NEMSIS OID approach

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The OID for NEMSIS, the organization as registrar, is 2.16.840.1.113883.17.3

There are no guidelines for how to structure an OID network, so we'll go with some principles:

1. We won't just assign random numbers; we'll build a taxonomy. This will make it easier to manage construction and to maintain.
   1. While the design principle behind OIDs is that they are "dumb"--i.e., no information resides in the identifier, which serves only as a key for referencing the thing identified--the registrar assignment paradigm makes a certain amount of information unavoidable. Further, the structure of the arc makes it pretty tempting to continue to use that pattern for internal purposes. We are happy to lean on the principle that no one should rely on the code for information, but we reserve the right to do so internally, and to point out to users the assumptions we're working with, just in case they find it handy.
2. For the primary nodes of the taxonomy, we'll reflect the HL7 node assignments (5 & 10). Normally I'd hesitate to do that sort of alignment, but
   1. The default is random anyway, so there's no real cost. The only risk is that we set an expectation and fail to meet it.
   2. There's not much to align, so that expectation is not unrealistic.
   3. If HL7 changes, we can't help that, but
   4. NEMSIS will stay consistent internally whatever else may happen.
3. For subsequent nodes, we'll assign numbers serially to keep it easy. Random assignment might be more methodologically pure, but harder to do well.

We'll create three sub-nodes:

• 2.16.840.1.113883.17.3.5 for the NEMSIS terminology system

• 2.16.840.1.113883.17.3.11.x for value sets

• 2.16.840.1.113883.17.3.10.x for templates

Within templates, we'll follow a pattern introduced by the CDC's NHSN program for a family of specification documents that may share sections:

• 2.16.840.1.113883.17.3.10.1 for the EMS superset (including all incident sections, optionally, and possibly some header information)
• 2.16.840.1.113883.17.3.10.2 for the Patient Care Report (specifying more header information and recommending specific sections)
• 2.16.840.1.113883.17.3.10.3 for the Agency Profile (including agency sections)
• 2.16.840.1.113883.17.3.10.4 for the Hospital Outcomes report

The following sections may have limited numbers of required elements, but more specific refinements (new templates) may be defined for specific use cases. E.g., the PCR document template will use a version of the Vital Signs section that requires certain entries.

• 2.16.840.1.113883.17.3.10.1.x (serially) for the shared sections
  • 2.16.840.1.113883.17.3.10.1.1 - EMS Patient Care Report Narrative (LOINC code 67781-5)
  • 2.16.840.1.113883.17.3.10.1.2 - EMS Dispatch (LOINC code 67660-1)
  • 2.16.840.1.113883.17.3.10.1.3 - EMS Response (LOINC code 67664-3)
  • 2.16.840.1.113883.17.3.10.1.4 - EMS Disposition (LOINC code 67661-9)
  • 2.16.840.1.113883.17.3.10.1.5 - EMS Billing (LOINC code 67659-3)
  • 2.16.840.1.113883.17.3.10.1.6 - EMS Exposures or Injuries of EMS Personnel (LOINC code 67658-5)
  • 2.16.840.1.113883.17.3.10.1.7 - EMS Protocol (LOINC code 67663-5)
  • 2.16.840.1.113883.17.3.10.1.8 - EMS Scene (LOINC code 67665-0)
  • 2.16.840.1.113883.17.3.10.1.9 - EMS Situation (LOINC code 67666-8)
  • 2.16.840.1.113883.17.3.10.1.10 - EMS Times (LOINC code 67667-6)
  • 2.16.840.1.113883.17.3.10.1.11 - EMS Outcome(not implemented at this time)
  • 2.16.840.1.113883.17.3.10.1.12 - EMS Advanced Directives(LOINC code 67840-9)
  • 2.16.840.1.113883.17.3.10.1.13 - EMS Allergies and Adverse Reactions(LOINC code 67841-7)
  • 2.16.840.1.113883.17.3.10.1.14 - EMS Cardiac Arrest Event(LOINC code 67799-7)
  • 2.16.840.1.113883.17.3.10.1.15 - EMS Current Medications(LOINC code 67844-1)
  • 2.16.840.1.113883.17.3.10.1.17 - EMS Injury Incident Description(LOINC code 67800-3)
  • 2.16.840.1.113883.17.3.10.1.18 - EMS Medications Administered(LOINC code 67849-0)
  • 2.16.840.1.113883.17.3.10.1.19 - EMS Past Medical History(LOINC code 67842-5)
  • 2.16.840.1.113883.17.3.10.1.20 - EMS EMS Physical Assessment(LOINC code 67668-4)
  • 2.16.840.1.113883.17.3.10.1.21 - EMS Procedures Performed(LOINC code 67802-9)
  • 2.16.840.1.113883.17.3.10.1.22 - EMS Social History(LOINC code 67843-3)
  • 2.16.840.1.113883.17.3.10.1.23 - EMS Vital Signs(LOINC code 67801-1)
    • 2.16.840.1.113883.17.3.10.1.23.1 - EMS Vital Signs, Test use of template constraining Consolidation Vitals
  • 2.16.840.1.113883.17.3.10.1.24 - Derived Section

And, within terminologies

• 2.16.840.1.113883.17.3.11.1 for, e.g., response mode, etc.