SIST 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
- Public Enquiry End Date
- 06-Nov-2025
- Publication Date
- 04-Oct-2026
- Technical Committee
- ITC - Information technology
- Current Stage
- 6060 - National Implementation/Publication (Adopted Project)
- Start Date
- 17-Sep-2026
- Due Date
- 22-Nov-2026
- Completion Date
- 05-Oct-2026
SIST EN ISO 13940:2026 is the Slovenian adoption of EN ISO 13940:2026, published by SIST and identical to ISO 13940:2026 as approved by CEN. It defines a system of concepts for social care and clinical care, with continuity of care as the main focus, so care actors can describe care processes, records, mandates, plans and related relationships in a shared semantic framework. It is aimed at care professionals, social care personnel, subjects of care, care managers, care funding organizations, care providers and local care teams.
What does SIST EN ISO 13940:2026 specify?
SIST EN ISO 13940:2026 specifies requirements for a system of concept definitions used to describe health and care businesses. The document is intended to support logical reference models, information systems and information for specified types of care processes, especially where interoperability matters across organizations and care settings.
The scope is broad enough to cover social care and clinical care together, but it does not specify how to perform particular care processes. It also leaves out research processes in the social and clinical care context, as well as welfare and educational processes.
The document is organized as follows:
- Clause 1 - Scope
- Clause 2 - Normative references
- Clause 3 - Terms and definitions
- Clause 4 - Abbreviated terms
- Clauses 5 to 12 - Additional explanations, concept relationships and normative statements for the main concept areas
- Annex A - Generic model of the continuity of care process
- Annex B - Alignment with an upper ontology
| Annex | What it covers |
|---|---|
| Annex A | A cyclic model of the continuity of care process, showing how investigation, treatment, evaluation and reassessment link together |
| Annex B | The relationship of the concept system to the DOLCE upper ontology |
What are the key requirements of SIST EN ISO 13940:2026?
SIST EN ISO 13940:2026 is a concept-model standard, so its main requirements are about how concepts are defined, related and used together. In practice, this means the document tells you what must be distinguished, linked or recorded when building interoperable care information models.
Continuity of care is the organizing principle
SIST EN ISO 13940:2026 defines continuity of care as a coherent and interconnected series of care events over time, and Clause 3.5.2 makes the continuity of care process the overarching care process. Annex A shows this as a cyclic model, where assessment, investigation, treatment and evaluation can repeat and lead into the next phase.
In practice, this matters because care is often spread across contacts, providers and organizations. The standard helps systems keep one consistent view of the same subject of care as their care needs evolve.
Care actors, roles and responsibility must be distinguished
SIST EN ISO 13940:2026 separates care actor, care provider, care third party, care organization, care personnel, care professional and subject of care in Clause 3.3 and Clause 6.4. A care actor can be involved directly or indirectly, while a care provider is a care actor that can be assigned care period mandates.
This distinction matters because funding, delivery and receiving care are not the same role. The document also distinguishes care employment, care professional entitlement and care professional, so organizational roles and professional authority are not confused in records or information systems.
Activities are classified by who performs them and why
SIST EN ISO 13940:2026 defines care activity, social care, self-care, prescribed self-care, automated care, care investigation, care treatment, care assessment and care needs assessment in Clause 3.4 and Clause 7.4. Automated care is explicitly initiated by a care actor and then delivered by an automatic medical device; the device does not hold responsibility.
This matters in practice because the same health result can come from different kinds of activity. The standard helps users document whether an activity was done by a provider, the subject of care, a third party or a device, and whether it was prescribed or not.
Requests, processes and episodes are linked
SIST EN ISO 13940:2026 defines request for care, initial request for care, referral, request for service and reason for request for care in Clause 3.5 and Clause 8.4. A referral is a request for care in which a care professional asks a care provider to make a care commitment for a care period mandate.
This matters because requests can be accepted, referred or declined, and accepted referrals transfer continuity responsibility for the specified health issues. The document also distinguishes episode of care, episodes of care bundle, care contact, initial contact and encounter in Clause 3.6, which helps systems track time, sequence and responsibility across multiple contacts.
Planning links knowledge resources to individualized care
SIST EN ISO 13940:2026 defines care guideline, protocol, care pathway, care plan, core care plan, social care plan, clinical care plan and integrated care plan in Clause 3.7 and Clause 10.4. Care planning manages a care plan that contains needed care activity, intended outcomes and care goals.
In practice, this means a generic guideline or pathway can feed a reusable core care plan, which then supports an individualized plan for one subject of care. The integrated care plan is the key concept for crossing organizational, professional and contextual borders.
