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

Fernando Campaña-Castillo , Olga Paloma-Castro , José Manuel Romero-Sánchez
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Abstract

Background

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.

Objectives

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

Methods

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.

Results

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.

Conclusions

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.
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制定和论证有关电子健康的公民权利和承诺宪章提案。
背景:随着 Covid-19 大流行病的爆发,医疗保健领域出现了一种新的技术模式。技术创新带来了挑战和机遇,公民、医疗保健专业人员和医疗保健组织必须适应这一现实。尽管大多数医疗服务机构都有关于公民一般权利和承诺的章程,但却没有关于电子医疗的具体章程:方法:专家们在讨论小组中制定了一份关于电子健康的最低公民权利和承诺的宪章:方法:专家们在一个讨论小组中制定了一份由二十个项目组成的宪章,其中包括十项权利和十项对电子健康的承诺。宪章的最终版本需要经过两轮协商一致。134 名专家、患者和医护人员参与了这两轮德尔菲法,对这 20 个项目的内容进行了验证,并对其适当性、相关性和可理解性进行了评估。他们采用 5 点李克特量表对每个项目的评估属性进行评分,以达成共识。内容有效性指数通过卡帕统计量(一种衡量评分者之间一致性的共识指标)计算得出:结果:第一轮共有 18 个项目通过验证,只有两项承诺的指数无法接受。这两项承诺都根据专家的意见进行了修改,并进入了第二轮评估,之后,这两项承诺的指数都达到了既定要求:结论:我们提出了一份关于电子医疗患者权利和承诺表的建议,该表显示了足够的内容有效性和观察者之间的可靠性。在当前情况下,该图表有望成为讨论技术在患者、专业人员和医疗服务互动方式中的作用的起点。
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