Hi @amoko, great question. And thanks @Sny for responding! I wrote this up yesterday but forgot to send it. What Sunny said is right, and I wanted to add one thing:
OCL’s External ID field (often stored as UUIDs which is separate the OCL’s uuid field) is often is intended to be unique within a non-OCL system e.g. OpenMRS. OpenMRS runs validations to make sure that there is only a single concept with the same External ID i.e. UUID. However, there’s no guarantee that the ID is truly unique if someone makes a copy of that concept in another source.