Templates contain ACLs. The users and roles are defined in a config file.
Template:

<?xml version='1.0' encoding='UTF-8'?>
<template name="ref_forunders" version="1.0" title="Refraktiv kirurgi forundersøgelse" restrict="employee">
  <macro name="header" static="true"/>
  <macro name="henvisning"/>
 
  <header caption="Anamnese"/>
  <macro name="allergier" requires="henvisning" restrict="doctor"/>
  <macro name="medicin" requires="henvisning" compact="true" restrict="doctor, nurse"/>
  <macro name="alment" requires="henvisning"/>
</template>

Users and Groups:

# some config file in libconfig++ format
roles = (
          {id="doctor"},
          {id="nurse"},
          {id="optician"},
          {id="employee"}
        );
users = (
          {id="akf"; name="Anne Kaufmann Frederiksen"; roles=("doctor", "nurse","employee)},
          {id="ua"; name="Ulla Andersen"; roles=("nurse", "employee")},
          {id="jbo"; name="Jens Børge Olfgård"; roles=("optician", "employee")},
          {id="vis"; name="Visitor"; roles=()}
        );

No changes to template. ACLs are defined in config file, with 'realms' being templates and macros.
ACL file:

Syntax: [template] | [*:macro] | [template:macro] action { rolelist }

ref_forunders write {"doctor"}
*:henvisning write {"nurse", "doctor"}
ref_forunders:allergier write {"doctor"}

Users and roles can be defined as in Design1.