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Italy: Issuing Electronic Orders to Become Mandatory in the Healthcare Industry Through the NSO


After announcing it at the end of 2017, the Italian government has issued the law that obliges suppliers of the National Sanitary Services (SSN) to manage the receipt of order flows in electronic mode through the NSO platform (Nodo Smistamento Ordini). This means that as of first of October 2019, all public entities in the healthcare sector will only send their orders electronically to any provider.

Italy has opted for an intermediate platform designated NSO, similar to the SdI (Sistema di Interscambio), which will handle document validation. Some of the system’ s technical specifications are as follows:

  • Electronic order messages must be based on the European UBL PEPPOL standard.
  • Connection with the NSO platform will be directly through the WebService protocol or via a PEPPOL Access Point in the network.

EDICOM is able to transform the orders to the message required in Italian law, and also offers companies the two options for connection to the NSO, adapting to the needs required in each case:

  • Direct connection with NSO platform: Through an integrated EDI service, EDICOM can transform the document into the PEPPOL standard and send it via WebServices to the NSO Hub so that this platform can forward the order to the relevant supplier.
  • PEPPOL network: Use of the PEPPOL infrastructure involves engaging an accredited PEPPOL Access Point, such as EDICOM. This way, the data transfer takes place between two certified Access Points which, in the case of the Administration, is managed by the Intercent-ER agency.

The NSO platform is intended to be the hub channel through which all orders are passed and forwarded to the respective suppliers. This way, MEF will be able to verify the relation between orders and invoices.

For several months, EDICOM has been participating in the pilot project in a satisfactory manner, conducting tests with the clients involved in this process, so that we are ready to meet the set deadlines.

What does this requirement mean for suppliers?

Healthcare sector suppliers in Italy were already obliged to send their bills in electronic format to the Public Administrations and now, with this new law, the purchasing cycle is consolidated and connected. This flow will now be automatic and instantaneous, shortening times in purchase and collection flows, benefiting both parties in the supply chain.

Those suppliers that already have an integrated and automated solution will be able to adapt their systems quickly and easily. On the one hand, an EDI service provider such as EDICOM will connect to the NSO platform to receive and transform the order into the language required by the target company and integrate it directly into the ERP for swift processing.

If using the PEPPOL network infrastructure, the order from a public entity will be sent to the EDICOM Access Point, which then converts the document to the schema required by the supplier’s internal management system.

Next step, the electronic dispatch advice

After rolling out e-invoicing and e-ordering, it would be logical to think that the next step will be to enter the electronic dispatch advice or delivery note.

In technical terms, this inclusion will not entail any large investment for the affected companies, as they will already have an EDI platform to send and receive invoices and orders. The dispatch advice requirement simply involves the inclusion of a new message to the electronic platform.

In operational terms, this new e-message will increase supply chain efficiency, as its function is to check that the goods sent by the supplier match the purchase order placed by the buyer. Moreover, warehouses can schedule the offloading of new products in advance, as they have advance information. This way, it is possible to speed up the reception process, optimizing space and human resources. It also ensures better stock control.

Healthcare sector digitalization in Europe

This new obligation consolidates the electronic flow and sets the precedents for affected companies to expand the use of EDI services to an increasing range of business communications.

The goal for all Italian public administrations is to quit working with paper and adopt an instantaneous system with a more efficient and traceable process. Through this process suppliers and purchasers will be able to automate the purchasing cycle and save time and money allowing them to channel resources to tasks which require human intervention.

In the international scope, we should highlight the European Union’s backing for the development of e-Procurement. By November 2019, public bodies in all Member States must make all public procurement processes electronic. The link between healthcare and the Public Administration will be key in promoting paperless strategies in the sector. The new European wide e-invoicing standards will enable public administrations to address the major challenges of security, fluid communications and transparency.

The British Department of Health (NHS) is also moving forward with its NHS e-procurement strategy. Medical device companies have been the first in a staggered rollout to begin shipping and receiving orders and invoices. The NHS strategy applies the GS1 and PEPPOL standards to ensure efficient interoperability throughout the supply chain.

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