Research on the health assessment of historical building timber frameworks reveals that many influencing factors are interdependent and causal, with significant coupling effects between various types of damage. This not only accelerates the deterioration of historical building, but also presents challenges to the systematic accuracy of health assessment systems. This study identifies the core factors influencing the health status of historical timber frameworks and constructs an evaluation system using the decision-making trial and evaluation laboratory (DEMATEL), interpretative structural modeling (ISM), and analytic network process (ANP) methods. First, DEMATEL-ISM is employed to calculate the importance and coupling effects of these factors, establishing a hierarchical structural model for assessment. Next, the ANP method is used to determine the weights of the factors, accounting for their mutual influences. Finally, using BIM secondary development technology, a health status assessment module for historical building wooden frames is integrated into the building information model platform, enhancing the digital tools for the operation and maintenance of historical buildings. The results of this study improve the comprehensiveness and scientific rigor of health status assessments, supporting preventive preservation decisions and the establishment of digital health records for historical buildings.