Details
Description
HL7 has an OID Registry which is absolutely vital to V3 (CDA). As of FHIR, HL7 also has URIs, in many cases for the same things that OIDs already existed for. I've argued many times against readable alternative identification for the same thing: that is not what this issue is about. This issue about on par, in tandem governance for uris and oids.
I'm noticing that terminology is sort of centralized into THO/UTG. Identifier maintenance also needs a proper home.
While the OID Registry has been meticulously maintained and OIDs have a tendency to be stable, the URIs more or less have a tendency to be created in an ad hoc and decentralized way, and also to be changed over time.
This means that many URIs exist for the same purpose. That in itself would be ok-ish, but it is in many cases impossible tell which is leading for a given version of FHIR, unless you have a reliable NamingSystem setup that marks one and only uri/oid as the preferred one for a given version of FHIR, and use that consistently in the FHIR Core specs and examples.
It is not possible to switch preferred uri/oid mid-FHIR-version as that constitutes a breaking change in implementations. It is also not possible to mix and match different uris for the same thing within the same version of FHIR. It should also not be possible to change the preferred oid/uri in a patch or minor update as - again - it is a breaking change.
HL7 has said to scale down V3 support to only supporting IG creation. The only way that holds is if OIDs and URIs bear a meaningful and computable relationship. That also means that new code system uris also SHALL have an OID assigned, e.g. ICD-11 and IDMP. They otherwise are unavailable for CDA and the world is not ready for full scale FHIR conversion.
So the administration of OIDs and URIs should be done centrally/in tandem and not in ad hoc/per working group fashion. This is a governance issue. To support why that is necessary I've done some analysis on what the relationship currently looks like.
You'll notice that in many cases the OID for the ValueSet is the same as for CodeSystem, and the same OID has been assigned to both a V2 and V3 ValueSet, i.e. different objects.
- 17 OIDs with more than 1 uri for R4
1.3.160
http://terminology.hl7.org/CodeSystem/gtin
https://www.gs1.org/gtin
1.3.6.1.4.1.19376.1.2.3
http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem
urn:oid:1.3.6.1.4.1.19376.1.2.3 (found in ValueSet.compose)
2.16.840.1.113883.1.11.10228
http://terminology.hl7.org/ValueSet/v3-Confidentiality
http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification
2.16.840.1.113883.1.11.20428
http://terminology.hl7.org/ValueSet/v2-0719
http://terminology.hl7.org/ValueSet/v3-InformationSensitivityPolicy
2.16.840.1.113883.1.11.78
http://terminology.hl7.org/ValueSet/v2-0078
http://terminology.hl7.org/ValueSet/v3-ObservationInterpretation
2.16.840.1.113883.3.1937.98.11.8
http://hl7.org/fhir/ValueSet/template-status-code
urn:oid:2.16.840.1.113883.3.1937.98.11.8 (found in CodeSystem.valueSet)
