Development and Validation of a Questionnaire to Measure Digital Maturity of General Practitioner Practices: Web-Based Cross-Sectional Survey Study

Abstract

Background: The digital transformation in health care requires valid instruments to assess the level of digitalization. Maturity models are widely used to measure the digital maturity level of institutions. To date, however, there is no standardized and empirically grounded measurement tool for general practices in outpatient care. Objective: This study aimed to identify and validate the key dimensions of digital maturity in order to develop a questionnaire to measure the digital maturity of general practices. The development of a questionnaire was intended to advance research into maturity models in outpatient care and provide general practitioners (GPs) and policymakers with a tool for the digital transformation process. Methods: A web-based cross-sectional survey study was conducted among GPs in Germany. Based on exploratory factor analysis (EFA), the underlying dimensions of digital maturity were first identified. The factor structure was then examined using confirmatory factor analysis (CFA). After evaluating convergent and discriminant validity, the overall model fit was assessed using fit indices. Following model adjustments based on modification indices, the final questionnaire was established. Finally, we calculated the digital maturity level for our sample, both for each individual dimension and as an overall score, by computing the mean value for each dimension and an overall mean across all dimensions. Results: Responses from 201 GPs were included in the data analysis. We identified and validated 6 dimensions of digital maturity, comprising 16 items. Both convergent and discriminant validity were confirmed. The model fit was excellent (robust comparative fit index [CFI]=0.993; robust Tucker-Lewis index [TLI]=0.990; robust root mean square error of approximation [RMSEA]=0.022; P value of close fit [PCLOSE]=.98; standardized root mean square residual [SRMR]=0.043). The questionnaire included six dimensions: effects of digitalization, participation of practice staff, maturity of the practice management system, staff competencies and sense of responsibility, IT security and data protection, and digitally supported processes. The scale showed good internal consistency (overall Cronbach α=.809). In our sample, the overall digital maturity averaged 3.77 out of 5, with the highest maturity observed in IT security and data protection (mean 4.45, SD 0.61) and the lowest in effects of digitalization (mean 3.1, SD 1.0). Conclusions: This is the first study in which the dimensions of digital maturity in outpatient care for GP practices have been empirically identified and validated as the basis for developing a questionnaire. The findings provide a foundation for further research on measuring digital maturity in outpatient care and for advancing the development of digital maturity models. The questionnaire allows GPs to assess their practices’ digitalization, identify areas for improvement (eg, infrastructure, staff skills), and support internal strategy or benchmarking. For policymakers, it offers a standardized tool to plan support measures and monitor digitalization progress.