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The intent is stated, but the model does not show what carries it out.", "evidence": [ "'It Has to Work' — Zero-tolerance reliability", "45-min RTO", "99.999% Availability", "99.999%+ Surgical Availability", "ANCC Magnet Recognition", "BCDR 45-min RTO", "Budget Governance", "CTO / IT Director" ], "evidenceTotal": 58, "action": "Trace each unrealized goal, requirement, or principle to the element that implements it.", "exitCriterion": "Every motivation element reaches at least one business, application, or technology element." }, { "id": "F-06", "severity": "high", "horizon": 1, "title": "Elements with no relationships", "detail": "139 of 353 elements carry no relationship in either direction. An element with no edges contributes nothing the model can be read from.", "evidence": [ "'It Has to Work' — Zero-tolerance reliability", "10 Conventional ORs", "10 Future Expansion Positions", "45-min RTO", "99.999% Availability", "99.999%+ Surgical Availability", "ANCC Magnet Application", "ANCC Magnet External" ], "evidenceTotal": 139, "action": "Connect each isolated element to the estate, or remove it from the model.", "exitCriterion": "No element in the model has a relationship degree of zero." }, { "id": "F-05", "severity": "medium", "horizon": 2, "title": "Model elements absent from every viewpoint", "detail": "80 of 353 elements exist in the model but are drawn on no viewpoint. No reader of this document will see them.", "evidence": [ "10-Year Medical Record Retention", "ANCC Magnet Application", "Acuity-Based Staffing", "Administrator", "Attending Physician", "BCDR 45-min RTO", "CFO / Finance", "Care Delivery Service" ], "evidenceTotal": 80, "action": "Add the missing elements to an existing viewpoint or introduce the viewpoint that covers them.", "exitCriterion": "Every model element appears on at least one viewpoint." }, { "id": "F-07", "severity": "medium", "horizon": 2, "title": "Data objects read or written under no stated constraint", "detail": "11 of 21 data and business objects are accessed by at least one element while no requirement, principle, or constraint governs them.", "evidence": [ "Training Data: AI/Analytics Object Store", "Training Data: Administrative NAS", "Training Data: Clinical Order", "Training Data: Clinical SAN (hot tier)", "Training Data: DICOM Study", "Training Data: Insurance Claim", "Training Data: NDNQI Measure", "Training Data: PACS Tiered (hot/warm/cold)" ], "evidenceTotal": 11, "action": "Attach the residency, retention, or access constraint that applies to each object.", "exitCriterion": "Every accessed data and business object carries at least one governing motivation element." } ], "roadmap": [ { "horizon": 1, "name": "Horizon 1 — Close the structural gaps", "intent": "Repair the places where the model cannot answer a question a board or auditor will ask. These findings block the others: a roadmap built over an incomplete model inherits its blind spots.", "findings": [ { "id": "F-01", "severity": "high", "horizon": 1, "title": "Business activity with no application support modelled", "detail": "11 of 11 business processes and services have no application element serving, realizing, or assigned to them. The model cannot show what runs the work.", "evidence": [ "Acuity-Based Staffing", "Nurse Call Response & Triage", "Shared Governance 5-Council Model", "WF-01 Patient Admission & Registration", "WF-02 Clinical Documentation & Orders", "WF-03 Medication Management", "WF-04 Surgical Scheduling & Execution", "WF-05 Diagnostic Imaging & Reporting" ], "evidenceTotal": 11, "action": "Model the application that carries each unsupported activity, or record it as deliberately manual.", "exitCriterion": "Every business process and service in the model resolves to a named application element or a recorded manual-by-design decision." }, { "id": "F-02", "severity": "high", "horizon": 1, "title": "Application elements with no technology footing", "detail": "61 of 79 application components and services have no technology node, device, service, or artifact behind them. Hosting, resilience, and data residency cannot be read from the model.", "evidence": [ "15 NDNQI Indicators", "AI Model Governance: cloud architecture", "AI Model Governance: enterprise architecture", "AI Model Governance: magnet", "AI Model Governance: network architecture", "Analytics / Data Warehouse", "BCDR / Backup & Restore", "Building Management System (BMS)" ], "evidenceTotal": 61, "action": "Attach each application to the node, service, or artifact that runs it.", "exitCriterion": "Every application component and service resolves to at least one technology element." }, { "id": "F-03", "severity": "high", "horizon": 1, "title": "Estate outside the governance boundary", "detail": "173 of 204 application and technology elements are bound to no goal, driver, requirement, principle, or constraint. Nothing in the model states what governs them.", "evidence": [ "10 Conventional ORs", "10 Future Expansion Positions", "10 Robotic-Capable ORs (10Gbps/suite)", "AI Data Pipeline: cloud architecture", "AI Data Pipeline: enterprise architecture", "AI Data Pipeline: magnet", "AI Data Pipeline: network architecture", "AI Inference: 15 NDNQI Indicators" ], "evidenceTotal": 173, "action": "Bind each element