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: 02-Aug-2026
• ICS: 35.240.80 - IT applications in health care technology
• Technical Committee: ISO/TC 215 - Health informatics
• Drafting Committee: ISO/TC 215/WG 3 - Semantic content
• Current Stage: 6060 - International Standard published
• Start Date: 03-Aug-2026
• Due Date: 14-Jul-2026
• Completion Date: 03-Aug-2026

• Consolidates: EN ISO 13940:2026 - Health informatics - System of concepts to support continuity of care (ISO 13940:2026)
• Effective Date: 12-Feb-2026
• Revises: ISO 13940:2015 - Health informatics — System of concepts to support continuity of care
• Effective Date: 18-Jan-2025

ISO 13940:2026 is an ISO health informatics standard that defines a system of concepts to support continuity of care across social care and clinical care. It specifies the concept definitions and relationships needed to describe care businesses, support semantic interoperability, and model care processes for care providers, care teams, subjects of care, and implementers of care information systems.

What does ISO 13940:2026 specify?

ISO 13940:2026 specifies a concept system for care that covers both social care and clinical care, with continuity of care as the main focus. It defines the terminology and conceptual relationships used to describe care businesses, care processes, planning, mandates, and health records.

The scope is practical: the standard supports logical reference models in the information viewpoint, information systems, and information for specified types of care processes. It does not prescribe how to perform care processes, and it stays away from research processes as well as welfare and educational processes.

Clause 3 contains the core terms and definitions, organized into general terms, health matters, actors and resources, activities, care processes, time, plans and events, mandates, and health records. Clauses 5 to 12 expand those terms with explanations, UML models, and normative relationship statements.

Annex	What it covers
Annex A	A generic model of the continuity of care process and the cyclic relationship between investigation, treatment, evaluation, and renewed assessment
Annex B	Alignment of the concepts in the standard with the upper ontology DOLCE

What are the key requirements of ISO 13940:2026?

ISO 13940:2026 requires a shared concept structure that can represent care across social and clinical settings, not just clinical treatment. In practice, that means the same semantic framework has to support handovers, referrals, care plans, records, and service descriptions across organizations and disciplines.

Care is modelled as a continuity of care process

Clause 3.5 defines care process, continuity of care process, request for care, referral, request for service, and reason for request for care. The continuity of care process is the process view of care from the subject of care perspective, and it includes provider activities and other prescribed care activities. In practice, this is the basis for tracking how responsibility and activity move from first contact through assessment, treatment, and follow-up.

The model distinguishes social care, clinical care, and shared concepts

Clause 3.2 and Clause 3.4 separate clinical matter, social matter, clinical care, and social care while keeping them under the shared concept of care. The standard also defines health matter, health issue, health problem, health thread, and health need. In practice, this lets a system represent a social issue, a clinical issue, or a mixed situation without forcing everything into a medical-only model.

Actors, providers, and resources are not the same thing

Clause 3.3 distinguishes care actor, care provider, care third party, care organization, care personnel, care professional, and care resource. A care actor can be a person or organization involved in care, but a care provider is the actor that can be assigned care period mandates. In practice, this matters for responsibility, funding, reimbursement, staffing, and who is authorized to act.

Care activities include direct, indirect, automated, self-care, and third-party action

Clause 3.4 covers care activity, care provider activity, social care, automated care, self-care, prescribed self-care, care third party activity, prescribed third party activity, care activities bundle, care service offering, and care service directory. The standard treats self-care and third-party care as part of the care model when they are relevant to continuity. In practice, records and care plans need to show who performs the activity, whether it is prescribed, and whether a device or another person carried it out.

Time concepts separate condition, activity, and mandate periods

Clause 3.6 defines health related period, health condition period, care activity period, mandated period of care, indirect care activity period, prescribed self-care period, care contact, initial contact, encounter, care appointment, episode of care, and care activity delay. The standard distinguishes the time a condition exists from the time care is delivered and from the time a provider is mandated to act. In practice, this helps avoid mixing observation time, service delivery time, and legal or organizational responsibility.

Planning links reusable knowledge to individualized care

Clause 3.7 defines care planning, care goal, intended outcome, care guideline, protocol, care pathway, care plan, and core care plan. Care guidelines and protocols are reusable knowledge resources, while care plans are personalized for one or more health needs. In practice, a system can reuse standard guidance and still produce a patient- or client-specific plan.

Mandates, consent, and objections govern what care may be delivered

Clause 3.8 defines care mandate, care commitment, informed consent, objection, consent competence, authorization by law, subject of care desire, care activity mandate, clinical care activity mandate, and related mandate types. A care mandate is built from commitment and either informed consent or authorization by law. In practice, the standard ties care delivery to a documented legal and ethical basis, including proxy decisions and objections by the subject of care.

