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CARE-IT Foundational Principles

The foundational principles form the normative center of the CARE-IT framework.

They do not describe technical functions and do not define process details.
They define the structural conditions under which digital clinical infrastructure can be governed responsibly within the clinical context.

CARE-IT does not evaluate individual systems.
CARE-IT evaluates the ability of an organization to make digital decisions consistently, systemically, and in alignment with clinical effectiveness.

What the Principles Provide​

The foundational principles serve three central functions:

  1. Normative Orientation
    They define the reference against which digital decisions must be aligned.

  2. Structural Assessability
    They make organizational capability measurable and comparable.

  3. Governance Foundation
    They form the basis for the maturity model, artifacts, and governance logic.

Without this normative foundation, tools and processes would remain arbitrary.

Organizational Capability Instead of System Function​

The foundational principles are not directed at individual products or projects,
but at the organization as a whole.

The central question is always:

Is the organization structurally capable of shaping digital clinical infrastructure in a clinically effective, safe, and sustainable manner?

CARE-IT therefore shifts the focus:

  • from technology to responsibility
  • from implementation to impact
  • from isolated decisions to systemic logic

Systemic Interdependence of the Principles​

The eight principles are not applied in isolation.
Each principle addresses a distinct structural dimension.
No principle can substitute another.

Clinical Effectiveness (P1) depends on Information Integrity (P7).
Patient Safety (P5) requires System-Level Thinking (P2).
Innovation Capability (P8) is not sustainable without Lifecycle Sustainability (P6).

The principles form a coherent structural model.

Weakness in one dimension will structurally affect others.

Role Within the Overall Framework​

The foundational principles:

  • are operationalized in the maturity model,
  • are specified through indicators,
  • are implemented through artifacts,
  • and are embedded in governance structures.

They are therefore not abstract guiding ideas,
but a structural governance instrument.

Further Reading​