Pamela Hussey Subhashis Das 2020-03-14T18:03:59Z Formal Ontology for Continuity of Care https://creativecommons.org/licenses/by-sa/4.0/ A formal ontology of concepts for care process modelling (Contsys). A system of concepts for the continuity of care. A visualisation of a model conforming to International Standard EN ISO 13940:2016. And extended concepts related to soical care. database_cross_reference CarePlan|DeviceRequest|ImmunizationRecommendation|MedicationRequest|NutritionOrder|ServiceRequest Healthcare event during which this observation is made Who and/or what the observation is about Organization on behalf of which the contact is acting or for which the contact is working. seeks to receive, is receiving, or has received Business Identifier for observation registered | preliminary | final | amended Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Patient.gender Patient.maritalStatus Access to preventive care Access to public transportation Access to qualified physicians Access to screening services Access to specialty care Access to working utilities Additional training at school Adequate training to healthcare staff Aggressive policing Alternative schooling Amount of workload Anxiety from community violence Anxiety over shopping for food Broadband access issues Bullying at school Cardiovascular illness Cardiovascular risk Chromosomal abnormalities Community engagement Community near landfills Community violence Complications and infections post surgery Criminal activities in neighborhood CrowdingAtHome Damaged appliances at home Defensive medicine Depression from ETOH abuse Depression from poor neighborhood Deteriorated immune response Economic stability includes key issues, such as poverty, employment, food security, and housing stability. These issues can affect how people prepare for and respond to an emergency. Economic stability Educational access and quality Emergency service wait time Emotional stress Employment programs Employment prospect Entrapment or collisions at home Exposed nails in home Exposure to asbestos in dwelling Exposure to environmental hazards Exposure to lead paints and lead pipes Exposure to violence Fall hazards in dwelling Fluctuating weight due to job stress low availability of nutritionally adequate foods; or inadequate chances to acquire acceptable foods properly Food insecurity Food spoilage Foster collaboration Generalized seizures from ETOH abuse Government funding Healthcare access and equality Healthcare disparities High cholesterol levels from unhealthy food High criminal activities High glucose levels from unhealthy food High risk of substance abuse Higher risk to pregnanat women Higher stress level Higher surgery rates Higher tax burden on wages Hospital readmission House dust mites Impact of food insecurity Impact of low educational access and quality Impact of poor healthcare access and quality Impact of poor housing Impact of poor neighborhood Impact of poor workplace condition Impact of social and community factors Inability to enroll in federal food assistance Inaccessible education due to thresholds of assistance programs Inaccurate diagnosis Inadequate budget for healthy meals Inadequate plumbing Inadequate prenatal care Inadequate ventilation Income above poverty level Instability of supply Irregular sleep cycles due to job stress Job insecurity Lack of air conditioning Lack of medical services near home LayOffFromJob Level of domestic hygiene and pest Limited internet access Low fetal weight Low household income Low quality maternal health Low wage job Lower earning Malnutrition due to insufficient food Mass incarceration Medical services not available in home Medication error Metabolic disturbances from poor nutrition Mold in dwelling Negative influence on biological response Neighborhood and built in environment Noise level at home Obesity from poor nutrition Pairing of team members at work Pediatric obesity due to lack of physical activity Peeling paints Perceived discrimination at job Perceived discrimination from society Performance management at work Polluted air Poor access to food Poor cooking practices Poor educational access Poor emotional well being Poor ergonomics (meaning poor design of equipment and methods to optimize human well-being) can cause or contribute to acute and chronic injuries. Poor ergonomics Poor food safety Poor food storage Poor health of pregnant women from unstable housing Poor housing Poor mental health from unstable housing Poor parenting Poor physical well being Poor psychological well being Poor response to life threatening situation Poor sanitation Poor utilization of food Poverty in neighborhood Premature mortality from community violence Problems associated with exposure to radiation Problems associated with exposure to tobacco smoke Providers linguistic and cultural competency Proximity to crematorium Proximity to hazardous sites Proximity to hazardous waste sites Proximity to solid waste incinerators Racial segreggation Rate of hate crimes in society Residential mobility Respiratory illness Risk of adverse kidney outcomes Risk of cancer Risk of substance abuse Risk of vector borne disease Role clarity at work place Running out of food Sexual violence Social-emotional skills training Social and community factors Social integration Social opportunity Structural failure Student status Substance abuse at work Substandard care at adult day care Substandard care at children center Substandard care at senior living Suicidal thoughts from poor neighborhood Technology training at workplace Trauma and anxiety Treatment from employers Unavailability of food Uncombusted fuel gas Unsafe clinical facility Unstable and unpredictable business continuity Water with high pollutants Work culture and environment Worklife balance Workplace condition Implicit/explicit bias of providers https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1 social determinants of health The social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.