Strengthening Continuity of Care during Infectious Disease Emergencies: An ISO 22301–based Business Continuity Maturity Roadmap with Digital and AI Enablers

<div> Background: Continuity of care during infectious disease emergencies depends on resilient operations, digital infrastructure, and prepared staff, yet BCMS implementation is often fragmented.&nbsp; </div> <div> <br> </div> <div> Methods: We developed an ISO 22301–aligned BCMS framework integrating evidence synthesis, a five-level maturity model, tiered critical-service recovery targets (RTO/RPO), and a 36-month implementation roadmap with digital enablement and optional AI modules. The framework was implemented in 12 healthcare organizations and evaluated using incident/downtime logs, recovery metrics, staff readiness surveys, ISO 22301 clause-fulfillment audits, and a cost-of-disruption model. </div> <div> &nbsp; </div> <div> Results: Mean total downtime incidents decreased by 53% (40–62%), with a 67% reduction in Tier-1 critical disruptions. RPO achievement improved from 51% to 93%; downtime procedure compliance from 46% to 83%; and staff readiness from 51% to 93%. ISO 22301 fulfillment rose from 31% to 87%, while high-severity audit findings fell by 83%. BCMS maturity increased from 1.8 to 3.3 (1–5). Modeled payback was 19 months (14–24) with a 3-year ROI of 271% (127–412%).&nbsp; </div> <div> <br> </div> <div> Conclusions: A staged, metrics-anchored ISO 22301 approach can reduce disruptions, improve recovery performance, and strengthen preparedness; prospective studies should evaluate AI-assisted risk forecasting and response orchestration. </div>