CIS 95C Risk Management Practicum

SMDC Dashboard Initiative
Risk Portfolio

12 Milestones · 12 Weeks · A Journey from Risk Identification
to Risk Leadership

12
Milestones
15+
Risks Identified
7
Controls Selected
5
Contingency Plans

[Your Name] · [Date] · [Course Section]

Project Context

What is SMDC — and Why Does Risk Matter Here?

SMDC (Shared Medical Data Collaborative) is building a real-time clinical monitoring dashboard for a safety-net health system serving predominantly low-income, multilingual urban patients managing chronic conditions.

"The dashboard succeeds not when it fires accurate alerts, but when patients understand their health, clinicians trust the data, and communities trust the system with their information."
— Project Mission Definition
Three Conditions Monitored
Hypertension · Type 2 Diabetes · Congestive Heart Failure
Primary Risk Domains
Technical · Clinical · Regulatory · Financial · Equity · Organizational
Why Risk Matters Here
Patient harm, irreversible community trust loss, and regulatory shutdown are all possible without proactive risk management
The 12-Milestone Journey

From Identification to Leadership

Phase 1: See
M1 RBS · M2 Impact Matrix · M3 Delphi
What could go wrong?
Phase 2: Diagnose
M4 Controls · M5 Root Cause · M6 TOWS
Why is it happening?
Phase 3: Decide
M7 Patient BMC · M8 Convergence · M9 Prioritization
What matters most?
Phase 4: Lead
M10 Decision Trees · M11 Contingency · M12 Portfolio
What do we do?

Replace the placeholder below with your 2–3 sentence synthesis of the most important shift in your thinking across the twelve milestones.

[Your synthesis: "The most important shift in my thinking was..." — connect to specific milestones and moments]
Risk Landscape Summary

What We Found — Priority Risk Profile

HIGH Priority Risks

R-01: Alert Calibration R-04: HIPAA Breach R-05: FDA SaMD R-06: Alert Fatigue R-07: Patient Misinterpretation

MEDIUM Priority / Partially Controlled

R-02: EHR Integration R-08: Language Exclusion R-15: Data Lag

Controls Deployed

C-01: Threshold Calibration ✓ C-04: Plain Language ✓ C-NEW1: Consent ✓
Most Important Finding
[Replace with your single most important risk finding from the project — specific, named, grounded in milestone data]
Biggest Surprise
[Replace with the risk finding that most surprised you — and why it was unexpected]
Milestone 3 + 8 — Stakeholder Synthesis

Where People Disagreed — and What It Taught Us

⚡ Conflict Zone
Alert tone: Patients felt scolded. Clinicians saw necessary precision. Engineers saw a content string. Three groups, one risk, three incompatible solutions.
⚠ Blind Spot
Nighttime alert anxiety: patients were frightened at 2am with no support. Clinical and engineering teams viewed this as 'alerts working correctly.'
🎭 False Alignment
Consent: clinical team said 'handled' (IRB approved). Patient experience said 'I signed something I couldn't read.' Same status, opposite realities.
[Replace with your most important quote from stakeholder analysis — from a clinician, patient, or engineer — that changed your thinking]
[Role / Source / Milestone]
Milestones 4 + 9 — Control Design and Prioritization

The Five Controls That Mattered Most

C1
Alert Threshold Calibration — E2, I5 → Priority 2.5
Prevents alert fatigue and clinical misinterpretation. Non-negotiable patient safety control. Clinical Director sign-off per sprint.
C4
Plain-Language + Health Literacy Review — E2, I5 → Priority 2.5
Directly reduces patient misinterpretation risk. Tests every screen at Flesch-Kincaid grade 6. Multilingual participants in usability testing required.
CN1
Consent Redesign + Verbal Confirmation — E3, I5 → Priority 1.7
Prevents irreversible community trust collapse. $3K cost prevents $1.2M+ OCR exposure. CHW verbal confirmation for low-literacy patients.
C5
Clinical Alert Response Protocol + Nursing Escalation — E2, I4 → Priority 2.0
Closes governance gap: RN is first alert responder, not attending. Marcus Webb's experience made this visible. A protocol document, not a technical fix.
CN6
Patient Feedback Acknowledgment SLA — E1, I3 → Priority 3.0
Best ROI control: costs nothing technically. Marcus Jr. submitted a 500-word feedback form, got no response, nearly left the pilot. One PM process change prevents this.
Milestone 10 — Decision Tree Analysis

The Decision That Proved 'Free' Is the Most Expensive

Consent redesign scenario: two options.

Option A: Redesign ($3K)
EV = 8.0
A1: P=0.80, Impact=9 → EV 7.2
A2: IRB delay P=0.20, Impact=4 → EV 0.8
Option B: Status Quo ($0)
EV = 5.1
B1: Legally compliant P=0.70, Impact=3 → EV 2.1
B2: Trust collapse P=0.30, Impact=10 → EV 3.0
🔴 NON-RECOVERABLE
The $3K investment prevents a P=0.30, Impact=10 outcome worth $1.2M+ in regulatory exposure — plus irreversible community trust loss. The 'free' option is the most expensive choice in the matrix.
Lesson
[Replace with your own takeaway from the decision tree exercise — what did modeling make visible that you hadn't seen before?]
Milestone 11 — Contingency Planning

When Controls Fail — Five Response Plans

CP-01: Alert Misfire
Trigger: response rate <70%. Response: calibration freeze + full validation. Tier 2 → Tier 3 if patient event.
CP-02: HIPAA Breach
Always Tier 3. Legal within 2 hours. OCR timeline starts at discovery. No external comms without legal review.
CP-03: Patient Misinterpretation
Clinical + UX co-response. CHW notification. Plain-language redesign of specific element. Patient safety registry.
CP-04: Data Sync Failure
15-min engineering acknowledgment. Data freshness indicator activated. EHR vendor escalation protocol.
CP-05: Community Trust Event
COO leads. CHW network activated in 4 hrs. No public statement without legal. Trust measured at 30/60/90 days.
Key Principle
[Replace with your own insight about what contingency planning taught you about leadership under pressure]
Milestone 12 — Leadership Reflection

What Risk Leadership Means to Me Now

Before this course, risk meant:
[Replace with your honest description of your starting mindset about risk]
Now, risk means:
[Replace with your evolved definition — ideally including human, organizational, and equity dimensions]
Three Things I'll Carry Forward
1
[First principle or practice you will apply in future work]
2
[Second principle or practice]
3
[Third principle or practice]
Advice to Future Students
[One sentence of advice for someone starting this course]
CIS 95C Risk Management Practicum — Final

Thank You

Questions? I'm glad to discuss any milestone in depth — the controls, the stakeholder tensions, the tradeoffs, or the equity implications we navigated.

12
Milestones completed
7
Controls selected and justified
5
Contingency plans operational

[Your Name] · [Your Institution] · [Date]

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