Standardization (ISO). ANSI does not produce standards itself but functions as an accreditor of SDOs through its Accredited Standards Committee (ASC). ANSI primarily ensures that SDOs adhere to the principles of openness, balance of interests, due process, and an appeals process and approves standards that could become U.S. national standards. ANSI does not perform quality checks on the data interchange standards developed or distribute standards interpretation and implementation guides for consistency. Several primary SDOs in the United States develop the various types of data interchange standards required for health care data (see Box 3-1).

Other independent groups are involved indirectly. They include the National Uniform Billing Committee, which develops a single billing form and standard dataset to be used nationwide by institutional providers and payers for handling health care claims, and the National Uniform Claims Committee, which develops a standardized dataset for use by the noninstitutional health care community in transmitting claim and encounter information to and from all third-party payers.

BOX 3-1
Primary Standards Development Organizations Setting Standards for Data Interchange in the United States

ASC X12N—the ANSI committee responsible for developing health care–related electronic data interchange (EDI) standards for administrative and financial transactions.

Health Level Seven (HL7)—chief developer of clinical data exchange, vocabulary, and document architecture standards.

Institute for Electrical and Electronics Engineers (IEEE)—developer of medical device transmission and vocabulary specifications.

American Society for Testing and Materials (ASTM)—developer of standards for medical and surgical materials and devices, emergency medical services, and health information systems.

Digital Imaging and Communication in Medicine (DICOM)—developer of transmission and vocabulary standards for radiological images; created jointly by the American College of Radiology and the National Equipment Manufacturers Association and now is an international organization.

American Dental Association (ADA)—developer of all standards relating to dentistry.

National Council for Prescription Drug Programs (NCPDP)—developer of transmission standards for documents related to prescription drugs.

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