to the requirement, principle, or constraint that governs it — or record why none applies.", "exitCriterion": "Every application and technology element carries at least one motivation relationship." }, { "id": "F-04", "severity": "high", "horizon": 1, "title": "Governance intent with no implementation path", "detail": "58 of 76 motivation elements connect only to other motivation elements. The intent is stated, but the model does not show what carries it out.", "evidence": [ "'It Has to Work' — Zero-tolerance reliability", "45-min RTO", "99.999% Availability", "99.999%+ Surgical Availability", "ANCC Magnet Recognition", "BCDR 45-min RTO", "Budget Governance", "CTO / IT Director" ], "evidenceTotal": 58, "action": "Trace each unrealized goal, requirement, or principle to the element that implements it.", "exitCriterion": "Every motivation element reaches at least one business, application, or technology element." }, { "id": "F-06", "severity": "high", "horizon": 1, "title": "Elements with no relationships", "detail": "139 of 353 elements carry no relationship in either direction. An element with no edges contributes nothing the model can be read from.", "evidence": [ "'It Has to Work' — Zero-tolerance reliability", "10 Conventional ORs", "10 Future Expansion Positions", "45-min RTO", "99.999% Availability", "99.999%+ Surgical Availability", "ANCC Magnet Application", "ANCC Magnet External" ], "evidenceTotal": 139, "action": "Connect each isolated element to the estate, or remove it from the model.", "exitCriterion": "No element in the model has a relationship degree of zero." } ] }, { "horizon": 2, "name": "Horizon 2 — Bind the estate to its governance", "intent": "Connect the systems that run to the intent that governs them, so that every control has a named subject and every subject a named control.", "findings": [ { "id": "F-05", "severity": "medium", "horizon": 2, "title": "Model elements absent from every viewpoint", "detail": "80 of 353 elements exist in the model but are drawn on no viewpoint. No reader of this document will see them.", "evidence": [ "10-Year Medical Record Retention", "ANCC Magnet Application", "Acuity-Based Staffing", "Administrator", "Attending Physician", "BCDR 45-min RTO", "CFO / Finance", "Care Delivery Service" ], "evidenceTotal": 80, "action": "Add the missing elements to an existing viewpoint or introduce the viewpoint that covers them.", "exitCriterion": "Every model element appears on at least one viewpoint." }, { "id": "F-07", "severity": "medium", "horizon": 2, "title": "Data objects read or written under no stated constraint", "detail": "11 of 21 data and business objects are accessed by at least one element while no requirement, principle, or constraint governs them.", "evidence": [ "Training Data: AI/Analytics Object Store", "Training Data: Administrative NAS", "Training Data: Clinical Order", "Training Data: Clinical SAN (hot tier)", "Training Data: DICOM Study", "Training Data: Insurance Claim", "Training Data: NDNQI Measure", "Training Data: PACS Tiered (hot/warm/cold)" ], "evidenceTotal": 11, "action": "Attach the residency, retention, or access constraint that applies to each object.", "exitCriterion": "Every accessed data and business object carries at least one governing motivation element." } ] } ], "workstreams": [ { "name": "Horizon 1 — Close the structural gaps", "ownerRole": "Governance & Risk Lead", "objective": "Repair the places where the model cannot answer a question a board or auditor will ask. These findings block the others: a roadmap built over an incomplete model inherits its blind spots.", "inputs": [ "The current ArchiMate model in its source form, with edit rights for the named owner.", "The system or process owners for the elements named in F-01, F-02, F-03, F-04, F-06.", "The governance artifacts — policies, standards, control statements — that the motivation elements should reference." ], "sequence": [ "F-01 — Model the application that carries each unsupported activity, or record it as deliberately manual.", "F-02 — Attach each application to the node, service, or artifact that runs it.", "F-03 — Bind each element to the requirement, principle, or constraint that governs it — or record why none applies.", "F-04 — Trace each unrealized goal, requirement, or principle to the element that implements it.", "F-06 — Connect each isolated element to the estate, or remove it from the model." ], "exitCriteria": [ "Every business process and service in the model resolves to a named application element or a recorded manual-by-design decision.", "Every application component and service resolves to at least one technology element.", "Every application and technology element carries at least one motivation relationship.", "Every motivation element reaches at least one business, application, or technology element.", "No element in the model has a relationship degree of zero." ] }, { "name": "Horizon 2 — Bind the estate to its governance", "ownerRole": "Data Governance Lead", "objective": "Connect the systems that run to the intent that governs them, so that every control has a named subject and every subject a named control.", "inputs": [ "The current ArchiMate model in its source form, with edit rights for the named owner.", "The system or process owners for the elements named in