ISO/TS 17120:2004
(Main)Health informatics — Country identifier standards
Health informatics — Country identifier standards
ISO 17120:2004 specifies country identifier standards suitable for use within health informatics applications and standards development by health informatics planners, developers, implementers and analysts.
Informatique de santé — Normes d'identificateur de pays
General Information
Standards Content (Sample)
TECHNICAL ISO
SPECIFICATION 17120
First edition
2004-09-15
Health informatics — Country identifier
standards
Informatique de santé — Normes d'identificateur de pays
Reference number
ISO/TS 17120:2004(E)
©
ISO 2004
---------------------- Page: 1 ----------------------
ISO/TS 17120:2004(E)
PDF disclaimer
This PDF file may contain embedded typefaces. In accordance with Adobe's licensing policy, this file may be printed or viewed but
shall not be edited unless the typefaces which are embedded are licensed to and installed on the computer performing the editing. In
downloading this file, parties accept therein the responsibility of not infringing Adobe's licensing policy. The ISO Central Secretariat
accepts no liability in this area.
Adobe is a trademark of Adobe Systems Incorporated.
Details of the software products used to create this PDF file can be found in the General Info relative to the file; the PDF-creation
parameters were optimized for printing. Every care has been taken to ensure that the file is suitable for use by ISO member bodies. In
the unlikely event that a problem relating to it is found, please inform the Central Secretariat at the address given below.
© ISO 2004
All rights reserved. Unless otherwise specified, no part of this publication may be reproduced or utilized in any form or by any means,
electronic or mechanical, including photocopying and microfilm, without permission in writing from either ISO at the address below or
ISO's member body in the country of the requester.
ISO copyright office
Case postale 56 • CH-1211 Geneva 20
Tel. + 41 22 749 01 11
Fax + 41 22 749 09 47
E-mail copyright@iso.org
Web www.iso.org
Published in Switzerland
ii © ISO 2004 – All rights reserved
---------------------- Page: 2 ----------------------
ISO/TS 17120:2004(E)
Contents Page
Foreword. iv
Introduction . v
1 Scope. 1
2 Normative references . 1
3 Country identifier standards. 1
3.1 General. 1
3.1.1 ISO 3166 . 1
3.1.2 ITU. 2
3.2 Rationale . 2
3.3 Liaison. 2
Annex A (informative) Technical introduction. 3
Annex B (informative) Overview of ISO 3166. 6
Annex C (informative) Overview of ITU country identifier standards . 8
Annex D (informative) Overview of other agency country identifier standards. 9
Annex E (informative) Strength and weakness analysis: ISO and ITU for health informatics . 11
© ISO 2004 – All rights reserved iii
---------------------- Page: 3 ----------------------
ISO/TS 17120:2004(E)
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards bodies
(ISO member bodies). The work of preparing International Standards is normally carried out through ISO
technical committees. Each member body interested in a subject for which a technical committee has been
established has the right to be represented on that committee. International organizations, governmental and
non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely with the
International Electrotechnical Commission (IEC) on all matters of electrotechnical standardization.
International Standards are drafted in accordance with the rules given in the ISO/IEC Directives, Part 2.
The main task of technical committees is to prepare International Standards. Draft International Standards
adopted by the technical committees are circulated to the member bodies for voting. Publication as an
International Standard requires approval by at least 75 % of the member bodies casting a vote.
In other circumstances, particularly when there is an urgent market requirement for such documents, a
technical committee may decide to publish other types of normative document:
— an ISO Publicly Available Specification (ISO/PAS) represents an agreement between technical experts in
an ISO working group and is accepted for publication if it is approved by more than 50 % of the members
of the parent committee casting a vote;
— an ISO Technical Specification (ISO/TS) represents an agreement between the members of a technical
committee and is accepted for publication if it is approved by 2/3 of the members of the committee casting
a vote.
An ISO/PAS or ISO/TS is reviewed after three years in order to decide whether it will be confirmed for a
further three years, revised to become an International Standard, or withdrawn. If the ISO/PAS or ISO/TS is
confirmed, it is reviewed again after a further three years, at which time it must either be transformed into an
International Standard or be withdrawn.
Attention is drawn to the possibility that some of the elements of this document may be the subject of patent
rights. ISO shall not be held responsible for identifying any or all such patent rights.
