Introduction: Why Measure Digital Maturity in GP Practices
General practitioner (GP) practices face ongoing challenges, including demographic shifts, specialist shortages, and uneven rural-urban distribution. Digital solutions—such as electronic health records, telemedicine, health apps, and intelligent scheduling—hold promise for improving efficiency and patient access. Yet to harness these benefits, GP practices need reliable ways to assess where they stand on digital maturity and where to invest next.
To address this gap, researchers developed and validated a screening instrument specifically designed for GP practices. The goal was to identify empirically grounded dimensions of digital maturity and to create a practical questionnaire that is both scientifically robust and usable in everyday practice.
What Digital Maturity Means in Outpatient Care
Digital maturity in GP settings encompasses a mix of structural, process, and outcome-oriented factors. Previous work in hospital settings, and in select GP initiatives, suggested several domains, but standardized, psychometrically validated tools for GP practices remained scarce. The present study aimed to fill that void by deriving a six-dimension, 16-item instrument through rigorous exploratory and confirmatory factor analyses.
Methods in Brief: How the Instrument Was Built and Tested
The study used a web-based cross-sectional design, surveying German GPs. Following CHERRIES guidelines, an online questionnaire was deployed via LimeSurvey to a random sample of practitioners. Data cleaning, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were conducted to identify and validate the underlying dimensions.
Item development drew on qualitative work with experts and practice representatives. An expert panel refined items across dimensions, with pretesting (n=20) to sharpen content validity and reliability. Ethical approval was secured, and informed consent was obtained from all participants.
The Result: A Validated, Multi-Dimensional Tool
The final instrument comprises 6 dimensions and 16 items, designed to measure a GP practice’s digital maturity. The dimensions cover:
- Effects of digitalization
- Participation of practice staff
- Maturity of the practice management system
- Staff competencies and sense of responsibility
- IT security and data protection
- Digitally supported processes
In the validation sample (n=201), the overall scale demonstrated good internal consistency (Cronbach alpha = 0.81). The mean digital maturity score was 3.77 out of 5, suggesting substantial room for targeted improvement across many practices. IT security and data protection emerged as the strongest area, while the effects of digitalization indicated the greatest opportunity for growth.
Implications for Practice, Policy, and Research
For GP practices, the instrument provides a structured way to benchmark digital maturity, identify gaps, and guide investments in infrastructure and staff development. The results can support internal discussions, strategic planning, and collaborative benchmarking across practices.
For policymakers and funders, a validated measure enables standardized needs assessments and the tracking of digitalization initiatives over time. Germany’s push toward digitization in outpatient care could leverage such a tool to allocate resources effectively and monitor progress against national digital health goals.
From a research perspective, this work lays a foundation for longitudinal studies linking digital maturity to the successful deployment of digital systems, patient outcomes, and workforce satisfaction. Future work should consider expanding the instrument to other outpatient specialties, and possibly to a broader set of health professionals beyond GP physicians.
Limitations and Opportunities for Improvement
The study acknowledges several limitations, including a German-language validation sample and the use of a single dataset for exploration and confirmation. Some dimensions were represented by only two items, which can constrain reliability. Further work should broaden sample sizes, add more indicators per dimension, and test the instrument in diverse primary care settings, including multi-disciplinary teams and different health systems.
Conclusion
This study presents the first empirically validated questionnaire to measure digital maturity in GP practices. The six-dimension, 16-item instrument captures the multifaceted nature of digital transformation in outpatient care and offers a practical means to guide improvement, benchmarking, and policy planning. As digital health evolves, ongoing refinement and wider validation will help ensure the tool remains relevant across settings and over time.
