National Accreditation Board for Hospitals & Healthcare Providers (NABH)‘s Digital Health Standard for Hospitals has eight chapters and 182 Objective Elements. What most readers never reach is the appendix at the back: a formal table of 11 Key Performance Indicators (KPIs), each one a measurable metric — with a defined formula, a unit, a reporting frequency, and a specific Objective Element it maps back to.

The NABH digital health KPI appendix turns “are we ready for accreditation?” from a feeling into a number. Instead of guessing “we’re probably mostly compliant already,” a hospital can calculate its Digital Appointment % this month and know, precisely, where it stands.

Read the standard yourself. NABH’s Digital Health Standard for Hospitals is available in full, free, at nabh.co/digital-health-standards — creating a free NABH account is required to access it. Nothing in this piece substitutes for the source document itself.

7 of the 11 KPIs apply from Silver tier onward; the remaining 4 (ABHA Creation, Digital Nursing Notes %, System Uptime, IT Support) only become relevant at Gold or Platinum. That split alone gives a hospital a natural place to start: the 7 Silver-tier KPIs are the ones worth measuring first, regardless of which tier the hospital is ultimately targeting.

Recommended starting point: This piece is from a series on the NABH Digital Health Standard for Hospitals and assumes familiarity with many fundamental terms such as Chapters, Standards, Objective Elements, the four bands, and tier requirements. If these terms are new to you, it may make more sense to start from the beginning.

A note on structure: every KPI in the appendix follows the same nine-field format — Indicator, Indicator Brief, Inclusion Criteria, Exclusion Criteria, Formula, Unit, Frequency of data collation, Corresponding Objective Element (OE), and Category, with a Remarks field noting what kind of system is needed to track it. Once that structure is familiar, every row in the table reads the same way regardless of which KPI it’s describing.

What the Appendix Actually Measures

Each KPI in the appendix isn’t a vague health-check question like “is scheduling digital?” — it’s an exact formula with defined inclusion and exclusion criteria, tied to a specific Objective Element from one of the standard’s chapters. NABH digital appointment percentage, for example, isn’t left to judgment calls about what counts as “digital enough.” The formula spells out precisely which OPD consultations count, which don’t, and what to divide by what.

Digital Appointment %

The Digital Appointment % measures how many OPD consultations were booked through a digital channel rather than in person at the desk.

• Formula: {Number of OPD consultations booked digitally (telephonically, through website, or app) ÷ Total number of OPD consultations, including walk-ins} × 100
• Inclusion: OPD consultations
• Exclusion: Emergency visits, dialysis, chemotherapy, vaccination, wound-dressing, antibiotic therapy, and diagnostic visits — anything that doesn’t require a direct clinician consultation
• Corresponding Digital OE: AAC.3.a — the hospital uses a digital system for booking an appointment by the patients
• Category: Silver, Gold, Platinum — this one applies at every tier

ABHA Creation

ABHA Creation counts how many new Ayushman Bharat Health Account linkages a hospital’s HIMS generates for patients, not how many patients already have one.

• Formula: Number of ABHA accounts created by the healthcare organization
• Inclusion: New ABHA accounts created by the healthcare organization
• Exclusion: Existing patient ABHA accounts (created elsewhere, before this hospital touched them)
• Corresponding Digital OE: AAC.2.c — the hospital uses a digital system with the capability to generate and capture a patient’s ABHA and link it to their unique patient identifier
• Category: Gold, Platinum only — this is the first KPI in the appendix that isn’t required at Silver

Digital Prescription %

Digital Prescription % measures how many OPD prescriptions were created in the hospital’s digital system rather than handwritten.

• Formula: (Number of digital OPD prescriptions ÷ Total number of OPD consultations) × 100
• Inclusion: OPD consultations
• Exclusion: The same non-clinician-consultation visit types excluded from Digital Appointment %
• Corresponding Digital OE: COP.1.b — the hospital uses a digital system for the treating medical practitioner to create OPD prescriptions and consultation notes
• Category: Silver, Gold, Platinum

Digital Nursing Notes %

Digital Nursing Notes % measures how much of a hospital’s inpatient nursing documentation is captured digitally rather than on paper charts.

