Grounded Analytical Pathways in eHealth Policy: Making Expert Reasoning Visible Through Integrated Qualitative Delphi Design

The Delphi method is widely employed in social and health research to explore complex problems, structure expert knowledge, and support collective processes of knowledge development. However, its qualitative and mixed-method applications sometimes display methodological ambiguity and limited standardization. In particular, the early stages of open-ended question design and narrative data analysis remain insufficiently defined, hindering comparability, transparency, and theoretical depth. This article proposes a systematic methodological framework for the design, analysis, validation and reporting of qualitative and mixed Delphi. Its aim is to contribute to the methodological development of these approaches by synthesizing existing debates and operationalizing procedures for transforming expert narratives into analytically grounded categories through iterative feedback and validation processes. Drawing on selected principles from Grounded Theory, the proposed approach emphasizes the systematic exploration and refinement of meanings, interpretations and expert perspectives. The framework is illustrated through a Delphi study on eHealth conducted in Spain. The case demonstrates how reflexive question formulation, transparent feedback mechanisms, and explicit validation criteria can support the Delphi as a robust strategy for the collective generation of situated, theoretically grounded knowledge. Ultimately, the qualitative Delphi emerges as a deliberative and structured methodology, capable of bridging empirical complexity and theoretical construction while providing a rigorous foundation for evidence-informed public policy. In conclusion, this study presents a methodological framework that highlights the independence and usefulness of the technique in exploratory or emerging contexts.