F-05, F-07.", "The governance artifacts — policies, standards, control statements — that the motivation elements should reference." ], "sequence": [ "F-05 — Add the missing elements to an existing viewpoint or introduce the viewpoint that covers them.", "F-07 — Attach the residency, retention, or access constraint that applies to each object." ], "exitCriteria": [ "Every model element appears on at least one viewpoint.", "Every accessed data and business object carries at least one governing motivation element." ] } ], "executiveSummary": [ "The submitted model describes 353 elements and 317 relationships across 6 architecture layers (Application 125, Technology 79, Motivation 76, Business 49), drawn on 4 viewpoints.", "Across the 5 structural dimensions this report measures, the model is 28% complete. Its strongest dimension is viewpoint documentation at 77%; its weakest is business enablement at 0%.", "7 findings follow, 5 of them rated high. Each names the elements that produced it and carries the observable condition that closes it.", "The transformation roadmap sequences the findings into 2 horizons; the implementation brief assigns each horizon an owner role, its required inputs, and its exit criteria." ], "undocumented": [ "10-Year Medical Record Retention", "ANCC Magnet Application", "Acuity-Based Staffing", "Administrator", "Attending Physician", "BCDR 45-min RTO", "CFO / Finance", "Care Delivery Service", "Chief Nursing Officer", "Clinical Protocol Compliance", "Code Blue / Rapid Response", "Device Health Attestation", "Diagnostic Service", "Discharge Initiated", "EBP & Research / Shared Governance", "Electronic Records Validity (Art 3–7)", "Facilities Service", "Facility Licensing", "Facility Management (FMS)", "Governance Leadership (GLD)", "Health Information Manager", "Health Regulator Portal", "IAM / RBAC / Break-Glass", "Implementation Event — Gap: Core AI — Clinical Services → Infrastructure — AI Compute & Network", "Implementation Event — Gap: Current State → Foundation — Security & Governance", "Implementation Event — Gap: Foundation — Security & Governance → Core AI — Clinical Services", "Implementation Event — Gap: Infrastructure — AI Compute & Network → Target State", "In-Country Data Residency (All PHI In-Country)", "Incident Reporting", "Infection Prevention (PCI)", "Information Management (MOI)", "JCI Survey Portal", "Lab Technologist", "Medication Management (MMU)", "Micro-Segmentation", "NDNQI Collection Trigger", "NDNQI Outcomes (15 Indicators from C07)", "Nurse Call Response & Triage", "Nursing Informatics Service", "Order Placed", "PHI Encryption At-Rest & In-Transit", "Patient / Family", "Patient Arrival", "Patient Digital Service", "Patient Safety Goals (IPSG)", "Pharmacist", "Pharmacy Service", "Practitioner Licensing", "QTSP Digital Signatures (Art 16–25)", "QTSP Provider (national digital ID / telecom carriers)", "Radiologist", "Registered Nurse", "Regulator Licensing API", "Result Available", "Retention Architecture (Hot/Warm/Cold)", "Revenue Cycle Service", "SIEM Correlation & Threat Detection", "Shared Governance 5-Council Model", "Structural Empowerment", "Surgeon", "Surgical Service", "Tamper-Evident Integrity (Art 26–29)", "Transformational Leadership", "VIP & Diplomatic Service", "VIP Arrival", "VIP Liaison", "WF-01 Patient Admission & Registration", "WF-02 Clinical Documentation & Orders", "WF-03 Medication Management", "WF-04 Surgical Scheduling & Execution", "WF-05 Diagnostic Imaging & Reporting", "WF-06 Lab Processing & Results", "WF-07 Discharge & Transition", "WF-08 Revenue Cycle & Billing", "Work Package — AI Infrastructure Buildout", "Work Package — Core AI Services Deployment", "Work Package — Full Integration & Validation", "Work Package — Security & Governance Hardening Package", "Workforce Mgmt Service", "mTLS Enforcement" ] }, "limitations": [ "The report measures the model, not the estate. Systems absent from the submitted model are invisible to it, so coverage figures are upper bounds on what the model can evidence.", "Relationship semantics are taken as modelled. A Serving relationship is counted as support whether or not the supporting system is operational.", "Coverage is a structural proportion, not a risk score. A fully connected model can still describe an estate with material governance exposure.", "Findings name the elements that produced them. Where an element list is longer than the print cap, the report states the full count alongside the sample shown." ], "methodologyNote": "Every figure in this report is computed from the submitted ArchiMate model. Each coverage dimension counts the elements of one kind that carry a qualifying relationship of another kind, and reports the proportion that do. Findings are the complement of those counts, named to the elements that produced them, so any figure can be traced back to the model. No score is inferred from documents, interviews, or benchmarks, and no element is scored on quality — this report measures structure, not intent.", "postureDisclosure": "This posture reads the structural completeness of the architecture model itself — how far its business, application, technology, and motivation elements connect to one another. It is not a governance certification: a certified tier is issued only from a governance assessment." }