-WHO data value used for representing information objects that may require special processing operations to be performed in order for the data to be interpreted or rendered NOTE This DATA_VALUE specialization is equivalent to ISO 21090:2011 ED data type. This document only supports the Binary data value (ED.data), whose attribute is renamed to ATTACHMENT.value. The following attributes from the ISO 21090:2011 ED data type are not included in this document: base component documenting the details of an attestation of a set of electronic health record components. abstract class that include the properties common for all revisable classes included in EHR extract data value used for representing a code in a code system implied and fixed by the context in which this data value occurs data value used for representing a code in a referenced code system data value used for representing a lapse of time NOTE This specialization is equivalent to ISO 21090:2011 PQ.TIME data type. The translation and coding rationale attributes have been removed. data value used for representing a quantity expressing the result of a measuring NOTE 1 The general pattern for a measurement is value unit of Thing. In this scheme, the PHYSICAL_QUANTITY represents the value and the unit, and the Thing is described by some coded concept that is linked to the PHYSICAL_QUANTITY by the context of use. This maps obviously to some measurements, such as subject of care Body Temperature of 37 Celsius, and 250 mg/day of Salicylate. NOTE 2 This DATA_VALUE specialization is equivalent to ISO 21090:2011 PQ data type. The translation and coding rationale attributes have been removed. data value used for representing a point in time with minimum resolution year, and maximum resolution fraction of second fhir:MedicationRequest http://purl.bioontology.org/ontology/SNOMEDCT/182888003 MedicationRequest Solicitud de medicación agentiveSocialObject http://purl.bioontology.org/ontology/SNOMEDCT/272379006 An occurrence-type is stative or eventive according to whether it holds of the mereological sum of two of its instances, i.e. if it is cumulative or not. A sitting occurrence is stative since the sum of two sittings is still a sitting occurrence.In general, events differ from situations because they are not assumed to have a description from which they depend. They can be sequenced by some course, but they do not require a description as a unifying criterion.On the other hand, at any time, one can conceive a description that asserts the constraints by which an event of a certian type is such, and in this case, it becomes a situation.Since the decision of designing an explicit description that unifies a perdurant depends on context, task, interest, application, etc., when aligning an ontology do DLP, there can be indecision on where to align an event-oriented class. For example, in the WordNet alignment, we have decided to put only some physical events under 'event', e.g. 'discharge', in order to stress the social orientedness of DLP. But whereas we need to talk explicitly of the criteria by which we conceive discharge events, these will be put under 'situation'.Similar considerations are made for the other types of perdurants in DOLCE.A different notion of event (dealing with change) is currently investigated for further developments: being 'achievement', 'accomplishment', 'state', 'event', etc. can be also considered 'aspects' of processes or of parts of them. For example, the same process 'rock erosion in the Sinni valley' can be conceptualized as an accomplishment (what has brought the current state that e.g. we are trying to explain), as an achievement (the erosion process as the result of a previous accomplishment), as a state (if we collapse the time interval of the erosion into a time point), or as an event (what has changed our focus from a state to another).In the erosion case, we could have good motivations to shift from one aspect to another: a) causation focus, b) effectual focus, c) condensation d) transition (causality).If we want to consider all the aspects of a process together, we need to postulate a unifying descriptive set of criteria (i.e. a 'description'), according to which that process is circumstantiated in a 'situation'. The different aspects will arise as a parts of a same situation. something that happens at a given place and time event evento legallyConstructedPerson AKA "internal description". Mental objects are dependent on an intentional agent mentalObject objeto mental SNOMEDCT_IE_2024_04_01:125676002 human being regarded as an individual person persona nonPhysicalObject unique framework of authority within which a person (3.3.4) or persons act, or are designated to act towards some purpose organización organization objeto físico physicalObject Within stative occurrences, we distinguish between states and processes according to homeomericity: sitting is classified as a state but running is classified as a process, since there are (very short) temporal parts of a running that are not themselves runnings. In general, processes differ from situations because they are not assumed to have a description from which they depend. They can be sequenced by some course, but they do not require a description as a unifying criterion. On the other hand, at any time, one can conceive a description that asserts the constraints by which a process of a certian type is such, and in this case, it becomes a situation. Since the decision of designing an explicit description that unifies a perdurant depends on context, task, interest, application, etc., when aligning an ontology do DLP, there can be indecision on where to align a process-oriented class. For example, in the WordNet alignment, we have decided to put only some physical processes under 'process', e.g. 