If you work in healthcare, you may have encountered PDF-Healthcare documents, commonly abbreviated to the file type PDF/H.
Learn more about this PDF subset developed by Adobe and AIIM and explore the origins of PDF subsets in general. We'll also explore how PDFs are used more broadly in healthcare.
What you’ll learn.
PDF-healthcare, commonly known as PDF/H, is a specialist PDF file type subset. Adobe created it alongside relevant experts to focus specifically on healthcare. This originated after the PDF format was made an ISO (International Organisation for Standardisation) standard. However, while the PDF/H is not an ISO standard itself, unlike some other subsets: it is a best practice standard.
To understand how these PDF file type subsets work, think of the original PDF format at the top of a family tree or management structure. Then, on the next row down, sit the PDF subsets, including PDF/H.
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PDF stands for Portable Document Format and PDF/H stands for Portable Document Format for Healthcare. The /H is what’s known as a ‘subset’ of the original PDF file type specification. There are several of these PDF subsets, each dealing with a different industry, sector or specialism.
The PDF/H was developed in 2007, when Adobe made it possible to create ‘subsets’ of its iconic PDF technology. But to talk more about the history of PDF/H, we must first discuss the original PDF file type.
The story of the PDF or Portable Document Format, begins in the early 1990s. In those days, the entire Adobe team could fit in the lunchroom at its Mountain View HQ.
Adobe co-founders John Warnock and Charles Geschke wanted to make it possible for people to view files universally, regardless of whether they were using a Mac, Windows or UNIX. Believe it or not today, back then every system presented files in its own way - creating havoc for document authors.
PDF changed all that. Launched with the Adobe Acrobat Reader in 1995, the PDF format created files that looked the same on every computer.
Until the mid-00s, Adobe controlled the specification of the PDF. But in 2007 it released the technical spec to the American National Standards Institute (ANSI), the Association for Intelligent Information Management (AIIM) and the International Organisation for Standardisation (ISO).
Experts at ISO soon defined the PDF an ISO standard - ISO 32000.
ISO defines its standards as ‘a formula that describes the main way of doing something’ based on agreement between relevant experts.
Soon after the PDF was made an ISO standard, experts began working on PDF subsets for specific industries. One of these was PDF/H - the healthcare-focused PDF. Some of these subsets became stand-alone ISO standards, others were considered best practice guides. PDF/H was a best practice guide, mostly developed by Adobe and the experts at AIIM.
PDF/H is used in the medical and healthcare sectors, particularly in the US. Medical professionals like doctors and researchers will often encounter these files. They’re not typically used in the UK.
In the US, the Health Insurance Portability and Accountability Act (HIPAA) governs the protection of health data. Under the HIPAA Privacy Rule, US healthcare providers must meet minimum standards for electronic documents that include people’s personal data.
The PDF/H standard was created in line with the HIPAA guidance for secure management of patient records in the US.
Moving away from the PDF/H file subset, we’ll look briefly at the use of PDFs more broadly in healthcare.
Things the NHS may use PDF/UA files for include:
If you have a document related to a public information campaign, for example a poster or a leaflet, you could use a PDF to digitise this and share with people via your GDPR-compliant email mailing lists.
If you compile reports on behalf of a health organisation as part of your role, your organisation may choose to use PDF tools to create them. Examples could include the annual report of a health trust.
One example of how the NHS has used accessible PDF/UA files is to digitise the documents on its website for the NHS Long Term Plan. Doctors, nurses, patients’ groups and subject-matter experts all fed into the plan. And you can download a PDF version of it direct from the site. The NHS follows Adobe guidance on ensuring these PDFs are accessible.
The easiest way to open and view a PDF on a Windows PC or a Mac is to download a free PDF reader such as Adobe Acrobat Reader.
On a Windows PC or laptop
On a Mac
Your Mac will likely try to open your PDF with its default Preview application. This gives you limited access to the PDF, so you may want to update your settings to make Acrobat your default PDF reader. Then, simply:
To edit a PDF, open Adobe Acrobat and then:
You can also use Adobe’s free tool to edit PDFs online.
Another PDF subset, PDF/An is focused on preserving archived documents.
PDF/E file types are focused on the engineering industry.
PDF/X sets specifications for the printing world.
Want to know more? Get the lowdown on the iconic file format with our timeline of the history of the PDF.
Adobe Acrobat Online has all the tools you need to do more with your documents.
A healthcare system PDF is a subset of the Adobe PDF format. Adobe developed it alongside experts at the AIIM data management organisation for use in the US healthcare sector. It arrived soon after Adobe opened the PDF format to the International Organisation for Standardisation, but the PDF/H file isn’t an ISO standard itself.
When Adobe opened the PDF standard to the International Organisation for Standardisation, the PDF format itself became an ISO standard with several PDF subsets, which became ISO standards in their own right. The PDF subsets made into ISO standards were PDF/A (PDF for Archive) and PDF/X (PDF for Exchange).
Officials at the International Organisation for Standardisation (ISO) defined the PDF format as an ISO standard in 2007. The standardisation came years after PDF first launched in 1993, but Adobe worked with experts to develop technical specifications for ISO from 1995 onwards. In 2021, the ISO standard for the PDF was revised periodically to ensure it kept pace with standards and technology. It was most recently revised in 2017 and 2021.
The main difference between PDF and PDF/H is that the PDF/H was designed specifically for use in US healthcare, whereas you can use the standard PDF format across many different industries and practical applications. The PDF is its own ISO standard, whereas the PDF/H is a best practice guide.
PDF/A stands for PDF Archive. It’s another PDF subset, like the PDF/H. Unlike PDF/H, however, PDF/An is an ISO standard in its own right (19005-1). PDF/An is concerned with ensuring electronic documents retain the same visual appearance over time, according to the PDF Association.
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