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: FprEN ISO 13940 - Health informatics - System of concepts to support continuity of care (ISO/FDIS 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

Overview

ISO 13940: Health informatics - System of concepts to support continuity of care is an international standard developed by ISO/TC 215, which specifies requirements for a conceptual system to define care processes necessary to achieve continuity of care in the health sector. This standard addresses both clinical and social care, supporting seamless patient management and communication across varied care settings. The framework provided by ISO 13940 enables consistent conceptual understanding and semantic interoperability, facilitating accurate information exchange within and between healthcare organizations, and supporting development and integration of health information systems.

Key Topics

• Continuity of Care: Emphasis on a coherent and interconnected series of care events over time, encompassing clinical and social care processes, enabling patients to experience coordinated and uninterrupted services.
• Concept System Alignment: Provides rigorous definitions for fundamental concepts such as health, care, health state, care actors, activities, and events, drawing on principles from upper-level ontologies (e.g., DOLCE).
• Semantic Interoperability: Supports the creation of logical reference models for health information systems to ensure data and processes are interpreted consistently at organizational, national, and international levels.
• Care Process Modelling: Enables the description and modelling of care processes, actors, resources, planning, responsibilities, and mandates through standardized terms and clear relationships.
• Integration of Clinical and Social Care: Reflects WHO’s broad definition of health and supports transitions and referrals between various care settings, including primary care, specialist services, community and home-based care, and long-term care.

Applications

ISO 13940 supports a wide range of practical applications in health informatics, such as:

• Development of Health Information Systems: Provides a conceptual foundation for designing robust information models that underpin electronic health records (EHR) and integrated care systems.
• Semantic Interoperability: Assists in harmonizing terminology between different healthcare IT systems, paving the way for accurate and meaningful data exchange and reducing miscommunication.
• Care Process Improvement: Facilitates clear definition and documentation of clinical and social care processes, enabling organizations to optimize workflows and enhance patient care coordination.
• Business Analysis and Policy Creation: Offers a standardized vocabulary for analyzing organizational structures, designing care pathways, and supporting evidence-based policy development in the health sector.
• Secondary Use of Care Data: Establishes a semantic foundation for using care data in research, analytics, and knowledge management without ambiguity, ensuring consistency and traceability.

Related Standards

Implementers of ISO 13940 should consider alignment with other key health informatics standards, including:

• ISO 13606-1: Electronic health record communication - Reference model for EHR architecture
• HL7/FHIR: Fast Healthcare Interoperability Resources standard for electronic exchange of healthcare information
• ISO/IEC 21838-3: Information technology - Top-level ontologies (for alignment of upper-level concepts)
• ISO 12967-1: Health informatics - Service architecture
• UNI/TR 11802:2020: Technical report providing a concept system for continuity of care, especially in the Italian context

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Adoption of ISO 13940 ensures stakeholders, from care professionals to IT solution providers, can refer to a shared, internationally recognized system of health informatics concepts. This enhances semantic clarity, streamlines integration efforts, and ultimately supports safer and more effective continuity of care for individuals receiving both clinical and social support.

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
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ISO copyright office
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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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