EN ISO 13940:2026
(Main)Health informatics - System of concepts to support continuity of care (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
- 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
EN ISO 13940:2026 is a CEN European Standard that adopts ISO 13940:2026 for health informatics. It specifies a system of concepts for continuity of care across social care and clinical care, so organisations can describe care processes, care information, responsibilities and records with a shared semantic framework. It is aimed at people who need interoperable care terminology for information systems, modelling and coordination.
What does EN ISO 13940:2026 specify?
EN ISO 13940:2026 specifies a system of concept definitions for health and care business, with continuity of care as the main focus. It supports logical reference models, information systems and information for specified care processes, but it does not define how to perform the care processes themselves.
The document is organized around a core vocabulary in Clause 3 and then expands that vocabulary through explanatory clauses and normative relationship statements in Clauses 5 to 12. Clause 4 lists abbreviations. Annex A gives the generic continuity of care process model, and Annex B shows the alignment with an upper ontology.
| Annex | What it covers |
|---|---|
| Annex A | Generic model of the continuity of care process and the cyclic relation between investigation and treatment |
| Annex B | Alignment of the concept system with the upper ontology, DOLCE |
What are the key requirements of EN ISO 13940:2026?
Continuity of care is the organising idea
EN ISO 13940:2026 defines continuity of care as a coherent and interconnected series of care events over time, and the continuity of care process as the care process that addresses identified or specified health issues. In practice, this gives a shared way to link referrals, requests, assessments, treatment, follow-up and handover across organisations and settings.
Clause 8 and Annex A show continuity of care as a process that can move between investigation and treatment and can span several care providers. For readers, that means the standard is about connecting care episodes and the information around them, not about prescribing clinical actions.
The standard separates health state, health matter and health issue
EN ISO 13940:2026 distinguishes health state, health matter, health condition, health issue, health problem and health thread in Clause 3 and explains their relationships in Clause 5. This matters because one observation, one professional assessment and one care problem are not the same thing, and the standard gives a vocabulary to keep them separate.
The document also covers variants such as observed condition, considered condition, professionally assessed condition and potential health condition. In practice, this supports clearer documentation when a care actor is observing a fact, considering a hypothesis, or recording an assessed problem.
Care actors, roles and resources are modelled separately
EN ISO 13940:2026 defines care actor, subject of care, care provider, care third party, care organization, care personnel, care professional, care performer and care resource in Clause 3, with relationship models in Clause 6. This separation matters because responsibility, performance, funding and support are not interchangeable in care work.
The standard also covers care employment, care professional entitlement, subject of care proxy, self-care performer, third party care performer and automatic medical device. In practice, this helps organisations model who is authorised to act, who actually performs an activity, and what resource or device is involved.
Care activity is distinct from care process, planning and evaluation
EN ISO 13940:2026 treats care activity as the basic unit of action, with subtypes such as social care, automated care, self-care, prescribed self-care, care investigation, care treatment, care assessment and care needs assessment. Clause 7 groups these concepts and Clause 8 links them to care processes.
This matters in daily use because a care process can contain several different kinds of activity, and not all of them are direct treatment. The standard also recognises care activity management and care process evaluation, so teams can model planning, execution and review as related but different tasks.
Planning uses goals, outcomes and reusable knowledge resources
EN ISO 13940:2026 defines care goal, intended outcome, care guideline, protocol, care pathway, care plan, core care plan, social care plan, clinical care plan and integrated care plan in Clause 3 and explains them in Clause 10. The practical point is that a care plan is not just a list of tasks - it is linked to goals, target conditions and reusable guidance.
The standard says that core care plans provide reusable content, usually based on care guidelines and protocols, and that integrated care plans cross organisational, professional and contextual borders. This is useful when a plan must be adapted to one person while still reusing agreed clinical or social guidance.
Responsibility depends on mandate, consent and commitment
EN ISO 13940:2026 defines care mandate, care commitment, informed consent, objection, consent competence, authorization by law, proxy mandate, care period mandate, request mandate, continuity facilitator mandate and mandate to export personal information in Clause 3 and Clause 11. This matters because the standard models care as something that must be authorised as well as performed.
In practice, this helps users distinguish a request for care from the legal and organisational authority to act on it. It also supports cases where a subject of care acts through a proxy, where law overrides the need for consent, or where a care provider accepts responsibility for a mandated period of care.