2.16.840.1.113883.3.912
http://cancer.sanger.ac.uk/cancergenome/projects/cosmic
http://hl7.org/fhir/ValueSet/cosmic
2.16.840.1.113883.4.642.1.0
http://hl7.org/fhir/audit-event-outcome
http://terminology.hl7.org/CodeSystem/applicability
2.16.840.1.113883.4.642.3.466
http://hl7.org/fhir/ValueSet/audit-event-outcome
http://hl7.org/fhir/ValueSet/audit-source-type
2.16.840.1.113883.6.280
http://hl7.org/fhir/ValueSet/ref-sequences
http://www.ncbi.nlm.nih.gov/nuccore
http://www.ncbi.nlm.nih.gov/refseq
2.16.840.1.113883.6.281
http://hl7.org/fhir/ValueSet/genenames
http://www.genenames.org
2.16.840.1.113883.6.282
http://hl7.org/fhir/ValueSet/variants
http://varnomen.hgvs.org/
2.16.840.1.113883.6.284
http://hl7.org/fhir/ValueSet/dbsnp
http://www.ncbi.nlm.nih.gov/projects/SNP
2.16.840.1.113883.6.3.2
http://hl7.org/fhir/sid/icd-10-nl
http://terminology.hl7.org/CodeSystem/ICD10dut
2.16.840.1.113883.6.4
http://www.cms.gov/Medicare/Coding/ICD10/index.html
http://www.icd10data.com/icd10pcs
2.16.840.1.113883.6.59
http://hl7.org/fhir/sid/cvx
http://terminology.hl7.org/CodeSystem/CVX
2.16.840.1.113883.6.73
http://terminology.hl7.org/CodeSystem/atc
http://www.whocc.no/atc
- 54 OIDs with more than 1 uri for STU3
1.2.276.0.76.5.409
http://hl7.org/fhir/sid/icd-10-de
urn:oid:1.2.276.0.76.5.409
1.3.6.1.4.1.19376.1.2.3
http://hl7.org/fhir/ValueSet/formatcodes
urn:oid:1.3.6.1.4.1.19376.1.2.3
2.16.840.1.113883.1.11.10228
http://hl7.org/fhir/ValueSet/v3-Confidentiality
http://hl7.org/fhir/ValueSet/v3-ConfidentialityClassification
2.16.840.1.113883.1.11.20428
http://hl7.org/fhir/ValueSet/v2-0719
http://hl7.org/fhir/ValueSet/v3-InformationSensitivityPolicy
2.16.840.1.113883.1.11.78
http://hl7.org/fhir/ValueSet/v2-0078
http://hl7.org/fhir/ValueSet/v3-ObservationInterpretation
2.16.840.1.113883.4.642.3.166
http://hl7.org/fhir/ValueSet/condition-ver-status
http://hl7.org/fhir/ValueSet/restful-capability-mode
2.16.840.1.113883.4.642.3.172
http://hl7.org/fhir/ValueSet/communication-category
http://hl7.org/fhir/ValueSet/event-capability-mode
2.16.840.1.113883.4.642.3.174
http://hl7.org/fhir/ValueSet/communication-not-done-reason
http://hl7.org/fhir/ValueSet/message-transport
2.16.840.1.113883.4.642.3.217
http://hl7.org/fhir/ValueSet/sequence-quality-standardSequence
http://hl7.org/fhir/ValueSet/variant-state
2.16.840.1.113883.4.642.3.257
http://hl7.org/fhir/ValueSet/encounter-admit-source
http://hl7.org/fhir/ValueSet/encounter-location-status
2.16.840.1.113883.4.642.3.259
http://hl7.org/fhir/ValueSet/designation-use
http://hl7.org/fhir/ValueSet/encounter-discharge-disposition
2.16.840.1.113883.4.642.3.275
http://hl7.org/fhir/ValueSet/goal-category
http://hl7.org/fhir/ValueSet/graph-compartment-rule
2.16.840.1.113883.4.642.3.305
http://hl7.org/fhir/ValueSet/immunization-recommendation-status
http://hl7.org/fhir/ValueSet/linkage-type
2.16.840.1.113883.4.642.3.378
http://hl7.org/fhir/ValueSet/entformula-type
http://hl7.org/fhir/ValueSet/message-reason-encounter
2.16.840.1.113883.4.642.3.397
http://hl7.org/fhir/ValueSet/issue-severity
