An increasing focus has been placed on clean energy, carbon neutrality, carbon footprint monitoring, and adaptation of building information modeling (BIM)-based facility management (FM). Hence, there is also a growing demand to evaluate and prioritize which BIM applications are the most relevant to FM and are the most beneficial in the asset lifecycle, particularly in the operations stage. To inform BIM-FM application on smart hospital management, this research introduces a one-systems method through an interpretive structural model (ISM) to establish a structural contextual interrelationship between BIM uses in the operations stages of the asset. Through a literature review, this research first summarizes facility management functionalities achievable by BIM-FM and establishes their pairwise contextual relationship. A structural self-interaction matrix (SSIM) is then established, followed by partitioning these functionalities into separate levels to form the ISM model, while using driving power and dependence to form a MICMAC analysis matrix. The finding that the BIM uses “Environmental Monitoring and Building Performance” is the foundation that enables the other functionalities whilst validating that ad-hoc operations and maintenance activities enablement has the highest driving power, and automation and robotics have the highest dependency. Among the applications, energy monitoring plays a pivotal and transitional role with a strong dependency between airflow monitoring and solar monitoring, while its performance would directly impact emergency responses.