CARE-IT Maturity Model
The CARE-IT Maturity Model provides a structured assessment of the organizational condition of digital clinical infrastructure.
It operationalizes the eight CARE-IT foundational principles and makes their structural embedding visible.
Maturity does not describe process formality, documentation volume, or KPI performance.
It describes the degree to which a healthcare provider can implement the CARE-IT principles in a stable, consistent, and interdisciplinary manner.
The objective is not certification,
but transparency, prioritization, and targeted structural development.
Normative Foundation
The eight CARE-IT principles (P1–P8) are the sole evaluation standard.
The maturity model introduces no additional normative criteria.
It measures exclusively the extent to which the principles are organizationally and structurally embedded.
The principles define direction.
The maturity model describes the developmental state of their implementation.
Low maturity in safety-critical principles — particularly P5 —
limits the interpretation of the overall maturity profile.
Maturity must therefore not be understood as additive
and must not be interpreted through simple averaging.
Two Perspectives on Maturity
The model considers maturity from two complementary perspectives:
Principle Maturity
For each of the eight principles, the degree of structural safeguarding is assessed.
Examples:
- P1 low → Clinical Effectiveness is not a binding governance criterion
- P3 low → Responsibility remains implicit or person-dependent
- P8 low → Innovation cannot be integrated sustainably
Principle maturity describes the normative stability of the organization.
Domain Maturity
The six CARE-IT domains (D1–D6) represent organizational action spaces
in which the principles manifest concretely.
Domain maturity describes:
- structural transparency,
- governance capability,
- organizational consistency,
- risk control capacity.
Domains are not a second normative layer.
They make visible how and where principles are carried organizationally.
Principles are the standard.
Domains are the observation spaces.
Maturity Levels
CARE-IT distinguishes five levels of development:
Level 1 – Ad hoc
Structures are person-dependent; decisions are situational and inconsistent.
Level 2 – Implicit
Partially structured practice exists, but is not stable or organization-wide.
Level 3 – Structured
Roles, responsibilities, and system interrelationships are defined and traceably documented.
Level 4 – Governed
Decision logics are consistent, interdisciplinary, and institutionally safeguarded.
Structures function predictably and are not dependent on individual persons.
Level 5 – Integrated
Principles are embedded organization-wide.
Further development occurs continuously without generating structural instability.
Maturity reflects increasing structural stability and coherence —
not increasing formalization or documentation density.
Level 5 does not describe maximum complexity,
but minimal structural friction combined with high organizational robustness.
Interpretation
A maturity profile makes structural weaknesses visible.
It enables:
- conscious prioritization of development initiatives,
- interdisciplinary discussion,
- comparison of clinical system constellations,
- long-term strategic governance.
Maturity describes organizational capability.
KPIs describe operational performance.
Both perspectives complement each other, but do not replace one another.
High performance at low structural maturity is possible —
but not sustainably stable.
See for visualization and interpretation:
Application
The maturity model is typically:
- applied per clinical system constellation,
- discussed interdisciplinarily,
- reflected within governance structures,
- reviewed regularly,
- related to operational KPIs.
It is not an audit instrument
and not a certification model.
It is a leadership and development tool
for sustainable digital clinical infrastructure.