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The OID in II should not be mandatory
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This is a serious problem, which makes the standard not useable.

At this moment, their is not a system that does the supply of OID's
Also, their is not an Internet-service which does resolve the OID's

It can take years before that is organised in the western world. I do not 
think the standard should be unusable during that time.

But when most of the western world will be covered, there will always be 
organisations that are not (yet) covered, it would be wrong to exclude them 
from delivering medical data, I don't think that will be in the interest of 
health-care.

In the global village it will be more and more important to have data 
available from organisations in other parts of the world, it will take many 
many years before they will be connected to an OID-system

Another objection is that it makes an application network-dependent
Especially datamining-applications, for example an alert-system for anthrax is 
a dataminig system, but  also research-application from universities will 
have performance issues, depending on the question it can be necessary to 
resolve the OID's which can slow down the application very much.

Making the asigningAuthority mandatory, if the OID is used could help a lot. 
An application was then able to decide wether or not it wants to resolve the 
OID.

It also is simple to make it optional, which solves the problem
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