'organic process', in order to stress the social orientedness of DLP. But whereas we need to talk explicitly of the criteria by which we conceive organic processes, these will be put under 'situation'. Similar considerations are made for the other types of perdurants in DOLCE. A different notion of event (dealing with change) is currently investigated for further developments: being 'achievement', 'accomplishment', 'state', 'event', etc. can be also considered 'aspects' of processes or of parts of them. For example, the same process 'rock erosion in the Sinni valley' can be conceptualized as an accomplishment (what has brought the current state that e.g. we are trying to explain), as an achievement (the erosion process as the result of a previous accomplishment), as a state (if we collapse the time interval of the erosion into a time point), or as an event (what has changed our focus from a state to another). In the erosion case, we could have good motivations to shift from one aspect to another: a) causation focus, b) effectual focus, c) condensation d) transition (causality). If we want to consider all the aspects of a process together, we need to postulate a unifying descriptive set of criteria (i.e. a 'description'), according to which that process is circumstantiated in a 'situation'. The different aspects will arise as a parts of a same situation. set of interrelated or interacting activities that use inputs to deliver an intended result process socialAgent socialObject sociallyConstructedPerson state expressing a state or condition rather than an activity or event stative coc:administrative_division a district defined for administrative purposes administrative division coc:city a large and densely populated urban area; may include several independent administrative districts coc:country the territory occupied by a nation coc:district a region marked off for administrative or other purposes coc:location location ubicación coc:organizationRole coc:personRole coc:socialCareProcess healthcare process encompassing all social care provider activities that addresses identified or specified social needs NOTE 1 As such, a social care process is a set of interrelated or interacting social care activities, which are performed for a subject of care with one or more social needs or vulnerable conditions NOTE 2 The primary input and output to a social process is the health state. NOTE 3 In a social care process a subject of care and health care professional (within the social care context) interact in all types of social care activities. coc:socialCareProviderActivity coc:socialNeed representation of a need related to the social determinants of health of a subject of care as identified by one or more healthcare actors socialNeed Loss of job, gambling addiction, loss of personal autonomy, physical and mental disability. 1 coc:socialRecord data repository regarding the social care of a subject of care 1 coc:social_care_activity activity intended to improve health state mitigating or removing factors related to social determinants of health actividad de asistencia social socialCareActivity coc:social_care_needs_assessment evaluación de las necesidades de atención social socialCareNeedsAssessment coc:socialcareActivityElement element of social care activity that addresses one type of purpose Elemento de actividad de atención social social care activity is a complex concept that can be subdivided in elements that represent different purposes with the action. The different purposes could be direct (social care investigation and social care intervention that directly involves the subject of care) or indirect (social care needs assessment, social care evaluation, social care documenting or social care activity management that do not necessarily directly involve the subject of care). coc:socialcareReport social record extract conveying specifically focused social care information in order to fulfil current information needs of the recipient socialcareReport Also known as 'functional role'. A concept that classifies (in particular, it is 'played by') endurants, as used in some description. Roles are the descriptive counterpart of endurants, and, as endurants participate in perdurants, they usually have courses as modal targets (see). The typology of roles is still preliminary. papel role 1 1 https://www.hl7.org/fhir/adverseevent-definitions.html#AdverseEvent unintended event that has negative influence upon healthcare processes acontecimiento adverso adverseEvent adverseEventManagement manejo de eventos adversos arrangement to meet someone at a particular time and place appointment cita provision in legislation that in certain circumstances may overrule the need for informed consent authorizationByLaw 1 1 method of delivering healthcare initiated by a responsible healthcare actor and thereafter delivered automatically by an automatic medical device atención médica automatizada automated care NOTE automated healthcare is not a healthcare activity in its own right since the automatic medical device doesn't have the capacity to be responsible. It is the healthcare actor who initiates and reviews the automated healthcare that is responsible for safe use of the automatic medical device. medical device capable of performing automated healthcare activities automatic medical device 1 SNOMEDCT_IE_2020_03_09:223366009 healthcare personnel having a healthcare professional entitlement recognized in a given jurisdiction profesional sanitario set of healthcare activities careActivityBundle paquete de actividades sanitarias NOTE A healthcare activities bundle may be delineated using a health thread comprising healthcare activities. 