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Definition

health record held under the responsibility of one healthcare provider and maintained by one or several healthcare professionals

 

This is a concrete item and can be implemented directly

Term: professional health record; 
Plural: professional health records; 

Notes

NOTE The responsible healthcare provider may allow the subject of care to access and/or offer contributions to the professional health record.

Examples

EXAMPLES health records held at their surgery or at a health centre by a GP, by a medical specialist, by a nurse, in a hospital department at a patient's bedside, by a care team in an integrated clinical network, by a dentist.

Required associations

one or more healthcare professionals maintains a number of professional health records
exactly one healthcare provider is responsible for a number of professional health records
one or more mandated periods of care is documented in one or more professional health records

Optional associations

a number of healthcare information for imports is imported into exactly one professional health record

Generalisations

        data repository
    health record
        data repository
    health record
professional health record

Specialisations

professional health record


The representation of a model conforming to the international standard ISO 13940 available through this site is provided by Oughtibridge Ltd.  It is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.  This work is based on a UML model prepared by Torbjørn Nystadnes of the Norwegian Directorate of Health, a subordinate agency of the Norwegian Ministry of Health and Care Services.