ISO/TS 21089:2018 describes trusted end-to-end flow for health information and health data/record management. Health data is originated and retained, typically as discrete record entries within a trusted electronic health record (EHR), personal health record (PHR) or other system/device. Health data can include clinical genomics information.

Health record entries have a lifespan (period of time managed by one or more systems) and within that lifespan, various lifecycle events starting with "originate/retain". Subsequent record lifecycle events may include "update", "attest", "disclose", "transmit", "receive", "access/view" and more.

A record entry instance is managed - over its lifespan - by the source system. If record entry content is exchanged, this instance may also be managed intact by one or more downstream systems. Consistent, trusted management of record entry instances is the objective of this document, continuously and consistently whether the instance is at rest or in motion, before/during/after each lifecycle event, across one or more systems.