EN ISO 13940:2026

• Abstract:

  This document defines the requirements for a system of concepts for different aspects of the provision of care encompassing social care as well as clinical care. The focus of this document is continuity of care.; This document defines requirements for a system of concept definitions needed to describe health and care businesses. Concept systems conforming to this document can be used to support the development of:; logical reference models within the information viewpoint as a common basis for semantic interoperability on international, national or local levels;; information systems;; information for specified types of care processes.; This document does not specify how to perform specific care processes. This document does not cover research processes in the context of social and clinical care, welfare and educational processes.

• Status: Published
• Publication Date: 11-Aug-2026
• ICS: 35.240.80 - IT applications in health care technology
• Technical Committee: CEN/TC 251 - Medical informatics
• Drafting Committee: CEN/TC 251/WG 1 - Information models
• Current Stage: 6060 - Definitive text made available (DAV) - Publishing
• Start Date: 12-Aug-2026
• Completion Date: 12-Aug-2026
• Ref Project: SIST EN ISO 13940:2026 - Health informatics - System of concepts to support continuity of care (ISO 13940:2026)

• Replaces: EN ISO 13940:2016 - Health informatics - System of concepts to support continuity of care (ISO 13940:2015)
• Effective Date: 22-Jan-2025
• Consolidated By: ISO 13940:2026 - Health informatics — System of concepts to support continuity of care
• Effective Date: 12-Feb-2026

Overview

EN ISO 13940:2026 - Health Informatics: System of Concepts to Support Continuity of Care establishes a comprehensive framework of standardized concepts essential for enabling the continuity and coordination of care across the health and social care sectors. Developed by CEN and based on ISO 13940:2026, this standard addresses the need for a unified conceptual structure to support semantic interoperability between care information systems at local, national, and international levels. It plays a key role in describing, modeling, and understanding various aspects of health and social care service provision.

The standard equips stakeholders-such as healthcare providers, IT system developers, and policy makers-with a common vocabulary and conceptual basis, facilitating more effective communication and data exchange in the delivery of integrated care services.

Key Topics

The standard covers a wide range of core concepts and terms that underpin the organization and delivery of care, focusing on:

• Continuity of Care: Defining concepts and relationships to ensure seamless transitions, coordination, and integration of care.
• Care Actors and Resources: Standardizing definitions for care providers, organizations, care personnel, patients (subjects of care), proxies, and resources.
• Activities and Processes: Structuring activities, investigations, treatments, assessments, management, and processes that constitute health and social care.
• Health and Social Care Matters: Providing clear terminology for health states, conditions, health needs, and social determinants of health.
• Timing and Events: Standardizing temporal concepts such as care episodes, periods, appointments, delays, and mandates.
• Plans and Records: Defining structures for care planning, documentation, and information management to support integrated care pathways.
• Semantic Interoperability: Enabling logical reference models and compatibility among different information systems through agreed concept systems.

Applications

EN ISO 13940:2026 supports a range of practical applications in health informatics and continuity of care:

• Development of Health Information Systems: System architects leverage the standard's conceptual framework when designing interoperable electronic health record (EHR) systems and social care information systems.
• Integrated Care Pathways: Facilitates communication and coordination among multidisciplinary teams, ensuring consistent understanding of roles, timelines, and care processes.
• Semantic Interoperability: Provides a baseline for developing logical reference models and data exchange protocols, crucial for connecting disparate IT solutions across organizations or regions.
• Care Process Improvement: Organizations utilize standardized terminologies to streamline care workflows, clarify responsibilities, and minimize errors in multi-provider environments.
• Policy and Regulation: Serves as a reference for regulatory bodies formulating guidelines and compliance requirements for care documentation and information sharing.
• Training and Education: Used as a foundational resource to educate healthcare professionals, administrators, and IT staff about the complexities and interdependencies of integrated care.

Related Standards

Several other standards complement and support EN ISO 13940:2026 in promoting semantic interoperability and integrated care:

• EN ISO 13606 (Health informatics - Electronic health record communication): Standard for the exchange of EHR data.
• EN ISO 12967 (Health informatics - Service architecture): Reference architecture for health information systems.
• EN ISO 18308 (Requirements for an electronic health record architecture): Specifies principles and requirements for EHR systems.
• HL7 FHIR (Fast Healthcare Interoperability Resources): Standard for exchanging healthcare information electronically.

