Development and validation of a proposal for a Charter of Citizens' Rights and Commitments regarding eHealth

There is a new technological paradigm in health care which has been reinforced following the outbreak of the Covid-19 pandemic. Technological innovations create both challenges and opportunities to which citizens, healthcare professionals, and healthcare organisations must adapt to this reality. Although most health services have charters of citizens' general rights and commitments, there is no specific charter concerning eHealth.

To develop and validate a proposal of a minimum set of citizens' rights and commitments to e-Health.

Experts in a discussion group developed a charter composed of twenty items, ten rights and ten commitments to e-Health. Two rounds of consensus were necessary to obtain a final version of the charter. The twenty items were validated for content and assessed for appropriateness, relevance, and understandability using an internet-based 2-round Delphi approach in which 134 experts, patients and healthcare professionals participated. They rated the assessed attributes for each item on a 5-point Likert scale for consensus. The content validity index was calculated with kappa statistic, a consensus measure of inter-rater agreement.

In the first round, 18 items were validated, leaving only two commitments with unacceptable indices. Both were modified using the experts' contributions and entered a second round of evaluation, after which the indices met the established requirements.

A proposal for a chart of patient rights and commitments to eHealth was developed and showed adequate content validity and inter-observer reliability. This chart is expected to become a starting point for the debate on the role of technology in the way patients, professionals, and health services interact in the current context.