More generic reference model

Daniel Karlsson daniel.karlsson at
Fri Sep 2 05:18:21 EDT 2016

Dear All,

while there is, as you note, overlap and resulting redundancy, I believe 
this is hard to avoid. If the archetype is an information requirement 
specification and and the information requirements are different for 
observations, evaluations, instructions, ... (which I believe they are) 
then this level is needed. Terminologies typically do not specify which 
pieces of information are needed in a given situation. CIMI e.g. has 
drawn the line between the RM and archetypes differently compared to 
openEHR and introduced more layers (RM, reference archetypes, clinical 
patterns, etc.) but the overall idea with specific clinically motivated 
constraints for classes of information. Not-quite-as-similarly, FHIR has 
specified information requirements in a growing number of clinical 

So, I do not see a trend moving away from information model frameworks 
(together with terminologies) being central to interoperability.

This doesn't mean that openEHR shouldn't try hard to improve (the 
guidance for) use of archetypes together with more terminologies like 
SNOMED CT, but we still jointly have to identify the "sweet spot" 
(Heather's words) which gives the most usefulness.


On 2016-09-01 09:54, Bert Verhees wrote:
> 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
> _______________________________________________
> openEHR-clinical mailing list
> openEHR-clinical at

Daniel Karlsson, PhD, sr lecturer
Department of Biomedical Engineering/Health informatics
Linköping university
SE-58185 Linköping
Ph. +46 708350109, Skype: imt_danka, Hangout: daniel.e.karlsson at

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