes the role of technology in facilitating data sharing. The participants of NCPDP fall into three categories, processors, general interest and producers. These standards are still in place in many sectors of healthcare. The National Provider Identifier, for instance, has remained steadfast that NCPDP SCRIPT version is the acceptable standard for prescription-related data.
Despite its crucial input in health care, the standard faces serious challenges. Arguably, the standard is a summation of best practices among health practitioners. However, the standard does not maintain a conventional rigid standard. Constant changes to the standards overly involve to an organization that lacks an efficient compliance mechanism. For instance, in the year 2008, the federal register released a new set of NCPDP on what it considered as the next set of NCPDP standards. A few of them have been adopted to date. In addition to this, a multiplicity of varying standards on a single field affects implementation of the rules in two ways. First, it makes application unpredictable. For instance, in the year 2008, the Centers for Medicare and Medicaid Services (CMS) proposed national provider identifier and recognized NCPD as acceptable e-prescriptions standard. This implies that providers can choose to adopt either but the limitations of either are bound to vary immensely.
ASTM Health Record Content Standard
As is an international nonprofit driven standard organ that focuses on publishing and developing consensual standards for a wide range of areas not limited to products, services, and materials (Hammond, 2005). To date, over 12000 voluntary, consensual standards operate globally. The organization has a long history dating back to its advent in 1898.
Its membership is open and voluntary to all with an interest in its activities. However, membership to specific committees is limited to one’s request. Its members fall into three categories, that is, general interest, consumers, users, and consumers. Its standards are developed at the committee level before publication. To ensure that the standard stays in compliance with antitrust laws, the organization requires producers to constitute at least 50 percent of each committee membership.
ASTM standard does not imply strict compliance on member states. In essence, it does not oblige specific member states to observe these standards. Notwithstanding this, its publications and standards therein are voluntary and consensual. Even so, members easily observe these standards without the need for coercion. However, a state could make them mandatory by referring to them in an external contract, government or corporations. The National Technology Transfer and Advancement Act, for instance, require the federal government to make use of privately developed standards whenever circumstances allow. The major issue here is the voluntary nature of the standard. The federal policy provides a light approach on the same. If anything, the standard presents an efficient way of beating mandatory standards. Reconciling the two presents a close to an insurmountable challenge.
RxNorm
RxNorm doubles as two things, a controlled naming system and a facilitative tool for promoting interoperation between terminologies and knowledge based systems in pharmacies (Mead, 2006). In a typical scenario different organizations pharmacies, records drug information own way. This situation presents a big challenge when sharing information across hospitals and organizations. The variations needlessly defeat any effort of sharing. RxNorm standard finds relevance in this situation by providing a regulated platform for naming drugs. The standard proposes on placing unique identifiers for available drugs. The governing object is to allow computer systems to relay drug related information without t identification limitations. The standard applies both to generic and branded drugs. RxNorm normalized naming applies widely. To date, about 60 percent of drugs use two names, one from the source vocabularies and normalized identifier. The remaining fraction lacks this identification because either it is out of scope or they are too ambiguous for normalized naming.
Although RxNorm naming has wide application, it contains insufficient information to add structure to some classes such as NCD. Even so, it is a classified issue, and study on the same is ongoing to explore ways of capturing information of structured product levels to take account of bottles versus boxes. Besides, lack of a significant link between drug products and dosages is a notable issue, and naming takes only the upper ontology. For instance, RxNorm of an inhaler takes focus on the container and not the content inside.
Adoption of Health Care IT Standards
Technological advancement is a contemporaneous issue that every sector of healthcare is striving to observe to improve interoperability and efficacy. In the modern society, efficiency is a dictate of the level of technological adoption and lack of it imputes many limitations. Some scholars have insisted that organizations have to engage some certain level of technology at least for survival. Sharing of information among several hospitals and pharmacies, for instance, can never happen efficiently without proper appreciation of the role of technology. Adoption of technology takes three standards. In functionality, IT standard involves among other things, transmission of information, certain computations, and operations performed by a system. Under purpose, health IT standard focus on improving treatment, facilitate payments and certain operations. Syntactically, the standard can use the traditional text-based electronic data or even binary formats.
These standards are conceived and developed by existing Standards Development Organizations. Based on compliance to set procedures, the American National Standards Institute accredits a standard organization. Standards development is a preserve of certain category of people that including IT geeks, health providers, policy makers and consumer advocate. In the US, the major developers of IT standard are the Health Level Seven International, DICOM, IEEE, and ASC. The US government use advocates for, develops and mandates the use of standards (Glaser et al., 2008). It also has a place for utilization of voluntary and consensual standards. Where the federal government declares a standard mandatory, the healthcare facility is bound to comply, and adoption is dictated. Where the same is voluntary, the federal government has to stamp and recognize such standards. A government is an overwhelming policy and legal maker and facilitates recognition through such efforts. Regulators such as CMS and ONC are important and have a big say in informing adoption. However, certain initiatives and legislations defeat this goal. Often, it is the case when there is a conflict of interest and when a regulation expressly downplays the relevance of a particular standard. Telemedicine and Telehealth initiatives such as remote monitoring signify the success of IT in the health sector (Choi et al., 2006). However, in the recent years, adoption has turned out to be too slow, overly political and cumbersome to attach any value.
Conclusion
Standardization is a necessary tool, an imperative in the health sector. Economies differ in strength, yet the claws of diseases are felt in equal magnitude. Standardization creates an avenue for a homogenous approach to deal with challenges that maim health sector. For instance, different naming formulas could ooze anarchy and cause disproportionate problems when seeking to identify certain drug brands. At the bottom of it, technology acts the facilitative role. However, technology has its issues such incapability to deal with the question of patient’s privacy. All in all, the few challenges could be corrected to confer the best to the future generations.
References
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