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This could for example be, if a group of orthopedic surgeons are developing a subset of SNOMED CT procedure concepts to be included in a certain pick list of their local Electronic Health Recordelectronic health record. The group already know what options should be available in the pick list, so they choose to create their own reference set and add the required component references to this reference set, see Figure figure below.

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Creating a new reference set without looking at any existing SNOMED CT reference sets

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Depending on the scope of content for the reference set there are different 6.3.3. Development Methods development methods that can be applied for selecting, or defining, reference set members.  

Developing a new reference set also requires the developing organization to make changes to the reference set as necessary to meet evolving requirements.

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