{"schema_version":1,"assessment_id":"eoa_inverse_innovation_exp03_opportunity320_20260801","source_experiment_id":"eoa_inverse_innovation_exp03_full320_20260801","cell_id":"layer_decay_and_expiration_management__medicine_healthcare","archetype_slug":"layer_decay_and_expiration_management","domain_slug":"medicine_healthcare","title":"Lifecycle-state governance for clinical decision-support artifacts","opportunity_summary":"The proposal would inventory versioned clinical content, route suspected stale artifacts through governed review, deactivate superseded versions from ordinary selection, preserve authorized historical access, and test restoration before destruction. It addresses a potentially consequential failure mode, but the sealed candidate does not establish its prevalence, stakeholder demand, operating performance, or distinctiveness from existing governance and EHR capabilities.","adopter_authorizer":"A hospital or health-system clinical-content governance body would authorize clinical activation and retirement, with health-informatics and EHR administrators implementing transitions and records, privacy, legal, and compliance officers controlling retention, holds, and destruction.","scores":{"meaningful_impact":{"score":4,"rationale":"If obsolete order sets, alerts, protocols, or references remain selectable, separating current clinical authority from historical retention could reduce outdated-guidance exposure while preserving incident reconstruction. The magnitude is conditional because the packet supplies no prevalence or outcome evidence."},"stakeholder_pull":{"score":3,"rationale":"Clinicians, content owners, informatics administrators, and safety, legal, and records personnel have proposal-specific reasons to value clearer authority and recoverability, but no observed demand, purchasing commitment, workflow pain measurement, or adoption inquiry is provided."},"incremental_advantage":{"score":4,"rationale":"Relative to mandatory periodic recertification alone, the proposal adds dependency tracing, exception and hold governance, reversible quarantine, archival restoration testing, and explicit separation of clinical authority from retention. Whether these additions produce material operational benefit remains untested."},"distinctiveness_plausibility":{"score":3,"rationale":"The integrated composition is meaningfully differentiated from the stated nearest rival, but prior-art status is explicitly unsearched and existing clinical-content governance or EHR lifecycle capabilities could substantially overlap it."},"technical_implementability":{"score":3,"rationale":"Inventorying versions, representing lifecycle states, recording approvals, and testing archives are technically plausible, but reliable identity resolution and discovery of external, runtime, or undocumented dependencies may be difficult and are central to safe operation."},"adoption_authority_feasibility":{"score":3,"rationale":"The candidate identifies the relevant clinical, informatics, records, privacy, and legal authorities and preserves their mandates. Feasibility is mixed because activation, retention, holds, and destruction require coordination across several bodies and potentially an EHR vendor."},"evidence_readiness":{"score":4,"rationale":"A reversible 12-week shadow pilot, ordinary-practice comparator, problem and intervention falsifiers, halt criteria, and a 100% sampled-restore fidelity gate are specified. Readiness falls short of the maximum because the reference standard, blinded adjudication process, denominators, and accuracy thresholds are not fully defined."},"safety_net_benefit":{"score":5,"rationale":"The proposal explicitly prohibits patient-facing activation and permanent deletion during the pilot, reserves clinical and legal authority to designated bodies, requires quarantine and restoration, and defines immediate halt and rollback triggers for classification, dependency, disclosure, restoration, or production-boundary failures."},"scalability":{"score":3,"rationale":"The lifecycle-state framework could be reused across content classes and service lines, but dependency structures, retention rules, clinical ownership, integrations, and validation requirements are likely to vary by institution and artifact type."}},"score_confidence":"MODERATE","costs":{"first_evidence":{"band_2026_usd":"50K_TO_250K","scope":"Prepare and conduct the 12-week shadow pilot for one service line and no more than 50 non-emergency order sets, including inventory, reference-standard adjudication, dependency review, simulated dispositions, sampled restoration, compliance oversight, and analysis.","confidence":"MODERATE","assumptions":["Existing version and audit data can be accessed without building a new production integration.","The pilot remains non-patient-facing and performs no permanent deletion.","Clinical, informatics, records, privacy, and legal reviewers contribute material labor.","The comparison is ordinary ticket or spreadsheet review over the same scoped artifacts."]},"initial_deployment_startup":{"band_2026_usd":"250K_TO_1M","scope":"Build a production-capable implementation for one hospital after favorable evidence, including content inventory connectors, lifecycle-state controls, permissions, audit trails, quarantine and restore functions, governance workflows, validation, and compliance review.","confidence":"LOW","assumptions":["The hospital can use supported EHR interfaces or exports.","The scope is one hospital rather than a multi-hospital enterprise rollout.","No replacement of the underlying EHR or clinical-content platform is required.","Required security and retention controls can be added without extensive bespoke infrastructure."]},"operational_launch":{"band_2026_usd":"1M_TO_5M","scope":"Launch across a hospital or limited health-system scope, including broader content migration, dependency verification, clinical validation, training, parallel operation, change management, go-live support, and initial revalidation cycles.","confidence":"LOW","assumptions":["Launch covers multiple content classes and service lines.","Historical versions require classification and ownership resolution.","Clinical governance must review exceptions and disputed states.","Vendor contracting or additional integration work may be necessary but wholesale platform replacement is excluded."]