prEN ISO 13940

SLOVENSKI STANDARD
01-september-2024
Zdravstvena informatika - Sistem pojmov za podporo neprekinjeni oskrbi (ISO/DIS
13940:2024)
Health informatics - System of concepts to support continuity of care (ISO/DIS
13940:2024)
Medizinische Informatik - Begriffssystem zur Unterstützung der Kontinuität der
Versorgung (ISO/DIS 13940:2024)
Informatique de santé - Système de concepts en appui de la continuité des soins
(ISO/DIS 13940:2024)
Ta slovenski standard je istoveten z: prEN ISO 13940
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.

DRAFT
International
Standard
ISO/DIS 13940
ISO/TC 215
Health informatics — System of
Secretariat: ANSI
concepts to support continuity of
Voting begins on:
care
2024-07-01
Informatique de santé — Système de concepts en appui de la
Voting terminates on:
continuité des soins
2024-09-23
ICS: 35.240.80
THIS DOCUMENT IS A DRAFT CIRCULATED
FOR COMMENTS AND APPROVAL. IT
IS THEREFORE SUBJECT TO CHANGE
AND MAY NOT BE REFERRED TO AS AN
INTERNATIONAL STANDARD UNTIL
PUBLISHED AS SUCH.
This document is circulated as received from the committee secretariat.
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Reference number
ISO/DIS 13940:2024(en)
DRAFT
ISO/DIS 13940:2024(en)
International
Standard
ISO/DIS 13940
ISO/TC 215
Health informatics — System of
Secretariat: ANSI
concepts to support continuity of care
Voting begins on:
Informatique de santé — Système de concepts en appui de la
2024-07-01
continuité des soins
Voting terminates on:
ICS: 35.240.80 2024-09-23
THIS DOCUMENT IS A DRAFT CIRCULATED
FOR COMMENTS AND APPROVAL. IT
IS THEREFORE SUBJECT TO CHANGE
AND MAY NOT BE REFERRED TO AS AN
INTERNATIONAL STANDARD UNTIL
PUBLISHED AS SUCH.
This document is circulated as received from the committee secretariat.
IN ADDITION TO THEIR EVALUATION AS
BEING ACCEPTABLE FOR INDUSTRIAL,
© ISO 2024
TECHNOLOGICAL, COMMERCIAL AND
USER PURPOSES, DRAFT INTERNATIONAL
All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may
STANDARDS MAY ON OCCASION HAVE TO
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Published in Switzerland Reference number
ISO/DIS 13940:2024(en)
ii
ISO/DIS 13940:2024(en)
Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
3.1 General terms .1
3.2 Terms related to health and care .10
3.3 Terms related to actors and resources .27
3.4 Terms related to activities concerned with health and care .52
3.5 Terms related to processes . .67
3.6 Terms related to time . 77
3.7 Terms related to planning care . 90
3.8 Terms related to responsibility . 103
3.9 Terms related to information and records . 112
4 Symbols and abbreviations .139
5 Health and care .139
6 Care actors .141
7 Activities .144
8 Process management .146
9 Time and events .147
10 Planning care and knowledge resources .148
11 Responsibility .149
12 Information management and care records .150
Annex A (normative) Conformance .152
Annex B (informative) The extension of ISO 13940:2015 to social care .153
Annex C (informative) Process approach describing continuity of care .156
Annex D (informative) Alignment with an upper ontology .159
Bibliography .160