1 1 1 1 1 1 1 activity intended directly or indirectly to improve or maintain a health state actividad sanitaria careActivity 1 health related period during which a healthcare activity is planned but not started careActivityDelay retraso en la actividad sanitaria 1 directory of the healthcare activities offered by a healthcare provider careActivityDirectory element of healthcare activity that addresses one type of purpose careActivityElement elemento de actividad sanitaria NOTE healthcare activity is a complex concept that can be subdivided in elements that represent different purposes with the action. The different purposes could be direct (healthcare investigation and healthcare treatment that directly involves the subject of care) or indirect (healthcare assessment, healthcare evaluation, healthcare documenting or healthcare activity management that do not necessarily directly involve the subject of care. 1 1 healthcare activity element during which the status of healthcare activities in a care plan are changed careActivityManagement gestión de la actividad sanitaria NOTE Examples statuses for healthcare activities are; planned, scheduled, resource allocated, ongoing, performed/finished, evaluated. healthcare mandate assigning the right and obligation to perform specific healthcare activities careActivityMandate 1 time interval during which healthcare activities are performed for a subject of care careActivityPeriod periodo de actividad sanitaria 1 1 part of a healthcare activity period during which one health issue is specifically addressed careActivityPeriodElement 1 organization or person participating in healthcare actor de salud careActor NOTE 1 The involvement of the healthcare actor will be either direct (for example, the actual provision of care), or indirect (for example, at organizational level). NOTE 2 According to this definition, people or organizations responsible for the funding, payment, or reimbursement of healthcare provision are healthcare actors, as well as organizations responsible for healthcare delivery. NOTE 3 In EN 13940-1:2007 healthcare party was the preferred term for this concept. 1 administrative activities related to healthcare processes Administración del cuidado de la salud careAdministration 1 1 appointment for a contact careAppoinment cita sanitaria healthcare activity element where an opinion related to health conditions and/or healthcare activities is formed careAssessment evaluación sanitaria 1 acceptance of a healthcare mandate by the healthcare actor to whom it is assigned careCommitment compromiso sanitario healthcare activity element where at least two healthcare actors communicate careCommunication comunicación sanitaria 1 healthcare activity element where health records are created or maintained careDocumenting documentación sanitaria 1 healthcare activity element where aspects of at least one other healthcare activity element is evaluated careEvaluation evaluación sanitaria NOTE 1 healthcare evaluation may be performed by all kinds of healthcare actors, including the subject of care. NOTE 2 See also clinical process outcome evaluation. information about a person, relevant to his or her healthcare careInformation 1 healthcare information that is a candidate for import into a professional health record after a healthcare professional has confirmed its clinical relevance to that professional health record careInformationForImport 1 healthcare activity element with the intention to clarify one or more health conditions of a subject of care careInvestigation investigación sanitaria NOTE 1 healthcare investigations add and improve information about aspects of a health state. NOTE 2 Some primary healthcare investigations can sometimes have an intended or secondary therapeutic effect, while some activities can be both investigating and therapeutic by essence (e.g. a fibroscopy, interventional cardiology, etc.) 1 1 1 1 1 1 mandate (commission) based on a commitment and either an informed consent or an authorization by law, defining the rights and obligations of one healthcare actor with regard to his involvement in healthcare processes performed for a specific subject of care representation of a matter related to the health of a subject of care and/or the provision of healthcare to that subject of care, as identified by one or more healthcare actors careMatter NOTE 1 Healthcare matter is a very broad and flexible concept that includes anything related to the health or the healthcare of a subject of care. This means that health conditions, healthcare activities, health problems, the result of healthcare activities, etc. all are possible to be identified as healthcare matters. Thereby healthcare matter might have several specializations and further associations. NOTE 2 According to this definition, a healthcare matter can represent a disease, an illness or another kind of health condition. In addition a healthcare matter may represent, for example, a request for a procedure (therapeutic or preventive) by the subject of care or another healthcare actor. NOTE 3 Concepts described and/or identified in a clinical terminology may represent types of healthcare matter. NOTE 4 Other specializations of this concept than those included in this International Standard, may be created when needed. 1 healthcare provider having an organization role careOrganization organización sanitaria 1 1 1 healthcare mandate commissioning a mandated period of care carePeriodMandate individual healthcare actor having a person role in a healthcare organization carePersonnel personal sanitario EXAMPLES GP, medical consultant, therapist, dentist, nurse, social worker, radiographer, nurse’s assistant, children’s nurse, nursing officer, head of department, social worker, medical consultant, etc. 1 1 1 1 dynamic, personalized plan including identified needed healthcare activities, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process carePlan carePlanning 1 healthcare evaluation where healthcare processes are systematically assessed against requirements careProcessEvaluation evaluación del proceso sanitario NOTE 1 The outputs of clinical processes are evaluated in a clinical process outcome evaluation. NOTE 2 Requirements are defined as a combination of needs and expectations that are stated, generally implied or obligatory. The needs can be represented by, for example, target conditions, goals for resource consumption, compliance to guidelines, etc. The expectations can be represented by the perceptions of the outcomes from each of the involved healthcare actor’s perspective (i.e. subject of care and healthcare professionals). 