Meta-standardization as a remedy for tensions and complexities: The case of medical service lists in Vietnam

Abstract

Standards are vital components in building large-scale and complex information systems, but not all standards are well functioning. Therefore, standardization, the process that produces standards, plays a crucial role in creating good standards. This paper contributes to standardization literature by presenting a case study involving negotiation and development of a standardized medical service list through mapping separated existing standards. In our conceptualization, meta-standardization is not a project but should be perceived as an open-ended learning process where no individual or institutions are omnipotent to foresee all the dynamics and offer a universal working solution at the first attempt. This process was part of a larger attempt to build a national electronic insurance claim system in Vietnam. We propose the concept of meta-standardization to understand the 3 aspects of that process: convergence/differentiation, learning, and multilevel. Practical implications include the following strategies for resolving tensions and complexities: building upon what exists, organizing a learning process, and automating the standardization.