The org has no structural owner for the patient between departments. Accountability ends at each department boundary and no one owns the seam — a gap that is structural, not individual. The organization finds out when the family calls.

Each team trusts its own source of truth, so no shared view exists. ER, wards, and pharmacy each keep their own record and distrust the others. A single view only works if it resolves whose version wins — a political question that cannot be dodged.

A new continuity-of-care reporting rule lands next year and they cannot meet it. An external, dated pressure with teeth — regulatory, not aspirational. It sets a hard floor on what the data model must capture and a real deadline behind the engagement, independent of how adoption goes.