More generic reference model

Bert Verhees bert.verhees at
Thu Sep 1 05:20:10 EDT 2016

Thank you for your reply, Diego.

But it does not solve the problem I see: the problem of redundant 

We are stating in an archetype that we are doing an observation on blood 
pressure, and we state that again using SNOMED and LOINC. LOINC to 
define the observation and SNOMED to support the 

As I am informed, that is the way interoperability is going. I don't 
understand the usefulness of the the observation-entry-type as defined 
in OpenEHR from this point of view.

Except from redundancy, there may also be a problem of not using the 
potential of SNOMED.

I am not sure about all this, but maybe there is also, when used a more 
generic solution, advantage when querying.
When knowing the path to a SNOMED or LOINC coding, then hierarchical 
querying over AQL becomes possible.


On 01-09-16 10:17, Diego Boscá wrote:
> Main problem I see there is that Snomed focus usually differs of what
> we look in the bindings, which makes binding process quite difficult
> (e.g. binding a blood pressure archetype entry with the blood pressure
> snomed ct term is wrong. It should be bound to something in the lines
> of "report about blood pressure").
> In the end, you can see the different classes of openEHR entries as
> generic entries with a (kind of) meaning provided by openEHR. Think
> something in the lines of 'openEHR::OBSERVATION'. I believe that
> ISO13606 part 3 proposes something in the lines of this to deal with
> different RM semantics
> By the way, there are countries that are proposing a national
> extension to Snomed to add that kind of "report about..." terms. This
> way they assure that the meaning of the archetype and the term is
> exactly the same.
> Regards
> 2016-09-01 9:54 GMT+02:00 Bert Verhees <bert.verhees at>:
>> Hi,
>> I am just wondering if there are some opinions about this.
>> Do we still need the not so generic reference model which OpenEhr has, with
>> archetypes denoting Observation, Evaluation etc?
>> Wouldn't a more  generic reference model, like ISO13606 be sufficient, when
>> the terminology, worldwide, is moving to SNOMED-CT?
>> Because the SNOMED-concepts already indicate in which hierarchy a data-item
>> belongs (clinical finding, procedure, body structure, etc), and with much
>> more detail then the OpenEHR reference model.
>> When using SNOMED in OpenEHR there will be redundant information created,
>> and to not create redundant information is one of the main golden rules in
>> system design.
>> I think the reference model design needs reconsideration. It comes from a
>> time when there was no SNOMED-CT.
>> Thanks for any thoughts.
>> Bert
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