Key indicators of ethical challenges in digital healthcare: A combined Delphi exploration and confirmative factor analysis approach with evidence from Khorasan province in Iran

Despite the undoubted benefits of digital healthcare, ethical challenges have become one of the biggest concerns amongst academic scholars and digital healthcare experts. Despite the extant literature on some of these challenges, knowledge gaps still exist in revealing which indicators are more important than others. This research, joining in the ongoing investigation, aims to explore and empirically validate the key indicators of ethical challenges in digital healthcare. We conduct two studies using a combined exploratory and confirmatory approach. We apply the Delphi method for exploring and forecasting the key indicators in the first study. The key indicators are validated in the second study employing confirmatory factor analysis of survey data. The Delphi experts are 26 medical professionals and academic professors in Iran. A sample of 210 survey observations was collected from general hospital staff in Iran. Our results suggest that there are six key indicators of ethical challenges in digital healthcare: procedure values, responsibility, privacy, autonomy, security, justice. This research contributes to the knowledge of ethical concerns in applying digital technologies in healthcare, particularly identifying and validating the key indicators of the ethical challenges. The results provide practical implications for decision-makers in the current and future digital healthcare sector.