Mapping digital health maturity models and accreditation-linked standards: a scoping review to position the National Accreditation Board for Hospitals & Healthcare Providers (NABH) digital health standards of India

Key findings from this study

• The review identified that NABH-DHS shows strong alignment with prominent international frameworks in core domains including Leadership, Governance, Clinical & Patient Safety, and Information & Data Management.
• The authors found that significant gaps exist relative to global best practices in AI governance, advanced cybersecurity maturity, granular interoperability assessment, health-equity perspectives, and Patient-Generated Health Data integration.
• The researchers propose that future NABH revisions incorporate light-weight, tiered requirements through annexes or 'Digital Plus' badges referencing mature external frameworks such as ISO/IEC 42001 and NIST CSF 2.0 to address identified gaps.

Overview

This scoping review mapped features, domains, and assessment approaches of prominent international digital health maturity models and accreditation-linked standards. The analysis positioned India's National Accreditation Board for Hospitals & Healthcare Providers (NABH) Digital Health Standards (2025 draft) within the global framework landscape. The review identified areas of convergence with international best practices and critical gaps relative to emerging priorities in digital health governance.

Methods and approach

A scoping review following PRISMA-ScR guidelines searched peer-reviewed databases (PubMed, Embase, Scopus) and grey literature sources from inception to 26 July 2025. Inclusion criteria targeted sources describing national or international maturity models or accreditation standards for healthcare provider organizations. Data were charted using customized forms, synthesized narratively using SWiM methodology, and analyzed comparatively through a conceptual crosswalk matrix and thematic gap map. The review included 38 sources: 8 systematic or scoping reviews, 17 official reports or standards, and 13 primary studies.

Results

The review mapped key international frameworks including HIMSS EMRAM, NHS England's WGLL, WHO-PAHO IS4H, JCI, and Australian models. The NABH-DHS, structured across 8 chapters, demonstrated strong alignment with these frameworks in core domains: Leadership, Governance, Clinical & Patient Safety, and Information & Data Management. Comparative analysis identified significant gaps relative to global best practices. These gaps encompassed absent or minimal coverage of explicit AI governance, advanced cybersecurity maturity alignment with NIST CSF 2.0, granular interoperability maturity assessment, dedicated health-equity perspectives, and systematic integration of Patient-Generated Health Data. The NABH-DHS provides a comprehensive foundation for core digital assurance in India, converging well with international standards on foundational elements.

Implications

The NABH-DHS establishes a robust baseline for digital health standardization across Indian healthcare providers. Its strong alignment with international core domains validates the framework's positioning within established global practice. However, the identified gaps indicate that foundational adequacy does not address emerging governance priorities that advanced health systems are integrating, particularly in artificial intelligence oversight and health equity. Future regulatory iterations require strategic incorporation of these dimensions to maintain alignment as the digital health ecosystem evolves internationally.

The review demonstrates that pragmatic mechanisms can address identified gaps without wholesale framework redesign. Tiered 'Digital Plus' badges or annexes referencing mature external frameworks such as ISO/IEC 42001 and NIST CSF 2.0 enable phased implementation aligned with organizational maturity. This approach supports scalability across India's heterogeneous healthcare provider landscape while integrating governance standards for emerging technologies. Strategic positioning of the NABH-DHS as foundational rather than aspirational preserves its credibility while creating pathways for progressive adoption of advanced requirements.

The mapping provides evidence-based policy guidance for stakeholders benchmarking progress against international standards. Healthcare organizations and accreditation bodies gain clarity on convergence areas, enabling focused resource allocation toward core compliance. The documented gaps offer a roadmap for strategic prioritization during upcoming NABH revisions. This approach positions India's digital health governance as both locally contextual and globally informed, supporting sustained stakeholder trust as digital health capabilities mature.

Scope and limitations

This summary is based on the study abstract and available metadata. It does not include a full analysis of the complete paper, supplementary materials, or underlying datasets unless explicitly stated. Findings should be interpreted in the context of the original publication.