However I do have some corrections or additional insight that I would like to provide the committee members, Mitre, and my blog readers.
I know that we have an aversion to creating federal patient identities. I think this is misguided. I want to see real discussion on the reasons for and against. One thing that we MUST do is make sure that what ever identity that is given is simply an identity. These identities should be PUBLIC. If they are designed to be public, then we will not improperly use them as a secret. If we had this, we would NOT NEED to have all that other demographics such as Address, Phone Numbers, Zip Code...
PDQ), Cross-Reference (PIX), Updating (PAM), and Community Discovery (XCPD). The other alternatives don't have these service interfaces.
XDS metadata (including XDM, XDR, and XCA). What this does is allow for some level of provenance to be maintained in the XDS Metadata even when the document is a simple text document, PDF, or other.
So I would say that the assessment for both XDS as well as CDA on Chain-Of-Custody are wrong. For XDS it is simplistic, but CDA includes the recording of the custodian of the original electronic document (the originator of the information), as well as the source of it (through the informant participation), and if you wanted to go further, you could. The exact way to do it simply isn’t specified, mostly because nobody have ever had a convincing use case for it.