},"annual_recurring":{"band_2026_usd":"250K_TO_1M","scope":"Operate the lifecycle program through content-owner reviews, governance and legal oversight, monitoring, archive and restore drills, periodic revalidation, software support, security review, and audit maintenance.","confidence":"LOW","assumptions":["Review demand is manageable through risk-based prioritization.","Existing governance personnel absorb part, but not all, of the workload.","Recurring cost excludes major EHR replacement and exceptional litigation or investigation work.","Automation supports workflow but does not replace clinical validation or hold authority."]}},"research_burden":"HIGH","earliest_credible_horizon":"3_TO_12_MONTHS","pipeline_gates":{"recognizable_externally_supportable_problem":{"status":"YES","reason":"The candidate identifies observable stale selectability, ambiguous version authority, missing ownership and dependencies, and restoration risk, with a scoped audit that could support or falsify the problem. It does not establish prevalence."},"identifiable_adopter_or_authorizer":{"status":"YES","reason":"The sealed candidate identifies a clinical-content governance body for activation and retirement, informatics administrators for implementation, and records, privacy, and legal officers for retention, holds, and destruction."},"distinct_testable_incremental_claim":{"status":"YES","reason":"The proposal can be compared with ordinary ticket or spreadsheet review and with recertification-only governance on stale-candidate accuracy, disposition time, dependency errors, and sampled restoration fidelity."},"bounded_next_evidence_step":{"status":"YES","reason":"The specified 12-week shadow pilot is limited to one service line and at most 50 non-emergency order sets, excludes production changes and deletion, and contains explicit comparison, falsifiers, halt conditions, and rollback."},"no_unresolved_safety_or_authority_stop":{"status":"YES","reason":"For the shadow pilot, clinical validation, retention, holds, and destruction remain with designated authorities, and any dependency, classification, disclosure, restoration, or production-boundary failure triggers a halt. This does not authorize production deployment."},"implementation_cost_scope_and_range":{"status":"UNCERTAIN","reason":"The pilot has a bounded scope that permits a broad resource range, but production scale, EHR interfaces, artifact volume, vendor capabilities, staffing, retention obligations, and enterprise rollout boundaries are unspecified."}},"blocking_evidence":["A scoped audit must determine whether obsolete artifacts are actually active or misleadingly discoverable rather than merely retained as hidden, required history.","A prespecified reference standard and adjudication process must establish current, superseded, archival, held, and erroneous classifications.","The shadow comparison must show better correct stale-candidate identification or faster owner disposition than ordinary review without any missed material dependency or current-content misclassification.","Sampled quarantined or archived artifacts must meet the predefined 100% fidelity restoration gate.","Adoption inquiry must establish that content owners and clinical, informatics, records, privacy, and legal authorities can sustain the review workload and agree on decision rights.","External prior-art and vendor-capability research must determine whether the proposed integrated mechanism materially differs from existing clinical-content governance and EHR lifecycle systems."],"next_evidence_step":"With one hospital partner, preregister and run the authorized 12-week shadow pilot on one service line and at most 50 non-emergency order sets. Compare lifecycle-assisted review with the ordinary ticket or spreadsheet baseline using blinded governance adjudication for stale-candidate correctness, time to owner disposition, dependency misses, current-content misclassification, and sampled restore fidelity. Stop the intervention claim if it fails to improve identification or disposition, produces any missed material dependency or current-content misclassification, or fails the 100% sampled-artifact restoration gate; make no production changes or permanent deletions.","research_questions":["How many scoped artifacts are active or misleadingly discoverable despite being obsolete, rather than safely retained as hidden history?","Can adjudicators reliably distinguish clinical authority from archival retention across the proposed lifecycle states?","Does the mechanism improve correct stale-candidate identification or disposition time relative to ordinary review?","What material dependencies are missed by automated and manual tracing, especially external or runtime consumers?","Can every sampled quarantined or archived artifact be restored with complete content, metadata, permissions, and audit fidelity?","How much review workload, disagreement, and superficial attestation does the process create for each authority group?","Which retention, privacy, legal-hold, and mandatory-deletion requirements conflict with quarantine or destruction policies?","Do existing standards, vendor products, or institutional implementations already provide the proposed integrated controls?","Are clinicians or maintainers currently encountering the purported stale artifacts, and do accountable adopters prioritize remediation?","Can the approach extend beyond one service line without unacceptable integration, validation, and governance burden?"],"recommendation":"PARTNERED_RESEARCH","uncertainty_constraints":["No external evidence establishes problem prevalence, realized patient-safety impact, stakeholder demand, market size, or adoption frequency.","Prior art is unsearched, so no novelty or competitive-distinctiveness claim is supportable.","Clinical validity does not decay monotonically with age, and rare use cannot be treated as evidence of obsolescence.","The detector's accuracy, dependency coverage, disposition-time effect, and restoration reliability are hypotheses.","Production architecture, EHR interfaces, content volume, staffing, and vendor constraints are unspecified, making deployment and recurring costs low-confidence broad ranges.","The favorable safety assessment applies to the bounded shadow pilot, not to autonomous production deactivation or destruction.","No benefit estimate can be generalized beyond the proposed service line and artifact sample without further evidence."],"closed_book_prior_art_boundary":"This assessment makes no claim that lifecycle-state gating, dependency tracing, governed quarantine, restoration testing, or their composition is novel, uncommon, or absent from current clinical-content governance or EHR products. Distinctiveness is evaluated only against the sealed candidate's stated recertification-only rival and requires external prior-art research."}