About ISO 13940:2026 (ContSys)
ISO 13940:2026 is the second edition of the international standard defining the system of concepts needed to describe health and care businesses and to support continuity of care across clinical and social settings.
ContSys was developed by ISO Technical Committee 215 (Health informatics) in collaboration with CEN/TC 251 under the Vienna Agreement, and the 2026 second edition replaces ISO 13940:2015 following a full technical revision. Three changes define the new edition:
- All concept definitions are consolidated into a single terms-and-definitions clause, each accompanied by a UML diagram of its immediate relationships.
- The concept system is extended to make explicit that continuity of care includes social care, incorporating the results of dedicated European standardisation work on integrating social and clinical care.
- The upper-level concepts are aligned to the DOLCE top-level ontology as specified in ISO/IEC 21838-3:2023.
What the standard covers
The normative clauses group the concept system into eight interlocking areas, each with explanatory text, relationship diagrams, and normative statements that a conformant model must support:
- Health and care — health states, health conditions, health issues, health needs, vulnerabilities, social environments, and social determinants of health.
- Actors and resources — subjects of care, care professionals and care personnel, care organizations, care third parties, subject of care proxies, medical devices, facilities, and care funds.
- Activities — care investigations, care treatments, care assessments, care activity management, and care evaluation, spanning clinical care, social care, self-care, and automated care.
- Processes — care processes, continuity of care processes, requests for care, and referrals.
- Events and time — care contacts, encounters, care appointments, episodes of care, and the periods and delays that structure care over time.
- Planning and knowledge — care plans (clinical, social, and integrated), care goals, intended outcomes, care guidelines, protocols, and care pathways.
- Responsibility — care mandates, care commitments, informed consent, objections, and authorization by law.
- Information and records — care data and care information, health records, health record extracts, health reports, health summaries, and care communication.
How concepts are expressed
Concept diagrams follow ISO 24156-1 notation: classes carry no attributes, because the standard defines concepts and relationships rather than data structures. Characteristics appear as related concepts, and associations are drawn undirected to show conceptual relationships rather than data access paths. That choice is deliberate — it is what allows an implementation to add attributes and platform detail while remaining conformant.