By now, providers should have at least heard mention of the forthcoming 2023 NCPDP Standard, which is in effect now and will be required by January 1, 2027. NCPDP (the National Council for Prescription Drug Programs) is the problem-solving forum for healthcare, and the new standard was developed to address the rise of telehealth, cybersecurity risks/compliance in ePrescribing, data needs, AI, and the growing demand for patient transparency. So what is the Standard solving for, and what can providers expect?
As a technology professional working alongside providers daily to help them prepare for this transition, I see four key themes in the 2023 NCPDP Standard:
1. Safety and clarity with standardization of data: With new Sig (prescription instruction) standards, for example, medication directions will be more clear and less subject to interpretation. They also increase the ability for more structured data, which enables machine learning and AI automation solutions.
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2. Easing communication among providers, patients and pharmacies: New standards for common practices such as pharmacy-to-pharmacy prescription transfers will improve coordination and reduce administrative burdens.
3. Simplifying processes for prior authorization and specialty medicine support: Improved workflows will accelerate review and approvals to get critically needed medications to patients more quickly.
4. Better interoperability: Automated data exchange can ensure data is structured in a way that it can be analyzed with AI tools, which will ultimately lead to more healthcare innovation and better care.
The common theme: Making unstructured data structured. Currently, a lot of healthcare data is unstructured — like handwritten sticky notes in a file – making it difficult to capture and analyze. Structured data can be analyzed by people or machines, making it more useful. As AI permeates medicine, structured data will be the foundation of innovation.
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Here are the most visible changes providers should expect:
- Structured SIG to reduce ambiguity about medicine directions. Free text directions like, “Take two tablets at bedtime” were unstructured, though most providers followed a similar format. As part of the 2023 NCPDP Standard, Structured SIG provides a standardized format for electronically structuring patient instructions for prescriptions.
- Improvement in Rx transfer and cancel Rx processes. As prescription pricing has become more transparent, Rx transfers and cancellations have become more common. 2023 NCPDP Standard adds new standard transactions for these processes, eliminating manual steps like faxing, in pursuit of accelerating these transactions for patients.
- More automation related to medicine adherence. Medicine adherence is always a top concern of providers. The 2023 NCPDP Standard introduces new features aimed at improving it, including one that automates refill workflows by enabling proactive, system-triggered medication resupplies—especially in long-term care—reducing manual intervention, minimizing therapy gaps, and improving adherence through timely, data-driven coordination between prescribers and pharmacies.
How and when are these changes going into effect?
Providers should be prepared to move to the new standard by January 1, 2027. The 2017–071 Standard will stop being supported January 1, 2028. That might seem a long time from now, but healthcare providers and technology providers can – and should – start preparing now.
Most of the transition burden is on technology vendors, who are already hard at work updating their back ends in support of the 2023 NCPDP Standard. If you haven’t heard from your vendor yet, check in and ask for a timeline.
During this transition, many providers will take the opportunity to look for new workflow experiences to maximize new features while taking a few technical steps to update the User Interface and APIs. Beginning the upgrade process soon will leave time for staff to be proficient with any changes, and for testing and certification long before support ends for the 2017 NCPDP Standard.
By prioritizing the updates needed to support the new Standard, providers will be in a better position to utilize the latest and greatest technology optimized for their workflow and patient care.
(The author wishes to thank Larry Gillette and David Rossi for their contributions to this piece.)
Photo: ronnachaipark, Getty Images
Julian Herbert started his career in tech product development as a business analyst focused on e-commerce in the semiconductor industry. Following his curiosity, he became a management consultant at Deloitte and led M&A divestiture and integration engagements in a variety of industries, including pharma and biotech. He then transitioned back into product development and e-commerce at Amazon, launching machine learning solutions for 3rd party sellers on the platform. Julian was also tasked to lead product development for AWS Startups, building their first micro-targeted product line.
At DoseSpot, Julian leads product innovation, helping the company grow and deliver safe and reliable ePrescribing technology and software integrations across multiple healthcare markets. Julian is originally from Louisiana and graduated as valedictorian from Southern University in Baton Rouge with a B.S. in Computer Science. He also has an M.B.A. from The Ross School of Business at the University of Michigan, focusing on strategy and entrepreneurship.
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