• Formula: (Number of digital nursing notes ÷ Total number of nursing notes prepared for patients) × 100
• Inclusion: IPD
• Exclusion: None specified
• Corresponding Digital OE: COP.2.b — the hospital uses a digital system to manage and record nursing care plans for IPD patients
• Category: Gold, Platinum only

IPD Digital Feedback %

IPD Digital Feedback % measures how many inpatient discharges were accompanied by at least one digitally-collected piece of feedback.

• Formula: (Number of unique discharges accompanied by at least one digital feedback ÷ Total number of unique discharges) × 100
• Inclusion: Feedback collected via SMS, kiosk, IVRS, or similar digital channels
• Exclusion: Feedback collected on paper or verbally
• Corresponding Digital OE: AAC.8.a — the hospital uses a digital system to collect patient and/or family member’s feedback
• Category: Silver, Gold, Platinum

The Remaining Six KPIs, At a Glance

The appendix’s other six KPIs follow the same formula-and-criteria structure. OPD Digital Feedback % is the outpatient counterpart to IPD Digital Feedback %, tied to the same AAC.8.a Objective Element. The rest connect the appendix back to chapters already covered in this series.

Indicator	What It Measures	Corresponding Digital OE	Category
OPD Digital Feedback %	Unique OPD consultations with at least one digital feedback, over total unique consultations	AAC.8.a	Silver, Gold, Platinum
Digital IPD Billing %	Discharge bills created digitally, over total discharges	FPM.3.e	Silver, Gold, Platinum
Digital Discharge Summaries/LAMA %	Discharge summaries created digitally (paper-only summaries excluded), over unique discharges	AAC.7.a	Silver, Gold, Platinum
System Uptime	Total system uptime for critical healthcare applications, against planned downtime — targeted at 99% including scheduled maintenance	DOM.2.c	Gold, Platinum
Access and Security	Number of cyber or security attacks detected by intrusion detection, anti-virus, or firewall systems	DIS.2.c	Silver, Gold, Platinum
IT Support	Percentage of IT support tickets resolved within agreed SLA	DOM.3.c	Gold, Platinum

KPI Appendix at a Glance — All 11 Indicators

#	Indicator	Unit	Category
1	Digital Appointment %	Percentage	Silver, Gold, Platinum
2	ABHA Creation	Number	Gold, Platinum
3	Digital Prescription %	Percentage	Silver, Gold, Platinum
4	Digital Nursing Notes %	Percentage	Gold, Platinum
5	IPD Digital Feedback %	Percentage	Silver, Gold, Platinum
6	OPD Digital Feedback %	Percentage	Silver, Gold, Platinum
7	Digital IPD Billing %	Percentage	Silver, Gold, Platinum
8	Digital Discharge Summaries/LAMA %	Percentage	Silver, Gold, Platinum
9	System Uptime	Percentage	Gold, Platinum
10	Access and Security	Number	Silver, Gold, Platinum
11	IT Support	Percentage	Gold, Platinum
Total	11 KPIs, all reported monthly	—	7 at Silver, 4 added at Gold

The Self-Check: Pick 3, Measure This Month

A hospital doesn’t need a formal assessment to start measuring. It needs three KPIs and a month of data.