iii
ISO/DIS 13940:2024(en)
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out through
ISO technical committees. Each member body interested in a subject for which a technical committee
has been established has the right to be represented on that committee. International organizations,
governmental and non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely
with the International Electrotechnical Commission (IEC) on all matters of electrotechnical standardization.
The procedures used to develop this document and those intended for its further maintenance are described
in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the different types
of ISO document should be noted. This document was drafted in accordance with the editorial rules of the
ISO/IEC Directives, Part 2 (see www.iso.org/directives).
ISO draws attention to the possibility that the implementation of this document may involve the use of (a)
patent(s). ISO takes no position concerning the evidence, validity or applicability of any claimed patent
rights in respect thereof. As of the date of publication of this document, ISO [had/had not] received notice of
(a) patent(s) which may be required to implement this document. However, implementers are cautioned that
this may not represent the latest information, which may be obtained from the patent database available at
www.iso.org/patents. ISO shall not be held responsible for identifying any or all such patent rights.
Any trade name used in this document is information given for the convenience of users and does not
constitute an endorsement.
For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and expressions
related to conformity assessment, as well as information about ISO's adherence to the World Trade
Organization (WTO) principles in the Technical Barriers to Trade (TBT), see www.iso.org/iso/foreword.html.
This document was prepared by Technical Committee ISO/TC 215, Health informatics.
This second edition cancels and replaces the first edition (ISO 13940:2015), which has been technically
revised.
The main changes are as follows:
— The move of all terms into Clause 3
— The inclusion of explicit clauses to highlight the continuity includes social care
— Remodelling roles to take into account ISO 21298:2017 Functional and structural roles
Any feedback or questions on this document should be directed to the user’s national standards body. A
complete listing of these bodies can be found at www.iso.org/members.html.

iv
ISO/DIS 13940:2024(en)
Introduction
0.1  General
Continuity is an important prerequisite for good and efficient care. An optimal order of investigating and
treating activities will promote a favourable outcome of the course of any health problem, be it a clinical
illness, a social problem or a physical injury. In order to achieve this continuity of care there are two major
requirements regarding planning and documentation of care: one of them is the common understanding
of processes in care; the other one is a common understanding of semantics in care. This document does
not standardise processes. Such standardisation can be found in other standard documents, for instance
ISO 12967, Health informatics – Service architecture (HISA) – where part 1, Enterprise viewpoint, describes
processes in the enterprise of care and how they should be represented in models and text. The purpose of
this document is to define generic concepts needed to achieve continuity of care. A subject of care will meet
care professionals in different organisations, and the exchange of information between these organisations
must be safe without conceptual ambiguity. At the same time all information must be clear to the reader in
order to prevent human misunderstanding.
Besides the support of care continuity, the concept system in this document also enables the use of care
information for other purposes such as secondary use for follow-up and knowledge management.
To cover continuity of care, concepts are therefore needed from all of these basic process aspects:
— care processes (in social care and clinical healthcare)
— management
— support
This system of concepts is based upon the enterprise perspective of care. All other areas of work in care
both relate to and interact with the care processes. As such, the management aspects of care are identified
in the process management areas, and similarly the resource support areas are correspondingly identified
in the processes. This architecture with the areas around the care process is described in Figure 1.
Conformance statements are entered in Annex A.

v
ISO/DIS 13940:2024(en)
Figure 1 — Architecture of the concept areas
0.2  Aims for this document
The general aim for this document is to provide a comprehensive, conceptual basis for content and context in
care services, be it social services, clinical services or integrated services seamlessly engaging both contexts.
It should be the foundation for interoperability at all levels in care organisations and for development of
information systems in care.
The core business in care is the interaction between subjects of care and care professionals. To be able to
support continuity of care, the standard also aims to include comprehensive concept definitions and concept
relations for the management and resource aspects of care.
In practice this document is intended for use whenever requirements for information in care are specified.
This will cover all levels of specifications in the development of
— enterprise models as a common basis for interoperability on international, national or local levels
— information systems
— structured information for specified types of clinical and social processes.
0.3  About the concept of health

