Introduction

The CARE-IT Reference Library is a curated knowledge graph describing clinical digital infrastructure.

Its purpose is not to replace existing healthcare terminologies or interoperability standards. Instead, it provides the architectural and governance context required to understand how clinical capabilities are realised through digital systems operating in healthcare organisations.

The methodology is based on the principle that digital healthcare should be described using internationally recognised concepts wherever possible, while explicitly modelling the relationships between clinical work, technology and organisational responsibility.

Design Principles

1. Reuse before invent

The library adopts existing international standards whenever suitable concepts already exist.

Examples include:

SNOMED CT for clinical concepts and procedures
LOINC for observations
HL7 FHIR for interoperability resources
openEHR for clinical information models
IHE Integration Profiles for interoperability workflows
ISO and IEC standards where applicable

New concepts are introduced only when no suitable international reference exists.

2. Capability-centred modelling

Clinical capabilities are the primary organisational unit of the library.

Technology is not considered an objective in itself.

Instead, applications, medical devices, integrations and information models are described according to the clinical capability they enable.

This approach keeps the focus on healthcare delivery rather than individual software products.

3. Knowledge graph instead of document hierarchy

Knowledge is represented as interconnected entities rather than isolated documents.

Each entity maintains explicit relationships to other entities.

For example, a Clinical Capability Profile may reference:

a Clinical Domain
SNOMED CT concepts
participating professional roles
required applications
medical devices
interoperability standards
regulations
governance responsibilities
associated risks

This allows knowledge to be explored from multiple perspectives.

4. Governance as first-class knowledge

Successful digital healthcare depends not only on technology but also on governance.

The library therefore models organisational concepts including:

ownership
operational responsibility
lifecycle management
information governance
operational readiness
regulatory accountability

Governance concepts are treated as reusable knowledge objects rather than implementation details.

5. System constellation perspective

Clinical capabilities are typically realised through multiple interacting systems rather than individual applications.

The library therefore documents system constellations instead of isolated products.

A system constellation may include:

clinical applications
medical devices
integration engines
identity services
communication services
infrastructure components

The constellation, rather than any individual component, represents the operational capability.

6. Vendor-neutral modelling

The library describes capabilities, architectures and standards independently of commercial products.

Vendor-specific implementations may be documented as examples but do not define the underlying concepts.

7. Evidence and traceability

Statements should, whenever possible, reference recognised standards, regulatory documents or authoritative publications.

Every important concept should remain traceable to its original source.

Information Model

The CARE-IT Reference Library is organised around reusable knowledge objects.

Examples include:

Clinical Domains
Clinical Capabilities
Clinical Capability Profiles
System Constellations
Applications
Medical Devices
Professional Roles
Standards
Regulations
Risks
Governance Concepts

Each object is uniquely identifiable and connected to related entities through explicit relationships.

Scope of the methodology

The methodology focuses on describing how clinical capabilities are enabled, governed and operated within digital healthcare environments.

It intentionally complements existing clinical terminologies and interoperability standards rather than replacing them.

Continuous evolution

The methodology will evolve as healthcare standards, technologies and governance models develop.

Changes are made conservatively to preserve consistency, interoperability and long-term maintainability of the knowledge graph.