1 1 1 1 1 1 1 1 1 1 healthcare actor that is able to be assigned one or more care period mandates careProvider proveedor de atención sanitaria 1 1 healthcare activity performed by a healthcare provider actividad del proveedor de atención médica careProviderActivity 1 coordinated activities to direct and control a healthcare organization with regard to quality careQualityManagement gestión de calidad sanitaria NOTE 1 The clinical processes are the most important type of healthcare processes related to healthcare quality management. NOTE 2 healthcare quality management activities include the establishment of a quality policy, setting quality objectives, the performance of audits, evaluation and a feedback loop for quality improvement, all resulting in quality assurance. 1 activities to direct and control the supply and use of the healthcare resources required to perform healthcare activities careResourceManagement gestión de recursos sanitarios healthcare third party having organizational role careSupportingOrganization organización de apoyo a la atención médica 1 1 healthcare actor other than a healthcare provider or the subject of care careThirdParty tercero sanitario 1 healthcare activity performed by a healthcare third party actividad de terceros en el sector sanitario careThirdPartyActivity 1 healthcare activity element intended to directly improve or maintain a health state careTretment tratamiento de salud NOTE 1 The treatment of a subject of care's health state, based on that subject of care's health conditions, is a part of the clinical process considered from a therapeutic perspective. NOTE 2 healthcare treatment is intended to contribute to fulfilling the assessed health need. NOTE 3 Prevention is a type of healthcare treatment where the risk of a health condition is treated. NOTE 4 healthcare treatment includes all types of activities that intend to influence the health state including, for example, rehabilitation, palliative care, education of subjects of care, caring, etc. 1 1 1 official document issued by a healthcare actor attesting healthcare matters relating to a subject of care certificateRelatedToACareMatter 1 set of systematically developed statements to assist the decisions made by healthcare actors about healthcare activities to be performed with regard to specified health issues clinicalGuideline 1 1 1 pathway for the healthcare activities informing the content of core care plans clinicalPathway NOTE 1 The concept clinical pathway includes subtypes, for example, 'integrated care pathways', 'multidisciplinary pathways of care', 'collaborative care pathways'. 1 1 1 healthcare process encompassing all healthcare provider activities and other prescribed healthcare activities that addresses identified or specified health issues clinicalProcess NOTE 1 As such, a clinical process is a set of interrelated or interacting healthcare activities, which are performed for a subject of care with one or more health issues. NOTE 2 The primary input and output to a clinical process is the health state. NOTE 3 In a clinical process a subject of care and healthcare professionals interact in all types of healthcare activities. NOTE 4 A clinical process comprises all kinds of healthcare activities, mainly healthcare provider activities, but also self-care activities as prescribed or recommended by healthcare professionals. NOTE 5 The clinical process can be regarded as the key type of process to support continuity of care from the perspective of the subject of care. NOTE 6 clinical processes are the essential, central and most important type of healthcare processes. NOTE 7 A relevant distinction exists between the primary input (the subject of care's initial health state) and secondary or ancillary inputs (the resources brought in to perform the clinical process). 1 health related period that includes all healthcare activity periods in one clinical process clinicalProcessEpisode episodio del proceso clínico health thread comprising all healthcare matters related to a specific clinical process clinicalProcessInterest interés del proceso clínico 1 healthcare evaluation where the effects of a clinical process on a health state are assessed against the target condition and/or a health condition representing the input health state clinicalProcessOutcomeEvaluation evaluación de resultados del proceso clínico NOTE 1 The subject of care and healthcare professionals are the main contributors to a clinical process outcome evaluation. NOTE 2 The target condition represents a requirement for the clinical process. health record extract conveying specifically focused healthcare information in order to fulfil current information needs of the recipient clinicalReport capability of the subject of care and/or the subject of care proxy to give informed consent or dissent consentCompetence 1 potential health condition considered by a healthcare actor on the basis of one or more observed conditions consideredCondition considered health condition 1 interaction between a subject of care and one or more healthcare personnel contact contacto healthcare activity period during which a contact occurs contactPeriod NOTE 1 Since during a contact, more than one health issue may be addressed, it may relate to more than one healthcare process and more than one episode of care. NOTE 2 In EN 13940-1:2007 the concept encounter was defined as 'contact in the course of which healthcare activities are delivered to a subject of care in her or his presence'. 