vi
ISO/DIS 13940:2024(en)
In this document health is defined with reference to the World Health Organization’s (WHO) declaration of
health from 1948: “. a state of complete physical, mental and social well-being and not merely the absence
of disease or infirmity”. In 1986 WHO made two amendments to the above definition: “resource for everyday
life, not the objective of living” and “health is a positive concept emphasizing social and personal resources,
as well as physical capacities”. The second amendment emphasizes the importance of social aspects on all
concepts in the context of health.
0.4  Care, healthcare and social care
Clinical healthcare as well as social care has the objective to influence, restore and maintain health in the
WHO sense. In this document the term “care” is preferred to stress the common characteristics and objectives
of both (clinical) healthcare and social care. It is a common understanding that healthcare is restricted to
clinical action against physical and mental health problems. That is not in line with the whole of the WHO
description, which includes social aspects on health. All kinds of activities have the potential to influence one
or more of the five components of health mentioned in the WHO International Classification of Functioning,
Disability and Health (ICF). Hence, the objective of this document is to support all parts described in the
ICF: body functions and structure, activity, participation, personal factors and environmental factors. It
supports smooth transition between social care and clinical care including referral from municipality care
to hospital and vice versa.
Reference to process models is entered as Annex C.
When a clear distinction is necessary to express the full meaning, terms social care, healthcare or clinical
care will be used with a clear explanation of the context. In most instances the short-term care is used to
stress the common character of most phenomena in the context of this document. Previous editions of this
document have been focused upon the part of healthcare that (in most cultures) does not emphasize social
care. The role of the subject of care was defined with respect to clinical healthcare and the terms chosen
were fetched from this sector. However, many of the concepts are equally relevant for the social care sector.
In this edition of ISO 13940 a set of concepts in the context of social care and welfare have been added to
the standard. Additional notes have been entered to explain the similarities and differences between the
contexts. Social care is considered equivalent with clinical healthcare in all terminological entries, so that
term and definition is valid in both contexts. The important overlapping area covering both contexts has
been recognised, for example the presence of social care workers in hospitals and physicians supporting
social care.
The foundation work for including the context of social care is described in Annex B.
0.5  Intended users for this document
All parties interested in the interoperability issues in clinical healthcare and social care are intended users
of this health informatics standard. This includes, but is not limited to, care professionals and teams, social
care personnel, subjects of care, care managers, care funding organisations and all types of care providers
and community care teams.
This system of concepts is relevant across all care information and the development and use of care
information systems. It can also be used for business analysis as a basis for organisational decisions and
more widely in development that is not inherently tied to the use of information systems.
0.6  The use of role concepts in this document
There are roles in healthcare, e.g. subject of care, care third party, care performer, care device. Between
these roles there may exist relations. Therefore, a concept system of roles in care will be conformant with
ISO 17115:2020 Health informatics -- Representation of categorial structures of terminology (CatStructure)
and described in the DOLCE standard. This is also the foundation of SNOMED CT.
0.7  Description and display of concepts
In this document the concepts are – in conformance with the ISO/IEC Directives, part 2 – listed in clause 3.
The order is logical with subclauses according to the kinds of concepts. Each of the concepts is defined and
described according to ISO 704 and ISO 10241. For most of the concepts the terminological entry includes a
small UML model with the relations and related concepts surrounding the core concept.

vii
ISO/DIS 13940:2024(en)
Clauses 5 to 12 provide additional description of the concepts and comprehensive UML diagrams showing
all relations between the concepts listed in clause 3.
Examples are provided wherever they are considered relevant and necessary.
The purpose of using a concept model in this document is to highlight the relationships between concepts.
In conformance with ISO 24156 no attributes are shown in the concept classes. Characteristics are shown
as related concepts. Attributes belong to classes in an information model, where they may represent related
concepts. This can be added in the course of implementation and still be conformity to this document.
The relation of this system of concepts to an upper ontology is described in Annex D.
0.8  Relationship of this standard to other relevant standards
— The terminology has been aligned with the ISO 13606 family of standards.
— The revision has been performed in collaboration with the development of ISO/TR 24305
— Process orientation is aligned with ISO 12967 series
— Issues concerning quality in care follows the ISO 9000 series
— The revision work is timely coordinated with the revision of ISO 27269
— ISO/IEC 21838-3:2024 Information technology — Top-level ontologies (TLO) — Part 3: Descriptive
ontology for linguistic and cognitive engineering (DOLCE) has been a guidance in the modelling work.

