Frequently Asked Questions

A compilation of Frequently Asked Questions (FAQ) related to the usage of the Clinical Knowledge Manager (CKM).

General Questions

 I want to get involved in the Clinical Knowledge Manager, what can I do?

For example, you can:

  • watch and adopt archetypes and other knowledge resources;

  • join in review rounds;

  • participate in discussions;

  • submit change requests;

  • submit proposals for new archetypes;

  • submit translations of archetypes into 'your' language.

Find out more details about ways to get involved here.

 I have found an issue with CKM or have a suggestion regarding CKM, what can I do?

If you have any problems, suggestions, or comments regarding the CKM tool, you can:

Note: Please be as specific as possible and please do not use this for suggestions to improve an archetype or template. See Archetype FAQs below.

 Where can I find more information about the openEHR approach itself?

The Clinical Knowledge Manager is standing on the shoulders of the openEHR approach, an open domain-driven platform for developing flexible e-health systems.

The openEHR approach is multi-level, single source modelling within a service-oriented software architecture, in which models built by domain experts are in their own layer. It is delineated by a set of specifications published by the openEHR Foundation.

If you don't know about openEHR yet, the following are good starting points:

Registration Process

 Why should I register?

If you are not yet a registered user of the international openEHR Clinical Knowledge Manager, you should consider to register:

The impact of CKM and its ability to publish archetypes and EHR artefacts will only come from the willingness and activity of its registered community of users.

As a registered user, you can become an active participant in the development and quality improvement of open and shared clinical content for eHealth projects via the collaborative CKM community:

  • watch and adopt archetypes and other knowledge resources;

  • join in review rounds;

  • participate in discussions;

  • submit change requests

  • submit translations of archetypes into 'your' language.

You will be also able to configure CKM to notify you about new archetypes or modifications to the existing ones.

Most importantly, by recording your domain expertise and a willingness to participate in archetype reviews, the Editors will be able to invite you to participate in projects and teams where your expert opinion will help to enhance the archetypes under review. This involves no commitment – participate as and when it is convenient for you.

If you have developed your own archetypes you can submit them to the Editors as a candidate for shared use within CKM.

Without registering, you can still view all of the CKM content, but not get access to all the good stuff 'under the hood'.

All visitors to CKM are welcome to self-register on the home page - there are no restrictions, and this will enable users to participate and to gain access to richness of CKM functionality.

Sign up as a registered user for the international CKM instance here.  
The registration process is explained in more detail here.
Find out more details about ways to get involved here.

 How can I create a CKM account for myself, i.e. register?

Just click on the 'Register' button in the top right hand corner of the CKM home screen and follow the instructions.

For more details view the detailed steps: Self-Registration in CKM

 I already have a CKM account for a different CKM instance. Do I need to register again?


If you would like to be registered user of two different CKMs, you need to create an account for both.
For example, if you already have registered for the international openEHR CKM hosted by the openEHR Foundation and you now want to register for a national CKM instance hosted by a national programme in your country, you need to register for that CKM in addition.
You can use the same or a different email address.

 What do I need to do if my email address changes?

You can log in to CKM and open your profile.
To open your profile, choose Tools/Update my Profile from the menu or click on your name in the Dashboard or CKM header.
On this page, update your registered primary email address and click on the Update Profile button.

CKM will send you a confirmation email to activate your new email adress. Note that the old email address will remain the active primary email address until you have activated your new email address.

 What do I do if I no longer want to remain registered?

You can delete your CKM account at any time: just log in to your CKM instance and select Tools/Delete my Account from the menu.

If you delete your account, your access to this CKM account and details about you will be deleted. THIS IS IRREVERSIBLE. Your username and any access to your account cannot be restored.
Please note that your contributions such as artefact reviews and discussions cannot be removed as they are a critical part of the provenance of the CKM artefacts.
Instead of deleting your account, you may also want to consider to reduce the amount of CKM emails you receive by unadopting some resources or adapting your user settings (Tools/Options in the menu).

 I want to register but my username is already taken, what can I do?

If CKM finds during the registration process that your username (usually consisting of firstname.lastname) is already taken, CKM will guide you through a process to determine if the account of that username may belong to you because you have previously registered.

If so, you can start using that account again.
Otherwise CKM will provide you with a different username.

 I want to register, but my email address is already taken, what can I do?

If CKM finds during the registration process that your email address is already taken, this usually means that you have already registered.

If you cannot remember your password, you can use CKM's "Forgot Your Password" functionality to retrieve your password.


 What is an archetype?

An archetype is a re-usable, formal definition of domain level information, defined in terms of constraints on an information model.
The key feature of the archetype approach to computing is a complete separation of information models (such as object models of software, models of database schemas) from domain models. 

Have a look at the dedicated Archetype FAQs on the general openEHR wiki for more details.

Often it simply helps to have a look at some of them - for example check out the Blood Pressure archetype on the openEHR CKM.

 I have a suggestion to improve an archetype - what can I do?