Records and extracts are used to communicate care
EN ISO 13940:2026 defines care data, care information, care documenting, health record, professional health record, personal health record, shareable data repository, health record extract, health report, discharge report, health summary and health concern in Clause 3 and Clause 12. The point is to model records as communication tools for continuity of care, not just storage.
This matters because the standard separates the full health record from extracts, summaries and reports used for specific recipients and purposes. In practice, that supports exchange between care settings, shared repositories, patient summaries and records that remain under clear custody.
What terms does EN ISO 13940:2026 define?
- continuity of care - a coherent and interconnected series of care events over time.
- care actor - an organization or person participating in care.
- subject of care - a person seeking to receive, receiving, or having received care.
- care plan - a dynamic, personalized plan that includes needed care activity, intended outcomes and care goals.
- care mandate - a mandate based on commitment and either informed consent or authorization by law, defining rights and obligations in care processes.
- health thread - a defined association between health matters as determined by one or more care actors.
- health record - a data repository regarding the health and care of a subject of care.
Who uses EN ISO 13940:2026?
EN ISO 13940:2026 is intended for everyone concerned with interoperability in clinical care and social care. Clause 0.5 names care professionals and teams, social care personnel, subjects of care, care managers, care funding organizations, care providers and local care teams.
Typical users include:
- care and social care organisations modelling shared processes
- health informatics teams designing information systems
- enterprise and business analysts defining care services and responsibilities
- quality managers documenting continuity of care and record structures
- policy and governance teams aligning terminology across services
- buyers and implementers who need a common vocabulary for interoperability work
What changed in EN ISO 13940:2026 from the previous edition?
EN ISO 13940:2026 supersedes EN ISO 13940:2016. The foreword and introduction say that this edition extends the concept system so that continuity of care across social care and clinical care is supported more explicitly, building on work such as UNI/TR 11802:2020.
Which standards are used with EN ISO 13940:2026?
Clause 2 lists no normative references, but the document aligns with and draws on several other standards and related specifications:
- ISO 13606-1:2019 - provides the reference-model background for care process and health record extract concepts.
- HL7/FHIR - used as a terminology alignment point for care record concepts such as record templates.
- ISO/IEC 21838-3:2023 and ISO/IEC 21838-1:2021 - provide the ontological framework behind the DOLCE alignment in Annex B.
- ISO 24156-1 - guides the UML notation used for concept modelling.
- ISO 12967-1:2020 - cited as the place where process models are described, and used as the process reference in the introduction.
- ISO 9000:2015 - supports the document’s use of process and information terminology.
- ISO/TS 17975:2022 - contributes to the consent-related context in the bibliography.
- ISO/TR 14292:2012 - contributes the subject of care context used in the definitions.
- ISO 27269 - appears as an example of a patient summary in the health summary definition.
What does the EN ISO 13940:2026 document contain?
EN ISO 13940:2026 contains a large concept model with definitions in Clause 3, explanatory text in Clauses 5 to 12, and many UML diagrams that show how the concepts relate to one another. It uses normative relationship statements to connect health state, actors, activities, processes, time, planning, responsibility and records.
Annex A provides a circular model of continuity of care with investigation and treatment cycles, which is useful for understanding how one care process leads into another. Annex B aligns the concept system with DOLCE, which helps readers place the terminology in a broader ontological framework.
The document also includes examples, specialisations and record concepts such as health summary, discharge summary, health concern and shareable data repository. In practice, these parts support terminology work, information modelling, interoperability design, and the structuring of care documentation across organisations.
Relations
- 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
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Frequently Asked Questions
EN ISO 13940:2026 is a standard published by the European Committee for Standardization (CEN). Its full title is "Health informatics - System of concepts to support continuity of care (ISO 13940:2026)". This standard covers: 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.
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.
EN ISO 13940:2026 is classified under the following ICS (International Classification for Standards) categories: 35.240.80 - IT applications in health care technology. The ICS classification helps identify the subject area and facilitates finding related standards.
EN ISO 13940:2026 has the following relationships with other standards: It is inter standard links to EN ISO 13940:2016, ISO 13940:2026. Understanding these relationships helps ensure you are using the most current and applicable version of the standard.
EN ISO 13940:2026 is available in PDF format for immediate download after purchase. The document can be added to your cart and obtained through the secure checkout process. Digital delivery ensures instant access to the complete standard document.
Standards Content (Sample)
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.
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Phone: +41 22 749 01 11
Email: copyright@iso.org
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
iii
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
iv
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
v
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 .
...