XAD-PID Change Management

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The XAD-PID Change Management (XPID) profile defines a single transaction for communicating a change to the XDS Affinity Domain Patient ID (XAD-PID) linked to a local Patient ID and how entries in a Document Registry should be updated.


  • Defines a standard process for notifying changes to the XAD-PID to local patient ID links to a Document Registry
  • Defines a consistent and predictable approach to updating metadata of document entries affected by the change.


The XAD-PID Change Management (XPID) profile provides a means by which a XDS Document Registry can be notified of external changes to XDS Affinity Domain Patient IDs (XAD-PIDs) links so that it can affect these changes, as appropriate, in its database. The XAD-PID is a critical attribute of every document contained in a XDS Document Registry. It provides the only manner by which documents pertaining to the same person can be grouped together in a longitudinal view, thus the imperative of having a correct identifier in every entry.

In many XDS implementations, the XAD-PID is determined by linking local patient identifiers (i.e., those used by the Document Source) with identifiers managed by the XAD patient identification domain. Once established, this relationship will be used to index every document with the corresponding XAD-PID. It is assumed that a Patient Identifier Cross-reference Manager is the system that creates and manages these links.

The problem addressed by this profile is what should happen if one or more links are discovered to have been created incorrectly, that in fact a local patient identifier should have been linked to a different XAD-PID. The Patient Identifier Cross-reference Manager is certainly able to detect the situation and corrects its own internal linkage sets. However, this change must now be communicated to other systems, in particular the XDS Document Registry, so that that actor may also correct the error within its databases.

Systems Affected

Systems involved in this profile are:

  • Document Registry
  • Patient Identity Cross-reference Manager

Actors & Transactions:

XPID Actors.jpg


Profile Status: Final Text

Documents: XAD-PID Change Management (XPID) Supplement

Underlying Standards:

  • HL7 v2.5