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

Kayode Philip Fadahunsi; Petra A Wark; Nikolaos Mastellos; Ana Luisa Neves; Joseph Gallagher; Azeem Majeed; Josip Car

doi:10.2196/58125

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

Kayode Philip Fadahunsi
, Petra A Wark
, Nikolaos Mastellos
, Ana Luisa Neves
, Joseph Gallagher
, Azeem Majeed
, Josip Car

University College Dublin
Imperial College London

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

41 Downloads (Pure)

Abstract

BACKGROUND: 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.

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

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

Original language	English
Article number	e58125
Number of pages	12
Journal	JMIR Medical Informatics
Volume	13
DOIs	https://doi.org/10.2196/58125
Publication status	Published - 30 May 2025

Bibliographical note

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited.

Funding

The authors are grateful to all health care professionals who participated in this survey. ALN is supported by the National Institute for Health and Care Research (NIHR) Patient Safety Translational Research Centre and the NIHR Biomedical Research Centre. AM and JC are supported by NIHR Applied Research Collaboration Northwest London. The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. KPF\u2019s doctoral research was funded by the Federal Government of Nigeria.

Funders
National Institute for Health and Care Research
NIHR Biomedical Research Centre
NIHR ARC South London
Federal Government of Nigeria

Keywords

Cross-Sectional Studies
Humans
Surveys and Questionnaires
United Kingdom
Male
Female
Adult
Electronic Health Records
Health Personnel/statistics & numerical data
Reproducibility of Results
Middle Aged
Digital Health

Access to Document

10.2196/58125Licence: CC BY

medinform-2025-1-e58125Final published version, 427 KBLicence: CC BY

Cite this

@article{c401bf32417a43a98f7706e7a6f9091a,

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

abstract = "BACKGROUND: 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.OBJECTIVES: The aim of this study is to assess the applicability, internal consistency, and construct validity of the CLIQ framework.METHODS: 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.RESULTS: 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.CONCLUSIONS: 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.",

keywords = "Cross-Sectional Studies, Humans, Surveys and Questionnaires, United Kingdom, Male, Female, Adult, Electronic Health Records, Health Personnel/statistics \& numerical data, Reproducibility of Results, Middle Aged, Digital Health",

author = "Fadahunsi, \{Kayode Philip\} and Wark, \{Petra A\} and Nikolaos Mastellos and Neves, \{Ana Luisa\} and Joseph Gallagher and Azeem Majeed and Josip Car",

note = "This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited. ",

year = "2025",

month = may,

day = "30",

doi = "10.2196/58125",

language = "English",

volume = "13",

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T1 - A Novel Framework to Assess Clinical Information in Digital Health Technologies

T2 - Cross-Sectional Survey Study

AU - Fadahunsi, Kayode Philip

AU - Wark, Petra A

AU - Mastellos, Nikolaos

AU - Neves, Ana Luisa

AU - Gallagher, Joseph

AU - Majeed, Azeem

AU - Car, Josip

N1 - This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited.

PY - 2025/5/30

Y1 - 2025/5/30

N2 - BACKGROUND: 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.OBJECTIVES: The aim of this study is to assess the applicability, internal consistency, and construct validity of the CLIQ framework.METHODS: 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.RESULTS: 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.CONCLUSIONS: 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.

AB - BACKGROUND: 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.OBJECTIVES: The aim of this study is to assess the applicability, internal consistency, and construct validity of the CLIQ framework.METHODS: 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.RESULTS: 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.CONCLUSIONS: 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.

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KW - Male

KW - Female

KW - Adult

KW - Electronic Health Records

KW - Health Personnel/statistics & numerical data

KW - Reproducibility of Results

KW - Middle Aged

KW - Digital Health

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

Abstract

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