viii
DRAFT International Standard ISO/DIS 13940:2024(en)
Health informatics — System of concepts to support
continuity of care
1 Scope
This document defines a system of concepts for different aspects of the provision of healthcare encompassing
social care as well as clinical care. The subject of the document is continuity of care.
The core business in care is the interaction between subjects of care and care professionals. Such interactions
occur in care processes and are the justification for the process reference in this document. To be able to
represent both clinical/social content and clinical/social context, this document is related to a generic care
process model as well as comprehensive concept definitions and concept models for the clinical, social,
management and resource aspects of care services.
In practice this document covers the concept definitions needed whenever structured information in care
is specified as a requirement. The definitions are intended to refer to the conceptual level only and not to
details of implementation. This document will cover all levels of specifications in 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, and
— information for specified types of care processes.
How to perform specific care processes is not covered by this document.
Research processes in the context of social and clinical care, welfare and educational processes are not
covered in this document.
2 Normative references
There are no normative references in this document.
3 Terms and definitions
For the purposes of this document, the terms and definitions given in ISO 1087:2019, ISO 9000:2015 and the
following apply.
ISO and IEC maintain terminology databases for use in standardization at the following addresses:
— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at https:// www .electropedia .org/
3.1 General terms
3.1.1
knowledge
maintained, processed, and interpreted information
[SOURCE: ISO 5127:2017, 3.1.1.17]

ISO/DIS 13940:2024(en)
Table 1 — Associations of knowledge
Specialization of Generalization of
care guideline
care pathway
core care plan
information model
Figure 2 — Knowledge (UML representation)
3.1.2
synonym
one of two or more terms denoting the same concept
[SOURCE: ISO 25964-1:2011, 2.58, modified - example and note removed]
3.1.3
organization
person or group of people that has its own functions with responsibilities, authorities and relationships to
achieve its objectives
Note 1 to entry: Groupings or subdivisions of organizations may also be considered as organizations where there is
need to identify them in this way for purposes of information interchange.
Note 2 to entry: In this document, this definition applies to any kind of organizations, whatever their legal status.
[SOURCE: ISO 9000:2015, 3.2.1]
Table 2 — Associations of organization
Association from Association name Association to
1.1 organization is 0.* care actor
1.* organization plays 0.* organization role

ISO/DIS 13940:2024(en)
Figure 3 — Organization (UML representation)
3.1.4
organizational pattern
relationships between the various parts of an organization
3.1.5
party
person or group performing a role in relation to the business of a specific community or domain
[SOURCE: ISO 8459:2009, 2.33]
3.1.6
person
individual human being
Table 3 — Associations of person
Association from Association name Association to
1.1 health state concerns 1.1 person
1.* person plays 0.* person role

Figure 4 — Person (UML Representation)
3.1.7
continuity of care
coherent and interconnected series of care events over time
Note 1 to entry: Care actor is defined in 3.3.1
Table 4 — Associations of continuity of care
Association from Association name Association to
1.* care actor is involved in 0.* continuity of care
1.* information is shared during 0.* continuity of care
0.* continuity of care relates to the delivering of 0.* care

ISO/DIS 13940:2024(en)
Figure 5 — Continuity of care (UML Representation)
3.1.8
resource
asset that is utilized or consumed during the execution of activities
EXAMPLE 1 Time, personnel, human skills and knowledge, equipment, services, supplies, facilities, technology,
data, money
EXAMPLE 2 Capital equipment, tools
EXAMPLE 3 Utilities such as power, water, fuel and communication infrastructures
Note 1 to entry: Resources may be reusable, renewable or consumable.
Note 2 to entry: Resources are used, consumed or renewed during activities as part of a process.
[SOURCE: ISO/IEC 15288:2015, 4.1.3.8, modified ‘execution of a process’ changed to ‘execution of activities’]
Table 5 — Associations of resource
Specialization of Generalization of
data repository
care funds
care resource
Association from Association name Association to
1.* resource care 0.* care
Figure 6 — Resource (UML Representation)

ISO/DIS 13940:2024(en)
3.1.9
process model
representation of a process
3.1.10
event
something that happens at a given place and time
Table 6 — Associations of event
Specialization of Generalization of
unintended event
Figure 7 — Event (UML Representation)
3.1.11
appointment
arrangement to meet someone at a particular time and place
3.1.12
mandate
commission to act
EXAMPLE A request for care means that an individual asks for help by care provider. But it is combined with the
authorisation for the care provider to access the necessary care resources including documentation and deliver those
services requested by the individual. Such a request contains a mandate given to care.
Note 1 to entry: A mandate is assigned by someone or as the consequence of legislation. It is always an obligation to
do something together with the associated authority to do that. If a mission is given to somebody, this actor needs
authority to perform what is necessary to fulfil the mission.

