Proposal for an implementation guide of OIDs with CEN/ISO 13606

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To focus minds, it is proposed that the dialogue on this topic should happen over a short period 1st September - 15th September.

Document for download: Use_of_OIDS_and_IIs_in_EN13606_V2

This text was authored by Damon Berry

It is clear that the use of OIDs and IIs within EN13606 is still wide open. Individual countries or regions could attempt to implement their own solution for identifiers within their EHR, but this is likely to result in a large-scale identifier mapping and interoperability problem. Therefore it is important to have SOME international agreement about how OIDs and IIs are used with the standard. This should be in the form of an implementation guideline - as a separate technical report e.g. ISO TS13606 Part 6 "Guidance for implementers on use of identifiers with EN13606". This proposed document should at least include the following:

1. Guidelines in relation to the use of IIs and OIDs and other identifiers for:

  • different classes of objects in an EN13606 based EHR
  • the various identity domain scopes {i.e. international, national/regional, organisational}
  • for INSTANCES {record components, EHRs, EHR extracts, etc}
  • for METADATA AND KNOWLEDGE THAT IS TIED TO INSTANCES. {terminology, archetypes, templates, code sets, referenced documents


2. A description of the OID management process for different types of OIDed objects (see below)

3. Guidance on goverance issues for organisations responsible for OID management to ensure that the system works effectively.

The informal OIDs-in-EN13606 document that is included [here] is intended as an input to the discussion of what needs to be agreed and placed in this proposed "EN13606 Part 6". The purpose of this informal document is to summarise some of the relevant information about OIDs, to suggest some approaches that could be taken and generally to help progress the discussion.


To arrive at an informed consensus, the following questions need to be answered in relation to the use of OIDs in EN13606. The document provides information and gives some ideas in relation to these questions.

As a mechanism for arriving at consensus on the proposed documents, here are some questions which the community should attempt to answer.

Q1: Which identifiers in a practical EN13606 compliant electronic health record of the future must be unique?

Q2: Do they all require the same uniqueness or uniqueness method to make them unique?

Q3: OIDs and IIs can be used by EN13606 compliant systems to identify people, medical devices and computing resources, organisations, metadata/archetypes, terminological systems, individual terms, algorithms, information systems, electronic health record instances and extracts, individual pieces of information within an EHR.

    Q3A Are the identifier requirements the same for all of these items?
    Q3B What is the most effective type of unique identifier for each category of object?

Q4: Do all objects mentioned above, have to be unique worldwide, nationally, regionally, within an organisation or within a single information system?

Q5: In what domain (knowledge, geographic, identity) should they be unique?

Q6: Are there different requirements for identifiers in an EHR-system or an EHR-Extract?

Q7: Who (which organisation(s)) should manage the EN13606 OIDs at international, national and regional levels?

Q8: What procedures should govern the behaviour of these organisations and how would they interact to ensure a resilient and effective OID management process?

Q9: What technology is needed to support this work at the simplest level?

Q10: What lessons can be learnt from HL7, who have already worked with OIDs?

This text was authored by Damon Berry

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