Digital maturity and its determinants in General Practice: A cross-sectional study in 20 countries

Fábia Teixeira , Edmund Li, Lilana Laranjo, Claire Collins, GREG IRVING, Maria Jose Fernandez, Josip Car, Mehmet Ungan , Davorina Petek, Robert Hoffman, Azeem Majeed, Katarzyna Nessler, Heidrun Lingner, Geronimo Jimenez, Ara Darzi, Cristina Jácome, Ana Luísa Neves on behalf of the inSIGHT

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

5 Citations (Scopus)
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Background: The extent to which digital technologies are employed to promote the delivery of high-quality healthcare is known as Digital Maturity. Individual and systemic digital maturity are both necessary to ensure a successful, scalable and sustainable digital transformation in healthcare. However, digital maturity in primary care has been scarcely evaluated.

Objectives: This study assessed the digital maturity in General Practice (GP) globally and evaluated its association with participants' demographic characteristics, practice characteristics and features of Electronic Health Records (EHRs) use.

Methods: GPs across 20 countries completed an online questionnaire between June and September 2020. Demographic data, practice characteristics, and features of EHRs use were collected. Digital maturity was evaluated through a framework based on usage, resources and abilities (divided in this study in its collective and individual components), interoperability, general evaluation methods and impact of digital technologies. Each dimension was rated as 1 or 0. The digital maturity score was calculated as the sum of the six dimensions and ranged between 0 to 6 (maximum digital maturity). Multivariable linear regression was used to model the total score, while multivariable logistic regression was used to model the probability of meeting each dimension of the score.

Results: One thousand six hundred GPs (61% female, 68% Europeans) participated. GPs had a median digital maturity of 4 (P25–P75: 3–5). Positive associations with digital maturity were found with: male gender [B = 0.18 (95% CI 0.01; 0.36)], use of EHRs for longer periods [B = 0.45 (95% CI 0.35; 0.54)] and higher frequencies of access to EHRs [B = 0.33 (95% CI 0.17; 0.48)]. Practicing in a rural setting was negatively associated with digital maturity [B = −0.25 (95%CI −0.43; −0.08)]. Usage (90%) was the most acknowledged dimension while interoperability (47%) and use of best practice general evaluation methods (28%) were the least. Shorter durations of EHRs use were negatively associated with all digital maturity dimensions (aOR from 0.09 to 0.77).

Conclusion: Our study demonstrated notable factors that impact digital maturity and exposed discrepancies in digital transformation across healthcare settings. It provides guidance for policymakers to develop more efficacious interventions to hasten the digital transformation of General Practice.
Original languageEnglish
Title of host publicationPerspectives in digital health and big data in medicine
Subtitle of host publicationCurrent trends, professional challenges and ethical legal and social implications
EditorsJoão Valente Cordeiro, Liliana Laranjo
ISBN (Electronic)978-2-8325-3704-6
Publication statusPublished - 13 Jan 2023

Publication series

NameResearch Topics


  • digital maturity
  • digital technology
  • electronic health records
  • health information interoperability
  • primary care
  • quality of care

Research Centres

  • Edge Hill Primary and Integrated Care Research Centre


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