ISO/DIS 13940:2024(en)
Table 7 — Associations of mandate
Specialization of Generalization of
care mandate
care professional entitlement
subject of care proxy
care employment
Figure 8 — Mandate (UML Representation)
3.1.13
commitment
obligation by one or more of the participants in an act to comply with a rule or perform a contract
Note 1 to entry: The enterprise object(s) participating in an action of commitment may be parties or agents acting on
behalf of a party or parties. In the case of an action of commitment by an agent, the principal becomes obligated.
[SOURCE: ISO 12967 1:2020, 3.7.2]
3.1.14
data
reinterpretable representation of information in a formalized manner suitable for communication,
interpretation or processing
Note 1 to entry: Data are defined without any context in such a way that by itself one cannot tell its correct meaning,
where it has meaning those data are information
Note 2 to entry: to entry Data are defined without any context in such a way that by itself one cannot tell its correct
meaning, where it has meaning this is information 3.9.5).
[SOURCE: ISO/IEC 2382:2015, 2121272, modified, notes removed, Note 1 added]
Table 8 — Associations of data
Specialization of Generalization of
care data
ISO/DIS 13940:2024(en)
Figure 9 — Data (UML Representation)
3.1.15
data repository
identifiable data storage facility
Note 1 to entry: In ISO 10303-22:1998 this is the definition of repository.
Table 9 — Associations of data repository
Specialization of Generalization of
resource health record
sharable data repository
ISO/DIS 13940:2024(en)
Figure 10 — Data repository (UML Representation)
3.1.16
information
knowledge concerning objects that within a certain context has a particular meaning
Note 1 to entry: Facts, events, things, processes, and ideas, including concepts, are examples of objects.
Note 2 to entry: Information is something that is meaningful. Data might be regarded as information once its meaning
is revealed.
[SOURCE: ISO/IEC 2382:2015, 2123204, modified removed ‘facts, events, things, processes, or ideas,
including concepts, that within a certain context has a particular meaning’ and made it Note 1]
Table 10 — Associations of information
Specialization of Generalization of
health record component
care information
Association from Association name Association to
1.* information is shared during 0.* continuity of care

ISO/DIS 13940:2024(en)
Figure 11 — Information (UML Representation)
3.1.17
information model
formal model of a bounded set of facts, concepts or instructions to meet a specified requirement
[SOURCE: ISO 10303-1:1994, 3.2.21]

Table 11 — Associations of information model
Specialization of Generalization of
knowledge
Figure 12 — Information model (UML Representation)

ISO/DIS 13940:2024(en)
3.1.18
care
provision of accommodations, comfort and treatment to an individual subject of care
[SOURCE: ISO/TR 18307:2001, 3.70, modified: “patient” deleted, “also implying responsibility for safety”
deleted]
3.1.19
role
set of competencies and/or performances that are associated with a task
[SOURCE: ISO 22600-2:2014, 3.33]

Table 12 — Associations of role
Specialization of Generalization of
organization role
person role
Figure 13 — Role (UML Representation)
3.2 Terms related to health and care
3.2.1
health
state of complete physical, mental and social well-being
Note 1 to entry: The definition is drawn from the WHO description of health a state of complete physical, mental and
social well-being and not merely the absence of disease or infirmity
3.2.2
health state
overall state of health of the subject of care

ISO/DIS 13940:2024(en)
Table 13 — Associations of health state
Specialization of Generalization of
input health state
output health state
Association from Association name Association to
0.* care investigation clarifies 1.1 health state
1.1 health state concerns 1.1 person
0.* health circumstance health state 0.* health state
0.* health condition health state 0.* health state
0.* care treatment influences 1.* health state
0.* health need is deficit in 1.1 health state

