143 GPS’ PERSPECTIVES ABOUT REMOTE DERMATOLOGY CARE DURING THE COVID-19 PANDEMIC Dimension Facilitating quotes (%) Neutral quotes (%) Impeding quotes (%) Exemplary relevant quotes People (n=65) 8 (12) 51 (78) 6 (9) • “[I learned] which questions are suitable for teleconsultation.” [ID 1710]b • “The learning capacity [of digital dermatology consultation] is strong. I notice that the number of consultations has decreased, partly due to the learning curve of comparable consultations.” [ID 1692]b • “The patient’s photography skills are on average poor (and so are the photographs).” [DHC; ID 1257]a • “The patient is not trained how [to take photographs].” [DHC; ID 1692]a Workflow and communication (n=13) 3 (23) 4 (31) 6 (46) • “Patients like [digital consultations] for a while but then want to be seen [physically] again. However, there is an increase in e-consultations that is partly extra and possibly better care, but certainly no relief from work.” [ID 1188]a Internal organizational policies, procedures, and culture (n=78) 1 (1) 66 (85) 11 (14) • “[I take photographs] with my own camera on [my] smartphone. That [camera] is fine. Only the attachment no longer fits and is no longer supplied unfortunately. Another stand-alone USB version would be possible, but it costs quite a lot. A little discount through [the telemedicine organization] (win-win) would have been nice...It is a pity that [the telemedicine organization] does not invest so much in teledermatology anymore. Devices used to be ‘free’ if you performed enough [consultations]. Now that is no longer the case, I perform fewer [consultations]. Because the attachment no longer fits. I think that we both benefit less from that. Then I just refer to the dermatologist.” [ID 1363]a • “Offer better phones as was common practice 4 years ago. This is an extra incentive to use the dermatology service and guarantees quality of the photo cameras.” [ID 1349]a Table 7.4: Exemplary quotes of open-ended and free-text remarks for each of the 8 dimensions of the sociotechnical model by Sittig and Singh [25]. (continued) 7
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