A Novel Framework to Assess Clinical Information in Digital Health Technologies: Cross-Sectional Survey Study

Digital health is a critical driver of quality, safety, and efficiency in health care. However, poor quality of clinical information in digital health technologies (DHTs) can compromise the quality and safety of care. The Clinical Information Quality (CLIQ) framework was developed, based on a systemic review of literature and an international eDelphi study, as a tool to assess the quality of clinical information in DHTs.

The aim of this study is to assess the applicability, internal consistency, and construct validity of the CLIQ framework.

This study was conducted as a cross-sectional survey of health care professionals across the United Kingdom who regularly use SystmOne electronic health records. Participants were invited through emails and social media platforms. The CLIQ questionnaire was administered as a web-based survey. Spearman correlation coefficients were computed to investigate the linear relationship between the dimensions in the CLIQ framework. The Cronbach α coefficients were computed to assess the internal consistency of the global scale (ie, CLIQ framework) and the subscales (ie, the informativeness, availability, and usability categories). Confirmatory factor analysis was used to assess the extent to which the survey data supported the construct validity of the CLIQ framework.

A total of 109 health care professionals completed the survey, of which two-thirds (67, 61.5%) were doctors and a quarter (26, 23.9%) were nurses or advanced nurse practitioners. Overall, the CLIQ dimensions had good quality scores except for portability, which had a modest score. The inter-item correlations were all positive and not likely due to chance. The Cronbach α coefficient for the overall CLIQ framework was 0.89 (95% CI 0.85-0.92). The confirmatory factor analysis provided a modest support for the construct validity of the CLIQ framework with the comparative fit index of 0.86 and standardized root mean square residual of 0.08.

The CLIQ framework demonstrated a high reliability and a modest construct validity. The CLIQ framework offers a pragmatic approach to assessing the quality of clinical information in DHTs and could be applied as part of information quality assurance systems in health care settings to improve quality of health information.