Figure 14 — Health state (UML Representation)
3.2.3
health circumstance
circumstance contributing to the health state of a person
Note 1 to entry: This is a circumstance which may call for care intervention, e.g. a medical statement, and immunisation,
a treatment but it may also be a circumstance which the person can manage alone e.g. by means of self-care activity
activities or needs no management.
Table 14 — Associations of health circumstance
Specialization of Generalization of
consent competence
health need
subject of care desire
health condition
Association from Association name Association to
0.* specific care information request attests 1.* health circumstance

ISO/DIS 13940:2024(en)
TTabablele 1 144 ((ccoonnttiinnueuedd))
0.* request for care concerns 1.* health circumstance
0.* mandate to export personal information has topic 1.* health circumstance
0.* health circumstance health state 0.* health state
1.* care actor identifies 0.* health circumstance
0.1 health circumstance labels 0.* health record component
0.1 health circumstance labels 0.* health record extract

Figure 15 — Health circumstance (UML Representation)
3.2.4
health condition
aspect of a health state
Table 15 — Associations of health condition
Specialization of Generalization of
health circumstance observed condition
potential health condition
resultant condition
health issue
Association from Association name Association to
0.* care needs assessment considers 1.* health condition
0.* health condition health state 0.* health state
1.1 health condition observed during 1.1 health state period
0.* care investigation reveals 0.* health condition

ISO/DIS 13940:2024(en)
Figure 16 — Health condition (UML Representation)
3.2.5
health issue
health condition motivating care
EXAMPLE 1 Loss of weight
EXAMPLE 2 heart attack
EXAMPLE 3 drug addiction
EXAMPLE 4 injury
EXAMPLE 5 dermatitis
EXAMPLE 6 need for a medical certificate
EXAMPLE 7 need for social support
EXAMPLE 8 eligibility for immunisation
Note 1 to entry: A health issue can correspond to a health problem a disease, an illness or another kind of health
condition
Table 16 — Associations of health issue
Specialization of Generalization of
health condition health problem

Association from Association name Association to
0.* care plan addresses 1.* health issue
0.* care pathway addresses 1.* health issue
0.* clinical process addresses 1.* health issue
0.* care provider activity addresses 1.* health issue
0.* care guideline is centred on 1.* health issue
0.* episode of care is centred on 1.* health issue
0.* health issue links 0.* health thread

ISO/DIS 13940:2024(en)
Figure 17 — Health issue (UML Representation)
3.2.6
health problem
health condition considered by a care actor to be a problem
Note 1 to entry: Health problems can be single observations but are usually more compound as a summary of several
observations. Single observations are often criteria for the more compound health condition considered to be a
health problem
Table 17 — Associations of health problem
Specialization of Generalization of
health issue
Association from Association name Association to
0.* health problem list health problems 0.* health problem

ISO/DIS 13940:2024(en)
Figure 18 — Health problem (UML Representation)
3.2.7
health problem list
care problem list
health thread linking a set of health problems
Table 18 — Associations of health problem list
Specialization of Generalization of
health thread
Association from Association name Association to
0.* health problem list health problems 0.* health problem

Figure 19 — Health problem list (UML Representation)
3.2.8
observed condition
health condition observed by a care actor
EXAMPLE A blood pressure, a swelling in the abdomen, tachycardia, body weight, lung infiltration on x-ray, a
haemoglobin value, pale skin.
ISO/DIS 13940:2024(en)
Note 1 to entry: Care professionals and subjects of care are examples of care actors that can perceive the observed
aspect of a health state.
Note 2 to entry: An observed condition is a health issue and as such is a representation of aspect(s) of the health state.
Table 19 — Associations of observed condition
Specialization of Generalization of
health condition professionally assessed condition

Association from Association name Association to
1.* observed condition has been observed during 1.1 health state period
1.* care actor has observed 0.* observed condition
0.* considered condition is based on 1.* observed condition
0.* working diagnosis is consistent with 1.* observed condition
0.* excluded condition is not consistent with 1.* observed condition
0.* care investigation reveals 0.* observed condition