Conclusion

EN ISO 13940:2026 is instrumental for advancing digital transformation in healthcare. By providing a rigorous system of concepts for the continuity of care, it fosters interoperability and consistent understanding across health and social care sectors-enabling safer, more effective, and patient-centered services in an increasingly interconnected care environment.

SLOVENSKI STANDARD
01-november-2026
Nadomešča:
SIST EN ISO 13940:2016
Zdravstvena informatika - Sistem pojmov za podporo neprekinjeni oskrbi (ISO
13940:2026)
Health informatics - System of concepts to support continuity of care (ISO 13940:2026)
Medizinische Informatik - Begriffssystem zur Unterstützung der Kontinuität der
Versorgung (ISO 13940:2026)
Informatique de santé - Système de concepts visant à favoriser la continuité des soins
(ISO 13940:2026)
Ta slovenski standard je istoveten z: EN ISO 13940:2026
ICS:
35.240.80 Uporabniške rešitve IT v IT applications in health care
zdravstveni tehniki technology
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

EN ISO 13940
EUROPEAN STANDARD
NORME EUROPÉENNE
August 2026
EUROPÄISCHE NORM
ICS 35.240.80 Supersedes EN ISO 13940:2016
English Version
Health informatics - System of concepts to support
continuity of care (ISO 13940:2026)
Informatique de santé - Système de concepts visant à Medizinische Informatik - Begriffssystem zur
favoriser la continuité des soins (ISO 13940:2026) Unterstützung der Kontinuität der Versorgung (ISO
13940:2026)
This European Standard was approved by CEN on 10 July 2026.

CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this
European Standard the status of a national standard without any alteration. Up-to-date lists and bibliographical references
concerning such national standards may be obtained on application to the CEN-CENELEC Management Centre or to any CEN
member.
This European Standard exists in three official versions (English, French, German). A version in any other language made by
translation under the responsibility of a CEN member into its own language and notified to the CEN-CENELEC Management
Centre has the same status as the official versions.

CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia,
Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway,
Poland, Portugal, Republic of North Macedonia, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Türkiye and
United Kingdom.
EUROPEAN COMMITTEE FOR STANDARDIZATION
COMITÉ EUROPÉEN DE NORMALISATION

EUROPÄISCHES KOMITEE FÜR NORMUNG

CEN-CENELEC Management Centre: Rue de la Science 23, B-1040 Brussels
© 2026 CEN All rights of exploitation in any form and by any means reserved Ref. No. EN ISO 13940:2026 E
worldwide for CEN national Members.

Contents Page
European foreword . 3

European foreword
This document (EN ISO 13940:2026) has been prepared by Technical Committee ISO/TC 215 "Health
informatics" in collaboration with Technical Committee CEN/TC 251 “Health informatics” the
secretariat of which is held by NEN.
This European Standard shall be given the status of a national standard, either by publication of an
identical text or by endorsement, at the latest by February 2027, and conflicting national standards
shall be withdrawn at the latest by February 2027.
Attention is drawn to the possibility that some of the elements of this document may be the subject of
patent rights. CEN shall not be held responsible for identifying any or all such patent rights.
This document supersedes EN ISO 13940:2016.
Any feedback and questions on this document should be directed to the users’ national standards
body/national committee. A complete listing of these bodies can be found on the CEN website.
According to the CEN-CENELEC Internal Regulations, the national standards organizations of the
following countries are bound to implement this European Standard: Austria, Belgium, Bulgaria,
Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland,
Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Republic of
North Macedonia, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Türkiye and the
United Kingdom.
Endorsement notice
The text of ISO 13940:2026 has been approved by CEN as EN ISO 13940:2026 without any modification.

