JMIR Publications

ABSTRACT

Background:

Teledermatology (TD) consists on the application of information and communication technologies (ICTs) for the care of skin diseases. The studies on TD indicate that it seems to be effective in diagnosing early malignant pathologies such as melanoma, and in reducing the waiting lists by prioritizing the urgent pathology. Despite these advantages, the implementation of TD is still low in many areas. Previously, most studies have focused on analysing the results of TD use. However, to fully understand TD it is necessary to consider the determinants of its use

Objective:

This study analyses the determinants of the intentions of medical professionals to use TD in their healtcare institution.

Methods:

A survey that targeted a total population of 743 medical professionals from a healthcare institution in Spain was used. The study simple was formed by 223 doctors (39% were dermatologists and 61% primary care physicians). Using an extended Technology Acceptance Model and microdata for the 223 physicians, the user's ICT profile (clusters analysis) and a binary logistic regression analysis were carried out.

Results:

This analysis showed the presence of three clusters in the sample with respect to the use of technology (Cluster 1: advanced use of ICTs, Cluster 2: moderate use of ICTs, Cluster 3: scarce use of ICTs). The analysis performed confirmed the model's goodness-of-fit, which allowed 69 percent of the variable's variance to be explained. The outcomes revealed that the factors that were most important when implanting a TD system were: user's ICT profile, system efficiency and preference of the subjects involved (p <0.005). The quality of the assistance, the difficulties due to the use of technology (information security and confidentiality) or the interest of the administration were not decisive factors for the implementation of TD. Subsequently, we performed a logistic regression separating the samples between primary care doctors and dermatologists. For the former, the determining factors were the ICT profile and the efficiency of the system; while between dermatologists only the preference of each of the individual seem to be determining.

Conclusions:

The use of TD should be accompanied by a comprehensive program of validation and evaluation. These results show that there is a difference between determinants of the implementation of TD according to the subjects involved. Therefore, it is essential to perform studies prior to the implementation of a TD system, to identify and to influence the aforementioned predictive factors