The following quote from “The Healthcare IT guy” encapsulates a key feature which I have been lobbying for over the past 9 years (emphasis is mine):

Support for robust patient identification and de-duplication. When working in a multi-entity legal framework, there won’t be a single patient identifier to rule all the systems. Good data models allow an unlimited number of mappable identifiers for any entity—a primary key for internal consistency plus any number of external identifiers. Every Person record should allow an extensible set of identification values to use for both ID lookups and de-duplication requirements that crop up when integrating multiple systems.

After reading that, I felt like maybe I’m not so crazy after all.

The 10-year-old NHS Scotland SCI Store system actually implements many of the next-gen attributes which are mentioned in the article, including “person” & “organisation” models, simultaneous entity roles, and support for patient identification/de-duplication (although the latter has been somewhat diluted from the original vision which I suspect was much closer to that described above).