1. Pick 3 KPIs from the Silver-tier list — Digital Appointment %, Digital Prescription %, and either IPD or OPD Digital Feedback % are a reasonable starting set, since all three map to systems most hospitals already have some version of (a booking channel, a prescribing workflow, a feedback mechanism).
2. Pull the raw numbers for one month — total OPD consultations, and how many of those were booked digitally, prescribed digitally, or followed by digital feedback. Most HIMS/EMR systems can produce these directly; where they can’t, that gap is itself informative.
3. Calculate the actual percentage — not an estimate. A hospital that assumes “we’re probably around 60% digital appointments” and calculates 23% has learned something no GAP analysis conversation would have surfaced as precisely.
4. Compare against the Objective Element, not just the number — a 40% Digital Appointment % isn’t just “below half.” It’s a specific, measurable gap against AAC.3.a, which means the fix is specific too: expand the digital booking channels available, not “improve digital adoption” in the abstract.

This is the exercise the brief for this piece describes directly: measuring gives an honest, numbers-based starting point instead of guessing “we’re probably mostly compliant already.”

From a Feeling to a Number

Every chapter piece in this series has made some version of the same point: a hospital that “has a HIMS” isn’t the same as a hospital that satisfies a specific Objective Element. The KPI appendix is where that distinction stops being conceptual and becomes arithmetic.

“We’re probably mostly compliant already” is not a number. 23% is a number. The gap between those two statements is exactly what this appendix exists to close — and it does so without requiring a formal NABH assessment, a consultant, or even much more than a month of data a HIMS is likely already generating.

This is the same instinct behind why hospitals need a business-of-medicine practice built on evidence rather than assumption — a system that works is one whose owners can actually measure whether it’s working, not one they assume is fine because nothing has visibly broken.

Closing the Loop: KPIs Tie Back to Specific Chapters

Every KPI in the appendix maps to a named Objective Element covered elsewhere in this series — which means a hospital that has already read the relevant chapter piece has a head start on knowing exactly what a low KPI number is pointing at.

• Digital Appointment %, ABHA Creation, OPD Digital Feedback %, IPD Digital Feedback %, and Digital Discharge Summaries/LAMA % all map to AAC Objective Elements — see “NABH Digital Health Standard for Hospital’s AAC Chapter Explained.“
• Digital Prescription % and Digital Nursing Notes % map to COP Objective Elements — see “NABH’s COP Chapter Explained.“
• Digital IPD Billing % maps to FPM.3.e — see “NABH Digital Health Standard for Hospital’s FPM Chapter Explained.“
• System Uptime and IT Support map to DOM Objective Elements — see “NABH Digital Health Standard for Hospital’s DOM Chapter Explained.“
• Access and Security maps to DIS.2.c — see “NABH’s DIS Chapter Explained.“

A hospital that has been working through this series chapter by chapter doesn’t need to start the KPI appendix cold — it can go straight to the KPIs tied to the chapters it has already assessed.

FAQ

How many KPIs are in NABH’s Digital Health Standard appendix?

11, each with a defined formula, unit, and reporting frequency. All 11 are reported monthly.

Do all 11 KPIs apply at Silver tier?

No. Only 7 apply from Silver onward (Digital Appointment %, Digital Prescription %, IPD Digital Feedback %, OPD Digital Feedback %, Digital IPD Billing %, Digital Discharge Summaries/LAMA %, and Access and Security). The remaining 4 — ABHA Creation, Digital Nursing Notes %, System Uptime, and IT Support — only become relevant at Gold or Platinum.

What does the NABH digital appointment percentage formula actually count?

{Number of OPD consultations booked digitally (telephonically, through website, or app) ÷ Total number of OPD consultations including walk-ins} × 100. It excludes visit types that don’t require a direct clinician consultation, such as dialysis, chemotherapy, and vaccination visits.

Can a hospital measure these KPIs before pursuing formal NABH accreditation?

Yes — that’s the point of this appendix. Every formula in it can be calculated from data most HIMS/EMR systems already produce, without waiting for a formal assessment.

The Decision

The KPI appendix doesn’t ask a hospital to do anything new. It asks the hospital to measure what it’s already doing, precisely, instead of estimating it. Picking 3 KPIs and running the numbers for one month costs almost nothing and replaces a guess with a fact — and that fact points directly at a named Objective Element, in a chapter this series has already covered.