The first option is to submit a new change request for the archetype: Just find and open the archetype and click on the Change Request icon, and then on the "Add New Change Request" button.

The second option to let the CKM editors in charge know about your suggestion is to start a new discussion topic for the archetype.
You can use this especially if the suggestion is not yet well defined, but rather a topic of discussion at present.

Just find an open the archetype, and click on the Discussion icon. Then use the "Start New Topic" button.

 I am missing a particular archetype on a specific topic, what can I do?

If you are missing a particular archetype, you can create a new archetype and submit your archetype as a 'Archetype Proposal' to the CKM repository.

See Archetype proposals process for a detailed description of how to submit an archetype proposal.

 An archetype has not been translated in my language, what can I do?

If the archetype has not been officially published after one or more review rounds, it may be best to wait, where possible.

If the archetype is published already, you can translate the archetype directly in CKM and submit it to the editor of the archetype.

You can also use any external Archetype Editor and submit your translation to CKM.

For details, please simply follow our instructions to Translate Archetypes Using CKM.

 How can I search for a specific archetype or topic?

Here's a little introduction on how to Search for Archetypes, Templates & Termsets in CKM.

 Why should I adopt an archetype and how?

Adopting an archetype in CKM serves a couple of different purposes.

  1. By adopting an archetype, CKM Users and Reviewers can express their interest in having the archetype reviewed for publication. As more people adopt archetypes, it will become self-evident what the openEHR community priorities are for archetypes that are required - adoptions will work a little like a vote!  Archetypes with the highest number of 'adopters' will be reviewed first.  In this way, the archetypes that are required by the community will be reviewed as a priority. 
  2. By adopting an archetype, the users also expresses an interest to participate in the review process for that archetype. When the review process starts, the user will be sent an invitation to review the archetype. This involves no commitment – participate as and when it is convenient for you. We encourage you to be involved because we are keen to integrate the various perspectives and potential differences from around the world in each archetype.
  3. By adopting an archetype, the archetype is made available in your Archetype Watchlist for easy access. 
  4. In addition, you can choose to get email notifications when the archetype is updated.

See more details and instructions on how to adopt an archetype and manage your archetype adoptions.

 What is the lifecycle of an archetype and what is the difference between the individual publication states?

Not all archetypes in CKM are ready for prime time yet. To differentiate stable and unstable archetypes, various lifecycle states are used in CKM.

See a full explanation of the Archetype Lifecycle States.

 How do I make sense of the layout and symbols for an archetype displayed in the Tabbed View?
 How can see how an archetype has been changed over time?

In CKM, the change history of an archetype can be viewed in its entirety - every change made to a model has been tracked, along with the modifier, time/date and a log message summarising the change.

Just click open the archetype and click on the Revision History icon.

Also view more details about the Archetype Change History.

 What are the different types/classes an archetype can have?

The most important types/classes of an archetype for clinical modellers are the Observation, Evaluation, Action & Instruction Archetype classes:

  • Observations are the 'uninterpreted' or raw information - i.e. the clinical observations or 'the evidence' - which includes anything reported by the patient as a symptom, event or concern; examination findings; and measurements/test results.
  • Evaluations are used to capture and record clinically interpreted findings, opinions and summary statements.
  • Instructions are statements about what should happen in the future - such as clinical orders for care or the initiation of a workflow process, such as a medication order.
  • Actions are statements about what was actually done.

In addition, Cluster archetypes are often used to reuse certain data elements across archetypes.

The Composition archetype class is used as a container class in the openEHR reference model and it is the unit of committal to the EHR. That is to say, all information stored within the EHR will be contained within a Composition. 

Section archetypes are used as an organizer, usually contained within a Composition archetype. Sections correspond to the headings that you might find on a blank piece of paper. 

There are also Admin entry archetypes for administrative information as well as a series of Demographic archetype classes.

Please refer to our Introduction to Archetypes and Archetype classes for a more detailed explanation.

 How can I link directly to an archetype or template in CKM?

The easiest way to share a direct link for an archetype or template with a colleague or for example use in a publication is to open the archetype or template and then select the "Share with Colleague" Email icon.

Also view the detailed explanation on how to link to an archetype or template in CKM.


 What is a template, what is an operational template (OPT)?

Templates (OET format)

While an archetype describes a maximum data set of everything that may ever be documented about the clinical concept described in the archetypes, a template is usually designed for a particular use case/scenario. To be able to properly describe such a use case, a template uses three main mechanisms:

  • A template references/aggregates a number of archetypes required for the particular use case.
  • A template then applies further constraints/rules to these archetypes. For example, a template can
    • Mandate some (originally optional) elements from archetypes
    • Exclude some elements from archetypes because they are not applicable for the template’s use case.
    • Rename element names of an archetype for the specific use case to clarify the element’s meaning within the context of the use case.
  • A template adds meta data describing its use etc. as well as adding annotations to individual elements.

In addition, a template can embed other templates, as applicable.

