PDF(Pubmed)
Abstract：
BACKGROUND: Despite the global upscale of teledermatology during the COVID-19 pandemic, persistent barriers, such as the poor anamnesis and photo quality, hinder its effective use in practice. Understanding Dutch dermatologists\' experiences and satisfaction with using the teledermatology system in the Dutch health care system is needed. A holistic evaluation may provide valuable insight to understand how barriers interrelate which is deemed necessary for the innovation of teledermatology in practice.
OBJECTIVE: Guided by a complex adaptive system perspective, this study aims to understand Dutch dermatologists\' experience and satisfaction with their training, support communication, interaction, and usage of a teledermatology platform of a Dutch digital hospital during the COVID-19 pandemic, uncovering insights to improve teledermatology services for the future.
METHODS: A web-based questionnaire was sent in December 2021 to Dutch dermatologists who (1) had an active teledermatology platform account, and (2) responded to a teledermatology consultation between October 1, 2019, and September 30, 2021. The questionnaire consisted of the validated Store-and-Forward Telemedicine Service User-satisfaction Questionnaire (SAF-TSUQ) questionnaire, and new questions regarding; demographics of teledermatologists, the use of teledermatology during the COVID-19 pandemic, the performance of teledermatology by general practitioners (GP), and the role of dermatologists in the teledermatology process. The open-ended questions were analyzed by a grounded theory approach guided by a sociotechnical model and complemented by a complex adaptive system perspective. A panel discussion with 3 dermatologists was performed to provide additional insight into the responses to the questionnaire.
RESULTS: We obtained responses from 25 out of the 249 (10%) invited dermatologists. Overall, dermatologists had a positive experience with teledermatology. Interestingly, teledermatology use frequency remained unaffected by the COVID-19 pandemic. However, the insufficient quality and incompleteness of the clinical content (photos and anamneses information) of the teledermatology consultation impacted the efficiency of the teledermatology workflow. Dermatologists expressed the need for improvement to avoid time-consuming processes or physical referrals. The panel discussion enriched and confirmed the responses, suggesting solutions like mandatory fields for the GPs for a complete anamnesis.
CONCLUSIONS: Dutch Dermatologists view teledermatology as a valuable tool to provide access to dermatology care. However, improvements regarding the quality and completeness of the provided clinical content are necessary for the effectiveness and efficiency of the complex teledermatology system in Dutch health care. This could increase both the dermatologists\' satisfaction and the quality of teledermatology services. Managing trade-offs, such as time investments versus image quality, is crucial for teledermatology implementation and should be assessed from a complexity perspective to understand trade-offs and prevent unintended consequences.
OBJECTIVE: Guided by a complex adaptive system perspective, this study aims to understand Dutch dermatologists\' experience and satisfaction with their training, support communication, interaction, and usage of a teledermatology platform of a Dutch digital hospital during the COVID-19 pandemic, uncovering insights to improve teledermatology services for the future.
METHODS: A web-based questionnaire was sent in December 2021 to Dutch dermatologists who (1) had an active teledermatology platform account, and (2) responded to a teledermatology consultation between October 1, 2019, and September 30, 2021. The questionnaire consisted of the validated Store-and-Forward Telemedicine Service User-satisfaction Questionnaire (SAF-TSUQ) questionnaire, and new questions regarding; demographics of teledermatologists, the use of teledermatology during the COVID-19 pandemic, the performance of teledermatology by general practitioners (GP), and the role of dermatologists in the teledermatology process. The open-ended questions were analyzed by a grounded theory approach guided by a sociotechnical model and complemented by a complex adaptive system perspective. A panel discussion with 3 dermatologists was performed to provide additional insight into the responses to the questionnaire.
RESULTS: We obtained responses from 25 out of the 249 (10%) invited dermatologists. Overall, dermatologists had a positive experience with teledermatology. Interestingly, teledermatology use frequency remained unaffected by the COVID-19 pandemic. However, the insufficient quality and incompleteness of the clinical content (photos and anamneses information) of the teledermatology consultation impacted the efficiency of the teledermatology workflow. Dermatologists expressed the need for improvement to avoid time-consuming processes or physical referrals. The panel discussion enriched and confirmed the responses, suggesting solutions like mandatory fields for the GPs for a complete anamnesis.
CONCLUSIONS: Dutch Dermatologists view teledermatology as a valuable tool to provide access to dermatology care. However, improvements regarding the quality and completeness of the provided clinical content are necessary for the effectiveness and efficiency of the complex teledermatology system in Dutch health care. This could increase both the dermatologists\' satisfaction and the quality of teledermatology services. Managing trade-offs, such as time investments versus image quality, is crucial for teledermatology implementation and should be assessed from a complexity perspective to understand trade-offs and prevent unintended consequences.