Figure 20 — Observed condition (UML Representation)
3.2.9
considered condition
considered health condition
potential health condition considered by a care actor on the basis of one or more observed conditions
Note 1 to entry: A request for care normally includes a health condition or symptom observed by the subject of care
and also a question about what the reason for that symptom might be. It is the potential health condition in this
question (the health condition behind the symptom) that is called a considered condition

ISO/DIS 13940:2024(en)
Note 2 to entry: A referral within a clinical process is normally motivated by one or several observed conditions and/or
professionally assessed conditions. However, the referral also normally includes a question that the care investigation
is supposed to get an answer to. The question formulated as a potential condition is a considered condition
Note 3 to entry: A considered condition remains considered until the associated observed conditions are changed
or completed. Care investigation and/or care treatment result in new observations that can verify or not verify the
(suspected) considered condition When a considered condition is verified it is transformed into an observed condition
and/or professionally assessed condition that also could be labelled as a working diagnosis If a considered condition
cannot be verified by relevant care activities it is transformed into an excluded condition
Note 4 to entry: A working diagnosis is often identified in the clinical process as a summary after the planned care
investigation are completed. A working diagnosis in this stage is often called a diagnosis. An excluded condition could
correspondingly be called a negation of a working diagnosis
Table 20 — Associations of considered condition
Specialization of Generalization of
potential health condition excluded condition
professionally assessed condition

Association from Association name Association to
0.* care professional considered condition 0.* considered condition
0.* considered condition is based on 1.* observed condition

Figure 21 — Considered condition (UML Representation)
3.2.10
professionally assessed condition
observed condition assessed by a care professional

ISO/DIS 13940:2024(en)
Table 21 — Associations of professionally assessed condition
Specialization of Generalization of
observed condition working diagnosis
considered condition vulnerability

Association from Association name Association to
0.* prognostic condition is based on 1.* professionally assessed condition
0.* professionally assessed condition is identified by 1.1 care professional

Figure 22 — Professionally assessed condition (UML Representation)
3.2.11
vulnerability
health condition that is an exposure to the risk of harm
EXAMPLE 1 Released from prison
EXAMPLE 2 Drug addiction
EXAMPLE 3 Loss of employment
EXAMPLE 4 Lives up a steep flight of stairs leading to increased risk of falls
EXAMPLE 5 Immunosuppressed leading to risk of infection
Note 1 to entry: In the perspective of health care and wellbeing the term vulnerable condition is often used to label
frail citizens and/or socio-economic and education conditions (e.g. housing, job, disability) that motivate certain social
care interventions, generally addressing a target population (e.g. older persons, children, families, homeless, refugees).
Note 2 to entry: The potential harm is a risk condition.
Table 22 — Associations of vulnerability
Specialization of Generalization of
professionally assessed condition

Association from Association name Association to
0.* vulnerability results in 0.* risk condition

ISO/DIS 13940:2024(en)
Figure 23 — Vulnerability (UML Representation)
3.2.12
excluded condition
discounted condition
non-verified condition
ruled out condition
ruled out considered condition
considered condition that one or more care professionals have determined not to be consistent with the
known observed conditions
Table 23 — Associations of excluded condition
Specialization of Generalization of
considered condition
Association from Association name Association to
1.* care professional has ruled out 0.* excluded condition
0.* excluded condition is not consistent with 1.* observed condition

Figure 24 — Excluded condition (UML Representation)

ISO/DIS 13940:2024(en)
3.2.13
working diagnosis
working hypothesis
considered condition that one or more care professionals have determined to be the most consistent with
observed conditions
Note 1 to entry: A working diagnosis is used as a label for the considered condition that one or more care professionals
assess as the most probable health condition and that could be concluded after further observations. The basis for
such assessments is the already observed conditions.
Note 2 to entry: Different care professionals may make different interpretations and assessments of the observed
conditions and thereby come to different conclusions and different working diagnosis
Table 24 — Associations of working diagnosis
Specialization of Generalization of
professionally assessed condition

Association from Association name Association to
1.* care professional has determined
...