1 healthcare mandate assigning the right and obligation to monitor and coordinate the delivery of care described in those care period mandates related to healthcare matters linked by specific health threads contibuityFacilitatorMandate reusable content and structure for a potential care plan for a specified set of circumstances coreCareplan NOTE 1 A core care plan is usually based upon knowledge in clinical guidelines (including protocols). NOTE 2 core care plans can be applied in healthcare planning as a clinical process management method. NOTE 3 A core care plan may include advanced formulated schemes for recommended healthcare activities. an identifiable data storage facility dataRepository 1 1 1 demand for healthcare provider activities expressed by a healthcare actor demandForCare demanda de atención 1 first demand for care concerning one or more specific health issues to be assessed by a healthcare provider demandForInitialContact demanda de contacto inicial 1 healthcare mandate implying the right and obligation to demand healthcare activities demandMandate NOTE 1 A demand for care is usually made by a subject of care him/herself, but there are circumstances where the subject of care is not in the position of making a demand for care. In that case, it has to be made on their behalf by another person. NOTE 2 Within certain jurisdictions a generic demand mandate may be explicitly or implicitly assigned to certain categories of citizens on the basis of their specific roles. It may also be directly or indirectly made necessary by law that such generic mandates are explicitly established. 1 clinical report concerning a completed, mandated period of care dischargeReport discharge report summarizing a mandated period of care dischargeSummary 1 1 refusal to permit specific healthcare activities to be performed disentimiento health record component which only includes information in electronic format electronicHealthRecordComponent 1 health record extract consisting solely of electronic record components electronicHealthRecordExtract electronic health record extract containing essential healthcare information intended for specific uses 1 health related period during which healthcare activities are performed to address one health issue as identified by one healthcare professional episodeOfCare episodio de cuidado 1 group of episodes of care delineated by a health thread episodesOfCareBundle episodios de paquete de atención NOTE 1 An episodes of care bundle starts with the very first contact with a healthcare provider for a health issue considered in a health thread and ends after the completion of all healthcare activities related to the last contact with any healthcare provider for a health issue encompassed in the same health thread. NOTE 2 As different health threads may be considered that reconcile the perspectives of different healthcare actors (e.g. a care team manager, or a health authority) or sets of healthcare actors, there may exist different health threads according to the specific perspectives of those sets of healthcare actors that justify building up such health threads. As a consequence there may exist as many episodes of care bundles as there are such health threads. NOTE 3 From the electronic health record point of view, an episodes of care bundle shows the overall healthcare activity period elements related to those health issues that are linked by the same health thread. NOTE 4 In EN 13940-1:2007 cumulative episode of care was the preferred term for this concept. 1 considered condition that one or more healthcare professionals have determined not to be consistent with the known observed conditions excludedCondition 1 episode of care during which the healthcare activities performed address one specific healthcare goal health record extract that includes all health record components associated with a health thread for a specific concern healthConcern NOTE 1 A concern is gathered information to support continuity of care for a subject of care. A health thread can include healthcare activities, health conditions, healthcare activity planning, activity management, evaluations and assessments. Thereby, all information needed for continuity of care for an individual subject of care can be covered by a health concern. NOTE 2 health concerns can be constructed to support continuity of care for healthcare processes, clinical processes and accumulations/associations of clinical processes. This means that concerns can relate to episodes of care, contacts, chronic disease management, multiple chronic disease management, etc. NOTE 3 health concerns can be represented and labelled in EHR as extracts or components. NOTE 4 health concern is closely related to the “concern tracking” based on HL7 standards. observed or potential observable aspects of the health state at a given time healthCondition healthcare activity delay caused by a health condition healthConditionDelay retraso en la condición de salud 1 1 health thread showing the evolution of health conditions during a healthcare process, starting with the health condition that represents the input health state evolución del estado de salud healthConditionEvolution health related period during which a health condition has been observed healthConditionPeriod período de condición de salud representation of an issue related to the health of a subject of care as identified by one or more healthcare actors healthIssue 1 deficit in the current health state compared to aspects of a desired future health state healthNeed 1 desired ultimate achievement of a healthcare process addressing health needs healthObjective NOTE A health objective could be expressed as one or several target conditions to be reached within a specified date and time. health condition considered by a healthcare actor to be a problem healthProblem NOTE 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. health thread linking a set of health problems healthProblemList lista de problemas de salud 1 1 1 1 data repository regarding the health and healthcare of a subject of care healthRecord part of a health record that is identifiable for the purposes of referencing and revision