ISO 81001-1 Edition 2 establishes fundamental principles and conceptual frameworks for ensuring safety, effectiveness, and security of health software and health information technology systems. Currently in Committee Draft (CD) stage under ISO/TC 210/WG1, the document is undergoing international standardization review with a voting deadline of March 27, 2026. This standard serves as a foundational framework supporting medical device software regulation globally, providing overarching principles that align with and complement harmonized standards including IEC 62304, ISO 14971, and others. The document addresses the integrated governance of safety, effectiveness, and cybersecurity across the health software lifecycle. Manufacturers should reference this standard to establish consistent quality management approaches and risk governance frameworks applicable to health software and IT systems. Edition 2 reflects evolving regulatory expectations regarding artificial intelligence, machine learning, and connected health technologies in the medical device ecosystem.