JMIR Publications

ABSTRACT

Background:

Although several digital health interventions (DHIs) have shown promise in the care of skin diseases their uptake in Germany has been limited. To fully understand the reasons for the low uptake, an in-depth analysis of patients' and healthcare providers' barriers and facilitators in dermatology is needed.

Objective:

We aimed to investigate the attitudes and perceptions of patients, dermatologists, and nurses towards DHIs in dermatology and to identify potential barriers and facilitators to their implementation.

Methods:

We conducted six focus groups each with dermatological patients (n=34), dermatologists (n=30), and nurses (n=30) using semi-structured guidelines with short descriptions of DHIs described in the literature. A content analysis was performed using deductive and inductive categories.

Results:

Patients identified many positive performance expectancies, such as reduced travel times and improvement of follow-up appointments. Dermatologists also stated positive effects (e.g., promotion of standardized care), but also negative implications of healthcare digitalization (e.g., increased workload). All stakeholders reported that a DHI should bring additional value to all stakeholders. A lack of digital competence among patients was identified as the major barrier to DHI adoption by all three groups. Nurses and dermatologists want applications that are easy to use and easy to implement into their daily routines. Trust in selected institutions (e.g., physician or patient associations), colleagues, and physicians was identified as a facilitator for DHIs. Patients reported their dependence on the dermatologists’ acceptance. All groups expressed concerns about data privacy risks and dermatologists even stated insecurities towards data privacy laws.

Conclusions:

To ensure successful digitalization in dermatology, applications should be user-friendly, adapted to users' skill levels, and beneficial for all stakeholders. The incorporation of dermatologists’ perspective is especially important as their acceptance may impact utilization among patients and nurses. DHIs should ensure and be transparent about data privacy. The found barriers and facilitators can be used for implementation strategies and thus enhance the delivery of dermatological care.