healthRecordComponent 1 1 part or all of a health record extracted for the purpose of communication healthRecordExtract time interval related to the health of a subject of care and/or the provision of healthcare for that subject of care healthRelatedPeriod período relacionado con la salud physical and mental functions, body structure, personal factors, activity, participation and environmental aspects as the composite health of a subject of care healthState 1 1 defined association between healthcare matters as determined by one or more healthcare actors healthThred hilo de salud care activities, services, management or supplies related to the health of an individual cuidado de la salud healthcare resource provided for funding healthcare delivery careFunds fondos de salud NOTE Funds may be provided by, for example, a health insurance fund, a governmental agency, a national or local authority, a welfare programme, the subject of care or any other person or organization having a role in the funding of healthcare. 1 desired achievement of one or more healthcare activities, considered as an intermediate operational step to reach a specific health objective careGoal NOTE A healthcare goal could be expressed as one or several target conditions to be reached within a specified date and time. request sent out by a healthcare actor to another healthcare actor for specific healthcare information needed for the provision of healthcare to a subject of care Solicitud de información sanitaria healthcareInformationRequest OTE 1 In order to fulfil the request, a mandate to export personal information is needed. NOTE 2 In EN 13940-1:2007 specific clinical information request was the preferred term for this concept. healthcare assessment during which a healthcare professional considers a subject of care’s health need and determines the needed healthcare activities evaluación de necesidades de atención médica healhcareNeedsAssessment NOTE 1 A healthcare needs assessment precedes healthcare planning. NOTE 2 healthcare needs assessments should be performed in a dialogue with the subject of care. The responsibility for a healthcare needs assessment is held by a healthcare professional. NOTE 3 The subjects of care interact with healthcare professionals in healthcare needs assessments and also describe their opinions on which healthcare activities should be asked for in a demand for care. 1 1 1 set of interrelated or interacting healthcare activities which transforms inputs into outputs healthcareProcess NOTE 1 The main type of healthcare process is the clinical process that has a health state as input and output and includes all activities in relation to one or more specified health issues. NOTE 2 A healthcare process is not by definition restricted to one healthcare provider or any other organizational unit borders. registered authorization given to a person in order to allow the person to have or perform specific roles in healthcare careProfessionalEntitlement resource needed to perform healthcare activities careResource recurso de salud NOTE As a healthcare process develops, the healthcare resources follow a life cycle. Examples of steps of such a life cycle are: 'available', 'booked', 'provided', ''in use', 'consumed', etc. 1 1 service that is the result of a healthcare process. Ex. Diagnostic investigation and result report. healthcareService directory of the types of healthcare services offered by one or more healthcare providers careServiceDirectory 1 permission to perform healthcare activities, voluntarily given by a subject of care having consent competence, or by a subject of care proxy, after having been informed about the purpose and the possible results of the healthcare activities informedConsent 1 contact during which a clinical process is initiated contacto inicial initialContact 1 health state at the initiation of healthcare process inputHealthState 1 1 healthcare mandate implying the right to communicate health record extracts mandateToExportPersonalInformation 1 set of healthcare activity periods where a healthcare provider is mandated to perform the healthcare activities required to address specific health needs. Ex. A hospital stay, a series of radiotherapy sessions at an outpatient clinic. mandatedPeriodOfCare período de atención obligatorio SNOMEDCT_IE_2024_04_01:63653004 any instrument, apparatus, implement, machine, appliance, implant, in vitro reagent or calibrator, software, material or other similar or related article, intended by the manufacturer to be used, alone or in combination, for human beings for one or more of the specific purpose(s) of dispositivo médico medicalDevice http://purl.bioontology.org/ontology/SNOMEDCT/763158003 https://www.hl7.org/fhir/medicinalproduct-definitions.html#MedicinalProduct any substance or combination of substances that can be administered to human beings for treating or preventing disease, with the view to making a medical diagnosis or to restore, correct, or modify physiological functions producto medicinal medium: material on which data is stored (e.g., a magnetic disk). medio care plan encompassing healthcare provider activities performed by healthcare professionals having different healthcare professional entitlements 1 healthcare activities bundle which includes those healthcare activities assessed as needed to address specified health need actividad sanitaria necesaria neededCareActivity NOTE 1 A needed healthcare activity is a healthcare activity that is assessed by healthcare professionals to be motivated/indicated by the health need. NOTE 2 A needed healthcare activity is the outcome of healthcare needs assessments performed by healthcare professionals. needed healthcare activities can be identified by any mandated healthcare professional performing healthcare needs assessment for a subject of care. NOTE 3 needed healthcare activities are managed in a care plan. person role being either the closest living relative of the subject of care or