The Norwegian archetype governance is working with the Norwegian SNOMED CT NRC to bind a set of vital signs archetypes to SNOMED CT. Initially we were both thinking the same way with regard to how this should be done, with Observable entitiy and Attribute SNOMED terms beng bound to data elements, and other concept types such as Finding, Physical object, Body structure for value sets. We didn’t have an agreement on how or if the archetype top level nodes should be bound.
Lately though, they’ve pivoted into a new approach, where they want to bind the top level node of the archetype (at0000) to an Observable entity (for example 75367002 | Blood pressure (observable entity) | for the Blood pressure archetype), and data elements in the archetype to an attribute of the Observable entity or one of its children (for example 723228002 | Systolic phase (qualifier value) | for the Systolic blood pressure data element).
We think this is a misrepresentation of the semantics of the archetypes’ data elements. It feels like trying to recreate the SNOMED CT ontological structure within the archetypes, which isn’t the intent of archetypes, or indeed any other information models.
We’re struggling to argue why this is a bad idea though. Does anyone else have any thoughts about this?