International
Standard
ISO 13940
Second edition
Health informatics — System of
2026-08
concepts to support continuity of
care
Informatique de santé — Système de concepts visant à favoriser
la continuité des soins
Reference number
ISO 13940:2026(en) © ISO 2026
ISO 13940:2026(en)
© ISO 2026
All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may
be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting on
the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address below
or ISO’s member body in the country of the requester.
ISO copyright office
CP 401 • Ch. de Blandonnet 8
CH-1214 Vernier, Geneva
Phone: [phone]
Email: [e-mail]
Website: www.iso.org
Published in Switzerland
ii
ISO 13940:2026(en)
Contents Page
Foreword .ix
Introduction .x
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
3.1 General terms .1
3.2 Health matters .4
3.3 Actors, performers and resources .18
3.4 Activities . 33
3.5 Care processes .43
3.6 Time. 49
3.7 Plans and events . 58
3.8 Mandates . 65
3.9 Health records . 73
4 Abbreviated terms .86
5 Health and care .86
5.1 General . 86
5.2 Explanations and comments . 86
5.2.1 Health state . 86
5.2.2 Health matter . 87
5.2.3 Health condition . 87
5.2.4 Health issue . 87
5.2.5 Health problem . 87
5.2.6 Health thread. 87
5.2.7 Potential health condition . 87
5.2.8 Observed condition . 87
5.2.9 Considered condition. 87
5.2.10 Vulnerability . 87
5.2.11 Social environment . 88
5.2.12 Social determinant of health . 88
5.2.13 Health need . 88
5.3 Representation of the relationships between concepts related to health state . 88
5.4 Normative statements .91
5.4.1 Relationships of health state .91
5.4.2 Relationships of health matter . 92
5.4.3 Relationships of clinical matter . 92
5.4.4 Relationships of social matter . 92
5.4.5 Relationships of health condition . 92
5.4.6 Relationships of health issue . 93
5.4.7 Relationships of social issue. 93
5.4.8 Relationships of clinical issue . 93
5.4.9 Relationships of health problem . 93
5.4.10 Relationships of health thread . 93
5.4.11 Relationships of health problem list . 94
5.4.12 Relationships of potential health condition . 94
5.4.13 Relationships of observed condition . 94
5.4.14 Relationships of considered condition . 94
5.4.15 Relationships of professionally assessed condition . 95
5.4.16 Relationships of vulnerability . 95
5.4.17 Relationships of excluded condition . 95
5.4.18 Relationships of working diagnosis . 95
5.4.19 Relationships of prognostic condition . 95
5.4.20 Relationships of resultant condition . 96

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ISO 13940:2026(en)
5.4.21 Relationships of target condition . 96
5.4.22 Relationships of risk condition . 96
5.4.23 Relationships of social environment . 96
5.4.24 Relationships of health need . . 96
5.4.25 Relationships of social need . 97
5.4.26 Relationships of clinical need . 97
6 Actors and resources .97
6.1 General . 97
6.2 Explanations and comments . 97
6.2.1 Care actor . 97
6.2.2 Subject of care . 97
6.2.3 Care organization . 97
6.2.4 Care third party . 97
6.2.5 Care personnel . 98
6.2.6 Care employment . 98
6.2.7 Care professional entitlement . 98
6.2.8 Care professional . 98
6.2.9 Subject of care proxy . 98
6.2.10 Care performer . 98
6.2.11 Prescriber . 98
6.2.12 Care resource . 98
6.2.13 Point of care . 98
6.2.14 Care funds . 99
6.3 Representation of the relationships between concepts related to care actors . 99
6.4 Normative statements . 101
6.4.1 Relationships of care actor . 101
6.4.2 Relationships of subject of care . . 102
6.4.3 Relationships of care provider . 103
6.4.4 Relationships of care third party . 103
6.4.5 Relationships of care organization . 103
6.4.6 Relationships of care employment . 104
6.4.7 Relationships of care personnel . 104
6.4.8 Relationships of care professional entitlement. 104
6.4.9 Relationships of care professional . 104
6.4.10 Relationships of other carer . 105
6.4.11 Relationships of care supporting organization . . 105
6.4.12 Relationships of subject of care proxy . 105
6.4.13 Relationships of care performer . 106
6.4.14 Relationships of self-care performer . 106
6.4.15 Relationships of third party care performer . 106
6.4.16 Relationships of prescriber . 106
6.4.17 Relationships of care resource . 106
6.4.18 Relationships of point of care. 107
6.4.19 Relationships of medical device . 107
6.4.20 Relationships of automatic medical device . 107
6.4.21 Relationships of medicinal product . 107
6.4.22 Relationships of care funds . . 107
6.4.23 Relationships of facility . 107
7 Activities .108
7.1 General . 108
7.2 Explanations and comments . 108
7.2.1 Care activity . 108
7.2.2 Care activities bundle . 108
7.2.3 Care investigation . 108
7.2.4 Care treatment . 108
7.2.5 Health condition assessment . 108
7.2.6 Care needs assessment . 108
7.2.7 Care activity management . 108