Mandates and consent govern who may act
SIST EN ISO 13940:2026 defines care mandate, care commitment, informed consent, objection, consent competence, authorization by law, proxy mandate, care period mandate, request mandate and continuity facilitator mandate in Clause 3.8 and Clause 11.4. A care mandate is based on commitment and either informed consent or authorization by law.
This matters because authority and responsibility must be explicit before care activities are performed. The standard also records the subject of care’s desire, which can influence whether specific activities are performed and how care is organized.
Records and extracts support communication
SIST EN ISO 13940:2026 defines health record, professional health record, personal health record, shareable data repository, health record extract, health report, health summary, discharge report, discharge summary and health concern in Clause 3.9 and Clause 12.4. A health record is a data repository regarding the health and care of a subject of care.
In practice, this supports communication between care actors and across settings. The document distinguishes records held by providers, records held by the subject of care, and shareable repositories used for authorized access and exchange.
What terms does SIST EN ISO 13940:2026 define?
SIST EN ISO 13940:2026 defines a large concept system in Clause 3. These are some of the most important terms.
- Continuity of care - a coherent and interconnected series of care events over time.
- Care actor - an organization or person participating in care, directly or indirectly.
- Subject of care - a person seeking to receive, receiving, or having received care.
- Care process - a set of interrelated or interacting care activities that transforms inputs into outputs.
- Care plan - a dynamic, personalized plan including needed care activity, intended outcomes and care goals.
- Health record - a data repository regarding the health and care of a subject of care.
- DOLCE - descriptive ontology for linguistic and cognitive engineering, used here as the upper-ontology alignment basis.
- UML - unified modelling language, used for the concept diagrams throughout the document.
Who uses SIST EN ISO 13940:2026?
SIST EN ISO 13940:2026 is intended for anyone involved in interoperability between clinical care and social care. The foreword and introduction identify care professionals and teams, social care personnel, subjects of care, care managers, care funding organizations, care providers and local care teams as intended users.
It is also relevant to people who design, analyze or govern care information systems. In practice, that includes business analysts, enterprise architects, standards developers and policy makers who need a common conceptual basis for care data, processes, records and responsibilities.
What changed in SIST EN ISO 13940:2026 from the previous edition?
SIST EN ISO 13940:2026 supersedes SIST EN ISO 13940:2016 and EN ISO 13940:2016. The introduction says the second edition extends the concept system to support continuity of care more explicitly across social care and clinical care.
The foreword also states that the text of ISO 13940:2026 was approved by CEN without modification. That means the European standard follows the international text as adopted.
Which standards are used with SIST EN ISO 13940:2026?
Clause 2 states that there are no normative references in this document. Even so, the standard explicitly aligns with or draws on several companion standards:
- ISO 13606-1:2019 - aligns terminology and supports concepts such as care process and health record extract.
- HL7/FHIR - used as a terminology alignment point, especially for record templates and questionnaire-style use.
- ISO/IEC 21838-3:2023 - provides the upper-ontology guidance used for modelling.
- ISO/IEC 21838-1:2021 - the ontological base behind ISO/IEC 21838-3.
- ISO 24156-1 - governs the UML concept-modelling notation used in the diagrams.
- ISO 12967-1:2020 - referenced for process descriptions and the enterprise viewpoint.
- ISO 9000:2015 - used for core vocabulary such as information, process and requirement.
- ISO 27269 - named as an example for patient summary use.
- ISO/TR 14292:2012 - cited for the definition context of subject of care.
- ISO/TS 17975:2022 - appears in the bibliography as a related consent standard.
What does the SIST EN ISO 13940:2026 document contain?
SIST EN ISO 13940:2026 contains a large terminology model built around clauses 3 to 12, with UML diagrams showing how the concepts relate to one another. Clause 3 lists the defined terms, and clauses 5 to 12 add explanations, representation figures and normative statements for health and care, actors and resources, activities, processes, time, planning, responsibility, and information and records.
The document also contains examples and notes that clarify how the terms are meant to be used in practice. A key design feature is that the concept classes show relationships rather than attributes, so implementers can add implementation-specific attributes while remaining conformant.
Annex A gives the generic continuity of care model as a cyclical process, including investigation and treatment. Annex B shows how the concept system aligns with the DOLCE upper ontology.
Relations
- Effective Date
- 01-Nov-2026
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Frequently Asked Questions
SIST EN ISO 13940:2026 is a standard published by the Slovenian Institute for Standardization (SIST). 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.
SIST 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.
SIST EN ISO 13940:2026 has the following relationships with other standards: It is inter standard links to SIST EN ISO 13940:2016. Understanding these relationships helps ensure you are using the most current and applicable version of the standard.
SIST 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.
ISO copyright office
CP 401 • Ch. de Blandonnet 8
CH-1214 Vernier, Geneva
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 .
...