Electronic Exchange of Clinical Laboratory Information: Issues and Opportunities. OBJECT IDENTIFIERS (OIDS)

12/23/2008

In order for computers to manipulate information, there is a frequent need to uniquely identify records and data objects in some way. There are many mechanisms for doing so; one currently popular mechanism is via OIDs. The OID mechanism allows for the assignment of globally unique identifiers to any type of object, thus assuring traceability of the object identified as it is propagated across networked applications.

In the context of lab exchange, OIDs may be used to help identify facilities, patients, providers and organizations. For example, if an OID code is assigned to a particular LIS and combined with a locally specific result number, then the combination of the two can uniquely identify the result as it is shared by multiple healthcare providers across a national network. Similarly OIDs can be used to uniquely identify lab orders (order number + lab OID) and alert providers and others to duplicate orders across the network.

Our discussions revealed that there is no real use or support for OIDs in the context of clinical laboratories. Some of the reasons for this lack of support include lack of awareness about OIDs, and technical issues with implementation and management of OIDs. For example, if a health center or other provider receives results from multiple sources that use different OIDs, there may be important technical implementation and workflow issues to consider if the ordering and reporting process is not fully automated. Informants for the study also indicated that the costs for implementing OIDs and the potential benefits to individual participants have not been well articulated.

As the Nationwide Health Information Network (NHIN)38 is established, the ability to uniquely identify labs, providers and organizations to support exchange of health information beyond geographic boundaries willincreasingly important. While the use of OIDs for the NHIN or to support lab exchange at a state or regional level is well understood, there is now no compelling reason for health centers and labs that are directly connected to each other to use OIDs. Additionally, nothing currently prevents an organization from obtaining multiple OIDs for similar purposes, and there is no national OID registry.

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