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ISO 13940:2026(en)
7.2.8 Care evaluation . 108
7.3 Representation of the relationships between concepts related to care activities . 109
7.4 Normative statements .110
7.4.1 Relationships of care activity.110
7.4.2 Relationships of care provider activity . 111
7.4.3 Relationships of social care . 111
7.4.4 Relationships of automated care . 112
7.4.5 Relationships of self-care . 112
7.4.6 Relationships of prescribed self-care. 112
7.4.7 Relationships of care third party activity . 112
7.4.8 Relationships of prescribed third party activity . 112
7.4.9 Relationships of care service offering . 113
7.4.10 Relationships of care activities bundle . 113
7.4.11 Relationships of care service . 113
7.4.12 Relationships of care service directory . 113
7.4.13 Relationships of care investigation .114
7.4.14 Relationships of care treatment .114
7.4.15 Relationships of care assessment .114
7.4.16 Relationships of health condition assessment .114
7.4.17 Relationships of care needs assessment .114
7.4.18 Relationships of needed care activity .114
7.4.19 Relationships of care activity management . 115
7.4.20 Relationships of care evaluation . 115
8 Processes .115
8.1 General . 115
8.2 Explanations and comments . 115
8.2.1 Care process . 115
8.2.2 Continuity of care process . 115
8.2.3 Request for care . 115
8.2.4 Reason for request for care .116
8.2.5 Care process evaluation .116
8.3 Representation of the relationships between concepts related to care processes .116
8.4 Normative statements .117
8.4.1 Relationships of care process .117
8.4.2 Relationships of continuity of care process . 118
8.4.3 Relationships of input health state . 118
8.4.4 Relationships of output health state . 118
8.4.5 Relationships of request for care .119
8.4.6 Relationships of initial request for care .119
8.4.7 Relationships of referral .119
8.4.8 Relationships of request for service .119
8.4.9 Relationships of reason for request for care . 120
8.4.10 Relationships of care process evaluation . 120
9 Events, time .120
9.1 General . 120
9.2 Explanations and comments . 120
9.2.1 Health related period . 120
9.2.2 Health condition period . 120
9.2.3 Care activity period . 120
9.2.4 Mandated period of care . 120
9.2.5 Indirect care activity period . 121
9.2.6 Prescribed self-care period . 121
9.2.7 Care contact . 121
9.2.8 Initial contact . 121
9.2.9 Encounter . . 121
9.2.10 Care appointment . 121
9.2.11 Episode of care . 121
9.2.12 Care activity delay . 121

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ISO 13940:2026(en)
9.2.13 Health approach . 121
9.3 Representation of the relationships between concepts related to time . 121
9.4 Normative statements . 122
9.4.1 Relationships of health related period. 122
9.4.2 Relationships of health condition period. 122
9.4.3 Relationships of care activity period . 123
9.4.4 Relationships of mandated period of care . 123
9.4.5 Relationships of indirect care activity period . 123
9.4.6 Relationships of prescribed self-care period . 123
9.4.7 Relationships of care contact . 123
9.4.8 Relationships of initial contact . 124
9.4.9 Relationships of encounter . 124
9.4.10 Relationships of care appointment . 124
9.4.11 Relationships of episode of care . 124
9.4.12 Relationships of episodes of care bundle. 125
9.4.13 Relationships of care activity delay. 125
9.4.14 Relationships of health condition delay . 125
9.4.15 Relationships of resource delay . 125
9.4.16 Relationships of subject of care preference delay . 125
9.4.17 Relationships of health approach . 125
10 Planning care and knowledge resources .126
10.1 General . 126
10.2 Explanations and comments . 126
10.2.1 Care planning . 126
10.2.2 Care goal . 126
10.2.3 Intended outcome . 126
10.2.4 Core care plan . 126
10.2.5 Care pathway . 126
10.2.6 Unintended event . 126
10.3 Representation of the relationships between concepts related to planning care . 126
10.4 Normative statements . 127
10.4.1 Relationships of care planning . 127
10.4.2 Relationships of care goal .128
10.4.3 Relationships of intended outcome . .128
10.4.4 Relationships of care guideline . 128
10.4.5 Relationships of protocol .128
10.4.6 Relationships of care pathway . 129
10.4.7 Relationships of care plan .129
10.4.8 Relationships of core care plan . 129
10.4.9 Relationships of social care plan .
...