摘要：
背景：尽管在COVID-19大流行期间，远程皮肤科在全球范围内普及，持久的障碍，比如糟糕的回忆和照片质量，阻碍其在实践中的有效使用。需要了解荷兰皮肤科医生的经验和在荷兰医疗保健系统中使用远程皮肤病学系统的满意度。整体评估可以提供有价值的见解，以了解障碍如何相互关联，这对于实践中的皮肤学创新是必要的。
目标：在复杂适应系统观点的指导下，这项研究旨在了解荷兰皮肤科医生的经验和对培训的满意度，支持沟通,互动,以及在COVID-19大流行期间使用荷兰数字医院的远程皮肤病学平台，发现见解，以改善未来的远程皮肤病学服务。
方法：2021年12月向荷兰皮肤科医生发送了一份基于网络的问卷，他们（1）拥有活跃的远程皮肤病学平台帐户，（2）在2019年10月1日至2021年9月30日期间回复了皮肤远程咨询。该问卷包括经过验证的存储和转发远程医疗服务用户满意度问卷（SAF-TSUQ）问卷，和新的问题；远程皮肤科医生的人口统计学，在COVID-19大流行期间使用皮肤学，全科医生(GP)的远程皮肤病学表现，以及皮肤科医生在远程皮肤病学过程中的作用。开放式问题是通过以社会技术模型为指导的扎根理论方法进行分析的，并辅之以复杂的自适应系统观点。与3位皮肤科医生进行了小组讨论，以提供对问卷答复的更多见解。
结果：我们从249位受邀皮肤科医生中的25位（10％）获得了响应。总的来说,皮肤科医生在远程皮肤科有积极的经验。有趣的是,远程皮肤科的使用频率仍不受COVID-19大流行的影响。然而,远程皮肤科会诊的临床内容(照片和查询信息)质量不足和不完整影响了远程皮肤科工作流程的效率。皮肤科医生表示需要改进，以避免耗时的过程或物理转诊。小组讨论丰富并确认了答复，建议解决方案，如全科医生的强制性字段，以进行完整的回忆。
结论：荷兰皮肤科医生认为远程皮肤科是提供皮肤科护理的宝贵工具。然而,有关提供的临床内容的质量和完整性的改进对于荷兰医疗保健中复杂的远程皮肤病学系统的有效性和效率是必要的。这可以提高皮肤科医生的满意度和远程皮肤科服务的质量。管理权衡，例如时间投资与图像质量，对于远程皮肤病学的实施至关重要，应从复杂性角度进行评估，以了解权衡并防止意外后果。
目标：在复杂适应系统观点的指导下，这项研究旨在了解荷兰皮肤科医生的经验和对培训的满意度，支持沟通,互动,以及在COVID-19大流行期间使用荷兰数字医院的远程皮肤病学平台，发现见解，以改善未来的远程皮肤病学服务。
方法：2021年12月向荷兰皮肤科医生发送了一份基于网络的问卷，他们（1）拥有活跃的远程皮肤病学平台帐户，（2）在2019年10月1日至2021年9月30日期间回复了皮肤远程咨询。该问卷包括经过验证的存储和转发远程医疗服务用户满意度问卷（SAF-TSUQ）问卷，和新的问题；远程皮肤科医生的人口统计学，在COVID-19大流行期间使用皮肤学，全科医生(GP)的远程皮肤病学表现，以及皮肤科医生在远程皮肤病学过程中的作用。开放式问题是通过以社会技术模型为指导的扎根理论方法进行分析的，并辅之以复杂的自适应系统观点。与3位皮肤科医生进行了小组讨论，以提供对问卷答复的更多见解。
结果：我们从249位受邀皮肤科医生中的25位（10％）获得了响应。总的来说,皮肤科医生在远程皮肤科有积极的经验。有趣的是,远程皮肤科的使用频率仍不受COVID-19大流行的影响。然而,远程皮肤科会诊的临床内容(照片和查询信息)质量不足和不完整影响了远程皮肤科工作流程的效率。皮肤科医生表示需要改进，以避免耗时的过程或物理转诊。小组讨论丰富并确认了答复，建议解决方案，如全科医生的强制性字段，以进行完整的回忆。
结论：荷兰皮肤科医生认为远程皮肤科是提供皮肤科护理的宝贵工具。然而,有关提供的临床内容的质量和完整性的改进对于荷兰医疗保健中复杂的远程皮肤病学系统的有效性和效率是必要的。这可以提高皮肤科医生的满意度和远程皮肤科服务的质量。管理权衡，例如时间投资与图像质量，对于远程皮肤病学的实施至关重要，应从复杂性角度进行评估，以了解权衡并防止意外后果。