identified as the one he has a close relationship with nextOfKin pariente más cercano healthcare information the relevance of which has not been assessed and explicitly stated as valid by a healthcare professional nonRatifiedCareInformation 1 http://purl.bioontology.org/ontology/SNOMEDCT/362976009 https://www.hl7.org/fhir/observation-definitions.html#Observation health condition observed by a healthcare actor observedCondition Observation NOTE 1 Healthcare professionals and subjects of care are examples of healthcare actors that can perceive the observed aspect of a health state. NOTE 2 An observed condition is a health issue and as such is a representation of aspect(s) of the health state. healthcare third party having person role Otra cuidadora otherCarer health state when a healthcare process ends outputHealthState person or group performing a role in relation to the business of a specific community or domain grupo health record held and maintained by the subject of care or a subject of care proxy personalHealthRecord 1 possible future or current health condition described by a healthcare actor potentialHealthCondition 1 1 self-care activity prescribed by a healthcare professional autocuidado prescrito prescribedSelfcare 1 actividad de terceros prescrita prescribedThirdPartyActivity output of an organization that can be produced without any transaction taking place between the organization and the customer producto health record held under the responsibility of one healthcare provider and maintained by one or several healthcare professionals professionalHealthRecord 1 observed condition assessed by a healthcare professional concerning the genesis, the course, the severity or the impact of the health state professionallyAssessedCondition 1 possible future or current health condition described by a healthcare actor prognosticCondition customized clinical guideline NOTE 1 A protocol is more precise than a clinical guideline. NOTE 2 protocols are often presented in a formal manner with respect to the expected behaviours and roles of healthcare actors. 1 subject of care or a subject of care proxy's perception of health needs motivating a demand for care reasonForDemandForCare 1 demand for care where a healthcare professional asks a healthcare provider to state a healthcare commitment for a care period mandate referral remisión http://purl.bioontology.org/ontology/SNOMEDCT/385644000 demand for care where a healthcare professional asks a healthcare provider to perform one or more healthcare provider activities pedido request asset that is utilized or consumed during the execution of a process recurso NOTE 1 to entry: resources may include diverse entities such as funding, personnel, facilities, capital equipment, tools, and utilities such as power, water, fuel and communication infrastructures. NOTE 2 to entry: resources may be reusable, renewable or consumable. healthcare activity delay caused by resource constraints where there is no health condition delay resourceDelay retraso de recursos observed condition representing an output health state resultantCondition potential health condition representing an unintended future health state riskCondition healthcare activity performed by the subject of care actividad autocuidado selfCareActivity healthcare activity period where prescribed self-care is performed periodo de autocuidado selfcarePeriod output of an organization with at least one activity necessarily performed between the organization and the customer servicio data repository containing exclusively electronic health record extracts, accessible for duly authorized healthcare actors independent of their organizational affiliation and placed under the custody of a healthcare actor sharableDataRepository NOTE 1 A sharable data repository has to be placed under the custody of a healthcare actor in order to assure and maintain its consistency. NOTE 2 In EN 13940-1:2007 sharable data repository was defined as 'electronic health record containing exclusively sharable data, placed under the custody of a healthcare party, to whom a continuity facilitator mandate has been delivered'. 1 1 1 1 1 1 1 http://purl.bioontology.org/ontology/SNOMEDCT/116154003 https://www.hl7.org/fhir/patient-definitions.html#Patient healthcare actor with a person role; who seeks to receive, is receiving, or has received healthcare Sujeto a cuidado subjectOfCare 1 desire expressed by the subject of care or the subject of care proxy regarding the performance of certain healthcare activities subjectOfCareDesire 1 healthcare activity delay by the preference of the subject of care, where there is neither a health condition delay nor a resource delay subjectOfCarePreferenceDelay sujeto de retraso en la preferencia de atención 1 1 healthcare third party having person role with the right to take decisions on behalf of the subject of care subjectOfCareProxy data repository containing summarized information for healthcare coordination and the continuity of care summarizedHealthcareInformationRepository potential health condition representing health objectives and/or healthcare goals targetCondition care plan limited to those healthcare provider activities performed by healthcare professionals having the same healthcare professional entitlement NOTE In EN 13940-1:2007 care plan was the preferred term for this concept. 1 considered condition that one or more healthcare professionals have determined to be the most consistent with the currently known observed conditions diagnóstico de trabajo workingDiagnosis Henry Z12367X Watson Male Single true true Pamela Hussey Subhashis Das 2020-03-14T18:03:59Z Formal Ontology for Continuity of Care https://creativecommons.org/licenses/by-sa/4.0/ A formal ontology of concepts for care process modelling (Contsys). A system of concepts for the continuity of care. A visualisation of a model conforming to International Standard EN ISO 13940:2016. And extended concepts related to soical care.