The oet format has been designed to be able to formally describe a template using the described mechanisms – aggregation, constraints, dataset specific metadata and annotations. The archetypes in combination with the template hold all the information required, but on different levels. This is appropriate for clinical modelling that aims to reuse the essential building blocks (archetypes).

Operational Templates (OPTs)

In contrast, Operational Templates (OPTs) are the computational format for operational EHR systems using archetypes. In addition, they also serve as the starting point for transformations to other (downstream) formats – for example: documentation, template data schemas, APIs.

OPTs are generated from templates and their referenced archetypes. The generated OPT combines all the information from all archetypes used in the template (and potentially its embedded templates), applies all constraints and descriptions explicitly as specified by the template. Thus, an OPT is a single – and usually massive – file that describes the computational format used by openEHR systems. In contrast to archetypes and templates, the purpose of the OPT is for technical implementation rather than clinical modelling.

A template (OET) is one of the primary assets in CKM. From it and its archetypes, we can then generate the Operational Template on demand, as a secondary asset. The Operational Template is then used by CKM - for example to generate the Form-based Template view or the template review form in CKM.


 How do I review an archetype?

Usually you will be invited via email and you can follow the instructions in the email to start your review directly from the email. To ensure you are invited, you should consider to 'adopt' the archetypes you want to review. The editors of the archetype will invite you via email when the next review round for each adopted archetype starts. Also ensure that you have opted to be a reviewer in your User Profile and that you have specified your Profession and the Health Domains you are knowledgable in, so that editors can invite you to relevant reviews. You can, of course, always decline an invitation to review.

View more detail on how to review archetype content.

Also view our Archetype Review Checklist for further details on what to consider when reviewing an archetype.

View more details on how to adopt an archetype.

 Can others see my review comments?


Once you have submitted your review, others can see it, for example in the summary view of each review round.
It is the nature of the CKM review process that all review comments as well as editor's comments are made publicly available.
The idea is to create total transparency about the provenance of an archetype, including its changes and additions during the review process.

CKM used to have the possibility to review anonymously, however this was never used, and apart from considerable overhead left the question of how editors could efficiently deal with this feedback.
If for some reason, you need to make a comment that is not meant for public distribution, you can consider emailing the editor(s) privately. 

 Can we prioritise review rounds/publishing for archetypes?

There is no general answer to this, however if you really need a particular archetype reviewed and published sooner rather than later, you can take the following steps.

  1. Adopt the archetype. Frequently adopted archetypes may be reviewed earlier.
  2. Contact the Clinical Knowledge Administrators to discuss options. Note however that the reviewing and publication process is largely based on voluntary contributions.

Subdomains, Projects & Incubators

 What are CKM domains, subdomains, remote domains, projects and incubators?

A CKM domain is essentially one CKM instance, functioning independently and providing a repository of archetypes, as well as templates and termsets as applicable.

In each CKM domain/instance, it is possible for several so-called subdomains to co-exist.
A subdomain is essentially a logical or practical grouping of CKM projects and incubators, each containing archetypes, templates and termsets.

Projects contain strictly governed resources, whereas incubators are used to store archetypes or other resources that are in their initial stages of development and a strong governance process is not yet needed.

remote subdomain is a special sub-domain that allows a 'read only' view of archetypes from another (remote) CKM instance. You can easily identify archetype from a remote CKM from the left hand archetype trees: Remote archetypes are displayed in italics.

See a more detailed explanation on CKM domains, subdomains, remote domains, projects and incubators.

Customisation, User Profile & Notifications

 What is the 'Preferred View' and how can I customise it in CKM?

The 'Preferred View' is the default or initial view of resources in the left-hand concertina's Preferred View Tab when you log in to CKM.

You can choose to customise your 'Preferred View' in the following way:

  1. Expand the 'All Resources' Tab in the left hand concertina
  2. Make your choices (such as selecting a project or only published resources
  3. Click on the 'Set as Preferred View' button.

The Preferred View is then prefilled with your preferred resources automatically on the left hand when you log in.

Note: You can also control which of the tabs of the left-hand concertina is being expanded for you when you sign in. Go to 'Tools/Options' and select the appropriate

See the full explanation on how to Customise the CKM Preferred View.

 Can others see my user profile?

Yes, other users can see your user profile.
For example, if you contribute to a discussion or review an archetype, this is linked to your user profile.
Your email address is only available to users with special roles such as administrators in order to be able to communicate with you directly as required.

 How can I get notified of new or updated archetypes or templates?

You have several options of how you get updated with new and updated archetypes and templates:

  • You can get email notifications for selected archetypes/templates you watch or adopt.
  • You can opt to receive email notifications on all new or updated archetypes/templates in projects and/or incubators.
  • You can also follow CKM on Twitter, GitHub, or simply use RSS.
  • You can also have a look at the new Dashboard News or the New and Recently Modified accordion tab in the left concertina.

See the full explanation on how to get notified of new or updated archetypes or templates.