ISO/TS 17120 was prepared by Technical Committee ISO/TC 215, Health informatics.
iv © ISO 2004 – All rights reserved
---------------------- Page: 4 ----------------------
ISO/TS 17120:2004(E)
Introduction
Mechanisms to identify countries and their sub-divisions exist in many forms and for many uses. From
statistical aggregation to telecommunications use, from internet top-level domains to member country lists,
and from healthcare information to athletic records, there is a need for the consistent, comparable, and
codified identification of countries. These mechanisms are “standard” in the sense that a formal list of names
and codes is kept and used by multiple individuals or groups, and processes are in place for maintenance of
these lists. This Technical Specification provides a description, review, and recommendation, all within a
healthcare information context, of two internationally recognized standards that are in use today for country
identifiers and their subdivisions.
Annexes A, B, C, D and E of this Technical Specification are for information only. These annexes provide an
overview of various country identifier standards used internationally, and provide guidance around the use of
such standards for purposes of developing other health informatics standards. A review of various
international organizations and their application or use of country identifier codes has also been included.
© ISO 2004 – All rights reserved v
---------------------- Page: 5 ----------------------
TECHNICAL SPECIFICATION ISO/TS 17120:2004(E)
Health informatics — Country identifier standards
1 Scope
This Technical Specification specifies country identifier standards suitable for use within health informatics
applications and standards development by health informatics planners, developers, implementers and
analysts.
2 Normative references
The following referenced documents are indispensable for the application of this document. For dated
references, only the edition cited applies. For undated references, the latest edition of the referenced
document (including any amendments) applies.
ISO 3166-1:1997, Codes for the representation of names of countries and their subdivisions — Part 1:
Country codes
ISO 3166-2:1998, Codes for the representation of names of countries and their subdivisions — Part 2:
Country subdivision code
ISO 3166-3:1999, Codes for the representation of names of countries and their subdivisions — Part 3: Code
for formerly used names of countries
ITU-T Recommendation E.164.1, Criteria and procedures for the reservation, assignment, and reclamation of
E.164 country codes and associated Identification Codes (ICs)
3 Country identifier standards
3.1 General
3.1.1 ISO 3166
ISO 3166-1 shall be the primary reference standard for use in health care to identify countries when systems,
applications or data formats require country identifiers.
ISO 3166-2 shall be the primary reference standard for use in health care to identify subdivisions of a country
where systems, applications or data formats require such subdivision identifiers. Where relevant to local or
administrative health care requirements, other subdivision identifiers may also be considered.
ISO 3166-3 shall be the primary reference standard for use in health care for historic data for those country
names that are no longer current and where systems, applications or data formats require such historic
country and subdivision identifiers.
© ISO 2004 – All rights reserved 1
---------------------- Page: 6 ----------------------
ISO/TS 17120:2004(E)
3.1.2 ITU
The International Telecommunication Union's ITU-T Recommendation E.164.1 shall be the reference
standard for use in health care to identify countries where a telecommunications patient contact requires
country identifiers.
3.2 Rationale
The rationale for the standards identified in 3.1.1 and 3.1.2 as country identifier reference standards is as
follows:
these two standards together provide both the full jurisdictional and geographic capability for country
identification;
these standards enable country identification for person based and service based health care use;
these two standards complement one another for purposes of location identification and contact
identification and for jurisdictional and geographical identification;
these standards allow for flexibility in use and implementation through the availability of alpha-2, alpha-3
and numeric-3 codes and enables stability and neutrality through the availability of the numeric-3 coding;
geographical aggregation of health data from multiple countries can be accommodated outside the above
standards, without affecting these standards or their use;
these standards have in place politically neutral maintenance agencies;
a process for updates between editions of the primary reference standard ISO 3166 (all parts) is in place
through web based formal newsletters issued by the maintenance agency.
3.3 Liaison
Ongoing liaison between ISO/TC 215 and the ISO 3166 Maintenance Agency (ISO 3166/MA) with respect to
the use of ISO 17120 and ISO 3166 (all parts) in health care as technical reference standards shall continue,
in order to:
improve communications for the health care sectors within all countries respecting the use and
maintenance of this Technical Specification;
address with ISO 3166/MA issues of code reassignment, user assigned code registration and timely
revisions.
