There are several dimensions along which the implementation guidance can be positioned, potentially providing different guidance depending on the context of the implementation.
Some of these dimensions are listed here.
Degree of interoperability
What is the degree of interoperability aimed for? Do we accept non-interoperable implementations of our profiles?
Restricitve vs. allowing profiles
Do we aim for homogenous population of resources or (b) permissive guidance to cater for greater flexibility? Can the same phenomenon be represented in two (or more) different ways or not? In practice this would translate to more or less restricted profiles, e.g. by selecting different binding strengths and differently scoped value sets.
SNOMED CT exclusivity
Is SNOMED CT the only terminology we should address?
Do profiles require a certain level of technological advancedness. Examples include constraint checking, model-to-model transformations, etc.