Adoption numbers say how often the system is used. Health says whether what ships still looks like what was approved. Most teams measure little: in the zeroheight Design Systems Report 2026, 41% of teams measure adoption and 26% measure product consistency (zeroheight).
The signals behind it
One score, with the list behind it
Leadership needs one number, and teams need the findings behind it. A simple score weights findings by reach. For example (illustrative): if 2,400 usages of tokens and components are tracked and 120 of them are affected by open divergences or bypasses, health is 100 × (1 − 120 ÷ 2,400) = 95.
Time to fix stays outside the score and is tracked next to it as a trend, such as the median number of days a finding stays open.
What to avoid
A score nobody can open is a vanity metric. Every point lost should lead to a finding someone can fix. And the score should be recomputed automatically, on every push or on a schedule, so the trend is real rather than a quarterly guess.