http://hl7.org/fhir/ValueSet/referencerange-meaning
2.16.840.1.113883.4.642.3.416
http://hl7.org/fhir/ValueSet/contactentity-type
http://hl7.org/fhir/ValueSet/device-action
2.16.840.1.113883.4.642.3.466
http://hl7.org/fhir/ValueSet/audit-event-outcome
http://hl7.org/fhir/ValueSet/audit-source-type
http://hl7.org/fhir/ValueSet/substance-code
2.16.840.1.113883.4.642.3.514
http://hl7.org/fhir/ValueSet/coverage-type
http://hl7.org/fhir/ValueSet/service-provision-conditions
2.16.840.1.113883.4.642.3.536
http://hl7.org/fhir/ValueSet/claim-modifiers
http://hl7.org/fhir/ValueSet/claim-use
2.16.840.1.113883.4.642.3.540
http://hl7.org/fhir/ValueSet/fm-itemtype
http://hl7.org/fhir/ValueSet/tooth
2.16.840.1.113883.4.642.3.542
http://hl7.org/fhir/ValueSet/service-uscls
http://hl7.org/fhir/ValueSet/teeth
2.16.840.1.113883.4.642.3.546
http://hl7.org/fhir/ValueSet/surface
http://hl7.org/fhir/ValueSet/udi
2.16.840.1.113883.4.642.3.552
http://hl7.org/fhir/ValueSet/process-priority
http://hl7.org/fhir/ValueSet/service-product
2.16.840.1.113883.4.642.3.564
http://hl7.org/fhir/ValueSet/service-modifiers
http://hl7.org/fhir/ValueSet/service-place
2.16.840.1.113883.4.642.3.566
http://hl7.org/fhir/ValueSet/claim-subtype
http://hl7.org/fhir/ValueSet/icd-10-procedures
2.16.840.1.113883.4.642.3.570
http://hl7.org/fhir/ValueSet/ex-onsettype
http://hl7.org/fhir/ValueSet/provider-qualification
2.16.840.1.113883.4.642.3.584
http://hl7.org/fhir/ValueSet/ex-payee-resource-type
http://hl7.org/fhir/ValueSet/fm-status
2.16.840.1.113883.4.642.3.594
http://hl7.org/fhir/ValueSet/benefit-category
http://hl7.org/fhir/ValueSet/ex-revenue-center
2.16.840.1.113883.4.642.3.596
http://hl7.org/fhir/ValueSet/adjudication
http://hl7.org/fhir/ValueSet/benefit-subcategory
2.16.840.1.113883.4.642.3.610
http://hl7.org/fhir/ValueSet/benefit-unit
http://hl7.org/fhir/ValueSet/explanationofbenefit-status
2.16.840.1.113883.4.642.3.612
http://hl7.org/fhir/ValueSet/benefit-term
http://hl7.org/fhir/ValueSet/bundle-type
2.16.840.1.113883.4.642.3.614
http://hl7.org/fhir/ValueSet/resource-type-link
http://hl7.org/fhir/ValueSet/search-entry-mode
2.16.840.1.113883.4.642.3.616
http://hl7.org/fhir/ValueSet/ex-paymenttype
http://hl7.org/fhir/ValueSet/http-verb
2.16.840.1.113883.4.642.3.632
http://hl7.org/fhir/ValueSet/metric-category
http://hl7.org/fhir/ValueSet/parameter-group
2.16.840.1.113883.4.642.3.658
http://hl7.org/fhir/ValueSet/profile-code
http://hl7.org/fhir/ValueSet/vision-product
2.16.840.1.113883.4.642.3.704
http://hl7.org/fhir/ValueSet/http-operations
http://hl7.org/fhir/ValueSet/testscript-operation-codes
2.16.840.1.113883.4.642.3.712
http://hl7.org/fhir/ValueSet/report-status-codes
http://hl7.org/fhir/ValueSet/testscript-profile-origin-types
2.16.840.1.113883.4.642.3.714
http://hl7.org/fhir/ValueSet/account-status
http://hl7.org/fhir/ValueSet/testscript-profile-destination-types
2.16.840.1.113883.4.642.3.731
http://hl7.org/fhir/ValueSet/contract-status
http://hl7.org/fhir/ValueSet/contract-subtype
2.16.840.1.113883.4.642.3.735
http://hl7.org/fhir/ValueSet/consent-category