2 © ISO 2004 – All rights reserved
---------------------- Page: 7 ----------------------
ISO/TS 17120:2004(E)
Annex A
(informative)
Technical introduction
A.1 Overview
Countries are both political and geographical entities. Reference to countries may be for their jurisdictional
relevance (political, administrative) or their physical location (geographical). The context of use of a country
identifier standard is useful in determining the applicability, adoption, or agreement for a standard. Whether
that use is for identification, contact or analysis purposes, different country identifier standards may be
applicable.
Two methods are being undertaken to address the context for a country identifier mechanism in health care.
The first, scenarios or “story boards”, provide the overall context and need for this standard and relate the
country identifier work to real and understandable healthcare situations. The second, use cases, provide very
specific tests and a formal validation capability for a standard. The following short use case and scenario
supports the use of this Technical Specification in health informatics standards development.
It is as important to understand what is excluded in this Technical Specification as it is to know what is
included. This Standard is not relevant in health care for very specific patient locations or in any way for
patient identifiers. It is not meant to serve as an exact geographical locator such as given in a geographical
positioning system. While acknowledging that country boundaries are inherently geographic, it is clear that this
country identifier technical reference standard does not apply to the location or identity of any specific patient,
beyond the identification of the country or sub-division of that patient.
A.2 An elderly man becomes ill while on vacation
A.2.1 Scenario
Mr. Jones was a resident of Australia and was on vacation in Canada. Mr. Jones became extremely ill with a
communicable disease and collapsed from exhaustion. He was taken by ambulance to the emergency
department of a public hospital in Toronto. After being assessed by the emergency room physician, Mr. Jones
was hospitalized. As a hospital inpatient, Mr. Jones continued to receive health services until his health
improved and he could be discharged. These events trigger a number of activities that require information
about “countries”.
First, Mr. Jones' country of residence is of interest to the hospital administration because it will need to
determine how the health service will be paid. Because Mr. Jones is a non-resident of Canada, the services
he receives are not eligible for payment under Canada's national health program. The hospital therefore
needs to know the country location of Mr. Jones' insurer, either public or private, so that a reciprocal billing
arrangement can be initiated.
Second, Mr. Jones was diagnosed as having “beaver fever”, a waterborne communicable disease known as
Giardiasis that has to be reported to the national health authorities in Canada and to the World Health
Organization as part of their international disease tracking activities. This information is stored in electronic
databases for easy retrieval. As part of the disease investigation process, the public health nurse in Toronto
learned that Mr. Jones had in the previous 2 weeks been on a camping trip in the Rocky Mountains in both the
north-western United States of America and in British Columbia, Canada. He had regularly consumed fresh
mountain water in these locations. While there was no conclusive location for the source of the disease, the
public health nurse recorded that it was most likely either Montana, Idaho or Washington in the United States
of America, or British Columbia or Alberta in Canada. The country location and their subdivisions is important
for disease tracking purposes.
© ISO 2004 – All rights reserved 3
---------------------- Page: 8 ----------------------
ISO/TS 17120:2004(E)
Finally, researchers at the Banff Centre for Environmental Health Research in Alberta, Canada have been
studying the prevalence of Giardiasis for the past decade. These researchers routinely access international
epidemiological data to study the prevalence of Giardiasis, the suspected source location of the disease, as
well as the type of people, such as tourists, who contract the illness. Epidemiologists are therefore interested
in country locations and their subdivisions with respect to the suspected source of the disease, as well as the
residence of the index case and, in some instances, contacts.
A.2.2 Use case
The use case information supporting evaluation and validation of country identifiers in health care provides
multiple, formalized points of view and ensures the Technical Specification fits health care use. Current points
of view (with the accompanying scenario relationship) for use cases and for consideration with the above
scenario include:
Patient (Mr. Jones)
Public health or physician provider (Emergency physician, public health nurse)
Payer/Funder of health services (Australian health services insurer)
Researcher (WHO, Banff Centre for Environmental Health Research)
Government (Province of Ontario, Canada)
Manufacturer/System vendor (Hospital emergency computer system vendor, product supplier)
Investigator/Insurer (Private insurance company)
In all of these points of view there are two primary u
...
Questions, Comments and Discussion
Ask us and Technical Secretary will try to provide an answer. You can facilitate discussion about the standard in here.