@startuml
hide footbox
participant "Patient Identity Source" as PatientIdentitySource
participant "Patient Identifier Cross-reference Manager" as PatientIdentifierCrossReferenceManager
activate "PatientIdentitySource"
activate "PatientIdentifierCrossReferenceManager"
"PatientIdentitySource" -> "PatientIdentifierCrossReferenceManager" : Add or revise Patient
"PatientIdentifierCrossReferenceManager" --> "PatientIdentitySource" : Patient added or revised
"PatientIdentitySource" -> "PatientIdentifierCrossReferenceManager" : Resolve Duplicate Patient
"PatientIdentifierCrossReferenceManager" --> "PatientIdentitySource" : Patient duplicate resolved
"PatientIdentitySource" -> "PatientIdentifierCrossReferenceManager" : Remove Patient
"PatientIdentifierCrossReferenceManager" --> "PatientIdentitySource" : Patient removed
deactivate "PatientIdentitySource"
deactivate "PatientIdentifierCrossReferenceManager"
@enduml