http://hl7.org/fhir/ValueSet/contract-term-subtype
2.16.840.1.113883.4.642.3.739
http://hl7.org/fhir/ValueSet/consent-state-codes
http://hl7.org/fhir/ValueSet/contract-action
2.16.840.1.113883.4.642.3.741
http://hl7.org/fhir/ValueSet/consent-except-type
http://hl7.org/fhir/ValueSet/contract-actorrole
2.16.840.1.113883.4.642.3.745
http://hl7.org/fhir/ValueSet/consent-content-class
http://hl7.org/fhir/ValueSet/contract-content-derivative
2.16.840.1.113883.4.642.3.763
http://hl7.org/fhir/ValueSet/concept-property-type
http://hl7.org/fhir/ValueSet/library-type
2.16.840.1.113883.4.642.3.765
http://hl7.org/fhir/ValueSet/codesystem-content-mode
http://hl7.org/fhir/ValueSet/measure-population
2.16.840.1.113883.4.642.3.767
http://hl7.org/fhir/ValueSet/codesystem-hierarchy-meaning
http://hl7.org/fhir/ValueSet/measure-scoring
2.16.840.1.113883.4.642.3.769
http://hl7.org/fhir/ValueSet/compartment-type
http://hl7.org/fhir/ValueSet/measure-type
2.16.840.1.113883.4.642.3.771
http://hl7.org/fhir/ValueSet/measure-data-usage
http://hl7.org/fhir/ValueSet/task-performer-type
2.16.840.1.113883.4.642.3.773
http://hl7.org/fhir/ValueSet/composite-measure-scoring
http://hl7.org/fhir/ValueSet/task-status
2.16.840.1.113883.4.642.3.794
http://hl7.org/fhir/ValueSet/action-participant-type
http://hl7.org/fhir/ValueSet/definition-topic
2.16.840.1.113883.4.642.3.809
http://hl7.org/fhir/ValueSet/action-type
http://hl7.org/fhir/ValueSet/adverse-event-outcome
2.16.840.1.113883.4.642.3.840
http://hl7.org/fhir/ValueSet/adverse-event-causality-assess
http://hl7.org/fhir/ValueSet/parent-relationship-codes
2.16.840.1.113883.4.642.3.842
http://hl7.org/fhir/ValueSet/adverse-event-causality-method
http://hl7.org/fhir/ValueSet/template-status-code
2.16.840.1.113883.4.642.3.848
http://hl7.org/fhir/ValueSet/chargeitem-billingcodes
http://hl7.org/fhir/ValueSet/questionnaire-item-control
- 16 OIDs with more than 1 uri for DSTU2
1.2.276.0.76.5.409
http://hl7.org/fhir/sid/icd-10-de
urn:oid:1.2.276.0.76.5.409
1.3.160
http://terminology.hl7.org/CodeSystem/gtin
https://www.gs1.org/gtin
1.3.6.1.4.1.19376.1.2.3
http://hl7.org/fhir/ValueSet/formatcodes
urn:oid:1.3.6.1.4.1.19376.1.2.3
2.16.840.1.113883.1.11.20428
http://hl7.org/fhir/ValueSet/v2-0719
http://hl7.org/fhir/ValueSet/v3-InformationSensitivityPolicy
2.16.840.1.113883.1.11.78
http://hl7.org/fhir/ValueSet/v2-0078
http://hl7.org/fhir/ValueSet/v3-ObservationInterpretation
2.16.840.1.113883.18.356
http://hl7.org/fhir/v2/0550
http://hl7.org/fhir/v2/0552
2.16.840.1.113883.3.88.12.3221.8.11
http://hl7.org/fhir/ValueSet/daf-medication-route
http://hl7.org/fhir/ValueSet/daf-product-form
2.16.840.1.113883.3.88.12.80.22
http://hl7.org/fhir/ValueSet/daf-cvx
http://hl7.org/fhir/ValueSet/vaccine-code
2.16.840.1.113883.4.642.2.0
http://hl7.org/fhir/ValueSet/daf-encounter-dischargedisposition
http://hl7.org/fhir/ValueSet/daf-encounter-reason
http://hl7.org/fhir/ValueSet/daf-encounter-type
http://hl7.org/fhir/ValueSet/daf-list-DAFMedListCode
http://hl7.org/fhir/ValueSet/daf-manifestation-ccda-codes
