144 CHAPTER 7 Dimension Facilitating quotes (%) Neutral quotes (%) Impeding quotes (%) Exemplary relevant quotes External rules, regulations, and pressures (n=21) 11 (52) 5 (24) 5 (24) • “Digital care where I [as GP] seek secondary care [dermatologist] for advice has not been increased. Digital care where I was able to come to a solution together with the patient has been increased.” [ID 1692]b • “[We] already used teledermatology and teledermoscopy, but [we] have also started to digitally assess [patients’] skin conditions ourselves.” [ID 1540]b • “Before [the pandemic] we did not allow patients to send in pictures; that has naturally crept in during the COVID-19 pandemic; this with a satisfying result.” [DHC; ID 1366]b • “Digital dermatology was already an absolute winner before the COVID19 pandemic. [Digital dermatology was used] less [often] during [the] COVID-19 [pandemic] because patients [were] preferably not [seen] live in [GP] practice, so spots had to wait.” [ID 1257]d • “[Digital dermatology] can lead to risky contacts at less than 1.5 meters.” [ID 1257]a System measurement and monitoring (n=85) 56 (66) 27 (32) 2 (2) • “Quick and easy for the patient, without [physical] referral with a long waiting time.” [ID 1667]b • “[Digital dermatology consultations are] a great way to communicate with [a] dermatologist.” [ID 1362]b • “It is nice to have [the patient] observed remotely and to be able to keep the patient out of the hospital.” [IDs 1313 and 1710]b Not able to code (n=23) N/Ae N/A N/A N/A a Impeding quote. b Facilitating quote. c DHC: digital dermatology home consultation. d Neutral quote. e N/A: not applicable. 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)
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