Records support communication, sharing, and continuity

Clause 3.9 defines record template, care data, care information, care documenting, health record, professional health record, personal health record [PHR], shareable data repository, health record extract, social record extract, health report, and social care report. The document treats records as repositories and extracts for communication, not just storage. In practice, it supports controlled sharing of the right information with the right care actor at the right time.

What terms does ISO 13940:2026 define?

• Continuity of care - a coherent and interconnected series of care events over time.
• Care actor - a person or organization participating in care, directly or indirectly.
• Subject of care - a person seeking, receiving, or having received care.
• Care activity - an activity intended to improve or maintain a health state.
• Care plan - a dynamic, personalized plan that brings together needed care activities, intended outcomes, and care goals.
• Care mandate - a mandate that defines rights and obligations for involvement in care, based on commitment and informed consent or authorization by law.
• PHR - personal health record, held and maintained by the subject of care or a subject of care proxy.
• UML - unified modelling language, used for the concept diagrams throughout the document.
• DOLCE - descriptive ontology for linguistic and cognitive engineering, the upper ontology used for alignment.

Who uses ISO 13940:2026?

ISO 13940:2026 is intended for everyone involved in interoperability across social care and clinical care. The foreword names care professionals and teams, social care personnel, subjects of care, care managers, care funding organizations, care providers, and local care teams.

It is also useful for people designing care information systems, enterprise models, and semantic reference models. In practice, that includes analysts, architects, quality managers, and buyers who need a common language for care delivery, records, planning, and handover.

What changed in ISO 13940:2026 from the previous edition?

ISO 13940:2026 is the second edition. The foreword says this edition extends the concept system so it more explicitly supports continuity of care across social care and clinical care, building on the contributions made in UNI/TR 11802:2020.

Which standards are used with ISO 13940:2026?

ISO 13940:2026 aligns and interacts with several related standards and frameworks named in the document.

• ISO 13606-1:2019 - supplies source terminology for care process and health record extract concepts and supports alignment of health record wording.
• HL7/FHIR - provides matching terminology for record templates, including the questionnaire and questionnaire response model.
• ISO/IEC 21838-3:2023 - provides the DOLCE upper ontology used as modelling guidance and alignment reference.
• ISO/IEC 21838-1:2021 - is the ontological foundation on which ISO/IEC 21838-3 is built.
• ISO 12967-1 - is used in the background discussion of care processes and process descriptions.
• ISO 9000:2015 - supplies general process, organization, and quality-management vocabulary used in several definitions and notes.
• ISO 24156-1 - underpins the way the concept models are presented without attributes in the class diagrams.

What does the ISO 13940:2026 document contain?

ISO 13940:2026 is a concept-heavy standard with definitions, explanation sections, relationship statements, and UML diagrams rather than procedural instructions. Clause 3 gives the main terminology, and Clauses 5 to 12 add the conceptual detail behind health, actors, activities, processes, time, planning, responsibility, and records.

The document uses many UML figures to show how concepts relate to one another. These figures support semantic modelling, implementation of information systems, and analysis of how care information moves across organizations and disciplines.

Annex A provides a cyclical model of continuity of care showing how investigation, treatment, evaluation, and renewed assessment fit together. Annex B places the concept system in relation to DOLCE, which helps readers understand how the standard fits an upper ontology.

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 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
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Phone: [phone]
Email: [e-mail]
Website: www.iso.org
Published in Switzerland
ii
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
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
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
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 . 130
10.4.10 Relationships of clinical care plan . 130
10.4.11 Relationships of integrated care plan . 130
10.4.12 Relationships of unintended event . 130
10.4.13 Relationships of adverse event . 130
10.4.14 Relationships of adverse event management . 130
11 Responsibility .130
11.1 General . 130
11.2 Explanations and comments . 131
11.2.1 Care mandate . 131
11.2.2 Care commitment . 131
11.2.3 Objection, subject of care desire . 131
11.2.4 Proxy mandate . 131
11.2.5 Care period mandate . 131
11.2.6 Continuity facilitator mandate . 131
11.2.7 Mandate to export personal information . 131
11.3 Representation of the relationships between concepts related to responsibility and
mandates . 132
11.4 Normative statements . 133

vi
11.4.1 Relationships of care mandate . 133
11.4.2 Relationships of care commitment . 133
11.4.3 Relationships of informed consent . 133
11.4.4 Relationships of objection .134
11.4.5 Relationships of consent competence .134
11.4.6 Relationships of authorization by law .134
11.4.7 Relationships of subject of care desire .134
11.4.8 Relationships of care activity mandate . 135
11.4.9 Relationships of clinical care activity mandate . 135
11.4.10 Relationships of social care activity mandate . 135
11.4.11 Relationships o
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