http://hl7.org/fhir/ValueSet/daf-observation-ccdasmokingstatus
http://hl7.org/fhir/ValueSet/daf-procedure-type
http://hl7.org/fhir/ValueSet/daf-race
http://hl7.org/fhir/ValueSet/daf-ucum-vitals-common
http://hl7.org/fhir/ValueSet/qicore-adverseevent-category
http://hl7.org/fhir/ValueSet/qicore-adverseevent-type
http://hl7.org/fhir/ValueSet/qicore-allergyintolerance-reason-refuted
http://hl7.org/fhir/ValueSet/qicore-appropriateness-score
http://hl7.org/fhir/ValueSet/qicore-communication-medium
http://hl7.org/fhir/ValueSet/qicore-communication-reason-not-performed
http://hl7.org/fhir/ValueSet/qicore-condition-certainty
http://hl7.org/fhir/ValueSet/qicore-condition-criticality
http://hl7.org/fhir/ValueSet/qicore-deviceuserequest-reason-rejected
http://hl7.org/fhir/ValueSet/qicore-diagnosticorder-precondition
http://hl7.org/fhir/ValueSet/qicore-diagnosticorder-reason-rejected
http://hl7.org/fhir/ValueSet/qicore-encounter-canceled-reason
http://hl7.org/fhir/ValueSet/qicore-encounter-condition-role
http://hl7.org/fhir/ValueSet/qicore-flag-category
http://hl7.org/fhir/ValueSet/qicore-goal-reason-rejected
http://hl7.org/fhir/ValueSet/qicore-medication-dose-type
http://hl7.org/fhir/ValueSet/qicore-observation-body-position
http://hl7.org/fhir/ValueSet/qicore-observation-delta
http://hl7.org/fhir/ValueSet/qicore-observation-verification
http://hl7.org/fhir/ValueSet/qicore-patient-disability
http://hl7.org/fhir/ValueSet/qicore-patient-military-service
http://hl7.org/fhir/ValueSet/qicore-priority
http://hl7.org/fhir/ValueSet/qicore-referralrequest-reason-rejected
http://hl7.org/fhir/ValueSet/sdc-dex-mimetype
http://hl7.org/fhir/ValueSet/sdc-group-special-type
http://hl7.org/fhir/ValueSet/sdcde-dataelement-sdccode
http://hl7.org/fhir/ValueSet/uslab-clinical-findings
http://hl7.org/fhir/ValueSet/uslab-cond-reasonforstudy
http://hl7.org/fhir/ValueSet/uslab-do-event
http://hl7.org/fhir/ValueSet/uslab-obs-codedresults
http://hl7.org/fhir/ValueSet/uslab-obs-codes
http://hl7.org/fhir/ValueSet/uslab-obs-interpretation
http://hl7.org/fhir/ValueSet/uslab-obs-kind
http://hl7.org/fhir/ValueSet/uslab-obs-spec-reject
http://hl7.org/fhir/ValueSet/uslab-patient-uslab-nameuse
http://hl7.org/fhir/ValueSet/uslab-patient-uslabph-nameuse
http://hl7.org/fhir/ValueSet/uslab-spec-bodysite
http://hl7.org/fhir/ValueSet/uslab-spec-type
http://hl7.org/fhir/ValueSet/uslab-units
2.16.840.1.113883.4.642.3.466
http://hl7.org/fhir/ValueSet/audit-event-outcome
http://hl7.org/fhir/ValueSet/audit-source-type
2.16.840.1.113883.6.280
http://www.ncbi.nlm.nih.gov/nuccore
http://www.ncbi.nlm.nih.gov/refseq
2.16.840.1.113883.6.282
http://varnomen.hgvs.org/
http://www.hgvs.org/mutnomen
2.16.840.1.113883.6.3.2
http://hl7.org/fhir/sid/icd-10-nl
http://terminology.hl7.org/CodeSystem/ICD10dut
2.16.840.1.113883.6.4
http://www.cms.gov/Medicare/Coding/ICD10/index.html
http://www.icd10data.com/icd10pcs
2.16.840.1.113883.6.59
http://hl7.org/fhir/sid/cvx
http://terminology.hl7.org/CodeSystem/CVX
2.16.840.1.113883.6.73
http://terminology.hl7.org/CodeSystem/atc
http://www.whocc.no/atc