Evaluation Logic of the CARE-IT Maturity Model
The CARE-IT maturity model does not follow an additive scoring logic.
Maturity is not the mathematical sum of fulfilled criteria,
but the expression of structural stability in relation to the CARE-IT principles.
CARE-IT is not an audit or certification instrument,
but a leadership and development model.
Normative Foundation
Only the structural embedding of the CARE-IT foundational principles (P1–P8) is assessed.
The maturity model introduces no additional normative criteria.
It describes the developmental state of the organizational implementation of the principles.
The principles define the evaluation standard.
The assessment measures how stably these principles are organizationally carried.
Low maturity in safety-critical principles — particularly P5 —
limits the interpretation of the overall maturity profile.
Maturity must be interpreted qualitatively, not aggregated additively.
CARE-IT explicitly refrains from overall scoring or averaging across principles or domains.
Evaluation Process
The assessment is conducted interdisciplinarily and consensus-oriented.
Recommended approach:
- Consider one principle or domain at a time
- Discuss relevant indicators jointly
- Determine the maturity level
- Briefly document the reasoning
- Derive prioritized development measures
Classification is based on the predominant structural condition —
not on isolated individual indicators.
Maturity emerges from structural stability of the organization,
not from formal completeness of individual measures.
Maturity Levels – Interpretation Logic
CARE-IT distinguishes five levels of development.
Maturity reflects increasing structural consistency, robustness, and predictability —
not increasing documentation density or formalization.
Level 1 – Ad hoc
- Decisions are situational
- Structures are person-dependent
- Responsibility is implicit
- Risks are not systematically visible
Level 2 – Implicit
- Partially recognizable structure
- Knowledge tied to individuals
- Responsibilities not stably safeguarded
- Structural inconsistencies frequent
Level 3 – Structured
- Roles, responsibilities, and system interrelationships clearly described
- Accountabilities traceable
- Structures largely consistent
- Majority of structural requirements stably fulfilled
Level 4 – Governed
- Decision logics consistent and organization-wide
- Structures resilient independent of individuals
- Interdisciplinary coordination structurally safeguarded
- Risks and goal conflicts transparently addressed
Level 5 – Integrated
- Principles embedded organization-wide
- Structure sustainably robust — even under change pressure
- Continuous development without structural instability
- Minimal friction combined with high organizational coherence
Level 5 does not describe maximum complexity,
but maximum structural integration capability.
Handling Heterogeneous Maturity
Different maturity levels across principles or domains are normal.
Example:
- High lifecycle sustainability (P6)
- Low innovation capability (P8)
This does not describe an error,
but a developmental state.
The goal is not equal distribution of maturity levels,
but conscious prioritization aligned with clinical effectiveness and patient safety.
Evaluation Grid (Orientation Tool)
The following grid serves as a structured discussion basis.
It does not replace expert judgment and involves no numerical weighting.
| Maturity Level | Structural Consistency | Responsibility | Decision Logic | Transparency |
|---|---|---|---|---|
| 1 – Ad hoc | No stable structure | Implicit or person-dependent | Situational | Hardly traceable |
| 2 – Implicit | Partial structure | Responsibility carried by individuals | Inconsistent | Partially visible |
| 3 – Structured | Structure clearly defined | Responsibility traceable | Consistently applied | Transparently documented |
| 4 – Governed | Organization-wide robustness | Responsibility clearly embedded | Predictable and consistent | Systematically traceable |
| 5 – Integrated | Sustainably resilient | Cross-level transparency | Continuously refined | Structurally embedded |
Relationship to KPIs
Maturity describes structural organizational capability.
KPIs describe operational performance.
A clinical system constellation may:
- show strong KPI performance,
but remain structurally unstable.
Or:
- demonstrate high structural maturity,
but lack operational transparency.
Maturity and performance must be considered separately.
They complement one another, but do not replace each other.
Character of the Model
The maturity model is an instrument for structured reflection.
It supports:
- strategic prioritization,
- interdisciplinary dialogue,
- long-term development,
- transparent governance.
It is not an inspection procedure
and not a certification model.
It is a leadership instrument
for sustainable digital clinical infrastructure.