JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic affected the delivery of primary care and stimulated the use of digital health solutions such as remote digital dermatology care. In the Netherlands, remote store-and-forward digital dermatology care was already integrated into Dutch general practice before the COVID-19 pandemic. However, it is unclear how GPs experienced this existing digital dermatology care during the pandemic period.

Objective:

We investigated GPs’ experienced barriers and facilitators on store-and-forward digital dermatology care during the COVID-19 pandemic in the Netherlands from a sociotechnical approach.

Methods:

In December 2021, a web-based questionnaire was distributed by email to approximately 3170 GPs who had performed a digital dermatology consultation in the previous 2 years. The questionnaire consisted of general background questions, questions from a previously validated telemedicine service user-satisfaction questionnaire, and newly added questions related to the pandemic and use of the digital dermatology service in general practice. The open-ended and free-text responses were analyzed for barriers and facilitators using content analysis guided by an eight-dimensional sociotechnical model.

Results:

71 GPs completed the entire questionnaire and 66 questionnaires were included in the data analysis. Most GPs reported that they used digital dermatology as often during as before the pandemic. Although GPs were overall satisfied with the digital dermatology service, the platform and the telemedicine organization, they also experienced crucial barriers in the use of the service during the pandemic. These barriers were (1) their (GPs’) and patients’ limited digital photography skills, (2) costs and lack of appropriate equipment, (3) human computer interface and interoperability issues on the telemedicine platform, and (4) different use procedures of the digital dermatology service.

Conclusions:

Even though remote dermatology care was already integrated into Dutch GP practice before the pandemic, which may have facilitated the positive responses of GPs on the use of the service, barriers impeded the full potential of its use during the pandemic. Training is needed to improve the use of equipment and photo quality of (dermoscopy) images taken by GPs and to inform GPs in which circumstances they can(not) use digital dermatology. Furthermore, the remote dermatology platform should be improved to also guide patients in taking photos of sufficient quality.