Understanding NCPDP Standards

Friday, January 13, 2017

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Adeptia

National Council for Prescription Drug Programs(NCPDP) publishes standards forthe electronic exchange of healthcare information related to pharmacy services.

NCPDP standards

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SCRIPT Standard for Electronic Prescribing

In this blog, we will discuss the SCRIPT Standard used in Electronics Prescribing. This standard covers data exchanges between prescribers, pharmacies, intermediaries and payers.

SCRIPT Format

SCRIPT is a standard data set for the interchange of prescription data and related information in the medical provider community.

So let’s talk about the formats used in this standard. There are two types, XML and EDIFACT. The older versions such as 4.2 are in EDIFACT format.

The newer version such as 10.6 has an XML format option. If you are a member of NCPDP, you can download all their standards and the related implementation guides.

  1. 1.Version 8 and later are now using XML data dictionary. The current standard is 10.6 (as of August 2014).
  2. 2.Version 8 and earlier are in UN/EDIFACT standard (transaction types in the UIH segment indicate the message type and subject)

We will show different message types in both XML and EDIFACT formats later in this post.

How does Adeptia integrate with NCPDP standards?

Adeptia is a member of NCPDP and provides full NCPDP Standards Data Dictionary, Process Templates and the Data Mapping rules to route and convert the NCPDP data into any target format. The process templates depend on the type of transaction we are working with.

Here are all the SCRIPT transactions along with their Message-IDs and descriptions of the most widely used transactions:

New prescription request(NEWRX)

  • Prescription request from the doctor to the pharmacy
  • Watch video herehttp://support.adeptia.com/entries/58395185-Use-Case-NCPDP-Integration-of-New-Prescription-Requests

Change of new prescription (RXCHG)

  • These transactions are used when the pharmacy is requesting change in the original prescription and the prescriber’s response. An example may be to change the daily dosage of the prescribed medicine or changing the medicine to a specific manufacturer.
  • Video:http://support.adeptia.com/entries/58135119-Use-Case-NCPDP-Integration-of-Change-Prescription-Requests

Cancel of prescription (CANRX)

  • This transaction is a request from the prescriber to the pharmacy not fill a previously sent prescription and the pharmacy response.

Refill/renewals request/response or Resupply in long-term care (REFREQ, RESUPP)

  • These transactions are used from the pharmacy to the prescriber requesting additional refills and the prescriber’s response.

Fill Status notification (RXFILL)

  • This transaction is sent to the prescriber from the pharmacy and indicates the status of the dispensing (dispensed, partially dispensed, not dispensed).

Medication history exchange (RXHREQ/RXHRES)

  • This transaction is from a pharmacy or a doctor requesting a medication history from a healthcare provider, and the medication history response.
  • Video:http://support.adeptia.com/entries/58581785-Use-Case-NCPDP-Integration-of-Medication-History-Requests

Following are some of the other transmission types:

  • Password Change (PASCHG)
  • Status is used to relay the acceptance of a transaction back to the sender (STATUS)
  • Verification (VERIFY)
  • Drug Administration exchange in long-term care
  • Prescriber-reported samples for more robust medication history
  • Query functions for new prescriptions

To summarize, companies can leverage Adeptia’s modern data integration solutions to seamlessly integrate with NCPDP (National Council for Prescription Drug Programs) format and standards, which are crucial in the healthcare and pharmacy industry. These solutions enable organizations to efficiently connect their systems and databases with the standardized formats and protocols required by NCPDP, ensuring smooth and compliant data exchange. By doing so, companies can enhance the accuracy and speed of processing prescription drug information, improve patient care, reduce errors, and streamline administrative tasks. This modern data integration solution not only simplifies the integration process but also ensures that businesses stay up-to-date with evolving NCPDP file and standards, ultimately contributing to better healthcare outcomes and operational efficiency.

How to Implement SCRIPT Process flow in Adeptia?

The advantage of using Adeptia Solution is that it enables your business users or non-technical users to configure the above transactions quickly without having to write code or to read through complex implementation guides. Adeptia has done all the work for you by providing a graphical process designer interface to allow you to configure any SCRIPT process and by giving you access to all the data dictionaries that will help in parsing, validating and converting any NCPDP data to any format. Here is an example of the New Prescription process suggested in the NCPDP data Implementation guide and the template flow in Adeptia.

script-process

Here is the New RX and Change RX Request/Response Process Flow template in Adeptia.

script-process-adeptia

Now apart from the SCRIPT processes as described above, understanding the SCRIPT data formats and how they relate to each other and more importantly how they can be converted into any other format (let’s say a database) is core to a successful implementation of a NCPDP standard format.

Let’s take a look at a sample SCRIPT XML message

The transport node consists of the following sections:

1. Patient information such as SSN, Name, Address, DoB, Phone.

xml1

2. Pharmacy data such as the NCPDPID, NPI, Address and Phone.

xml3

3. Prescriber data such as the NPI, Name, Address, Phone.

xml2

4. Medication prescribed that contains the Drug Description, Dosage/Quantity and instructions.

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Let’s take a look at a sample SCRIPT UN/EDIFACT message

A SCRIPT message interchange consists of the following segments.An interchange is defined as communication between partners in the form of a structured set of messages and service segments.

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A sample SCRIPT message in UN/EDIFACT format:

edi1

Here the UIH segment uniquely identifies that it is SCRIPT interchange type with NEWRX as the message type. Adeptia provides the full UN/EDIFACT data dictionary to parse and validate SCRIPT data and allows users to map it to any format.

How to map the SCRIPT data in Adeptia?

In Adeptia’s Data Mapper, simply pull up the particular XML or UN/EDIFACT Schema of the SCRIPT transaction type and map it to the target system. Sample mapping is shown below.

script_map