Janda Monika, Horsham Caitlin, Koh Uyen, Gillespie Nicole, Vagenas Dimitrios, Loescher Lois J, Curiel-Lewandrowski Clara, Hofmann-Wellenhof Rainer, Peter Soyer H
Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
School of Public Health and Social Work, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Digit Health. 2019 Feb 6;5:2055207619828225. doi: 10.1177/2055207619828225. eCollection 2019 Jan-Dec.
The aim of the study is to evaluate healthcare practitioners' views on and satisfaction with (i) digital image acquisition and storage and (ii) store-and-forward teledermoscopy services for the diagnosis of skin cancer in their clinical practice.
An online survey was conducted among 59 healthcare practitioners (GPs (=17), dermatologists (=22), dermatology registrars (=18), a dermatology research fellow (=1) and a plastic surgeon (=1)) to assess usability of digital image acquisition and storage for when the imaging process is conducted by the healthcare practitioners themselves, or by their patients. The study identifies the enablers and barriers of this emerging mode of medical practice. A thematic analysis was used to extract key themes from open-ended responses, which involved identifying themes and patterns within and across participants.
Thirty-four healthcare practitioners (58%) had previously used a mobile dermatoscope within their practice. Participants most appreciated its use in their practice for lesion monitoring (59%) and record keeping (39%). Challenges reported were the increased time to support the additional workload (45%), technical issues (33%) and cost of equipment (27%). Practitioners were unsure (36%) or did not advocate teledermoscopy for direct-to-consumer use (41%). Only 23% supported the use of direct-to-consumer teledermoscopy.
While most practitioners are receptive to mobile teledermoscopy, there was less support for patient-initiated use, whereby the patient controls the imaging process. As technology improves rapidly it is important to evaluate practitioners' acceptance and satisfaction of evolving telehealth services, moving forward with models of practice where healthcare practitioners and other healthcare providers will feel comfortable engaging in telehealth services.
本研究旨在评估医疗从业者对（i）数字图像采集与存储以及（ii）用于皮肤癌诊断的存储转发式远程皮肤镜检查服务在其临床实践中的看法和满意度。
对59名医疗从业者（全科医生（=17名）、皮肤科医生（=22名）、皮肤科住院医师（=18名）、一名皮肤科研究员（=1名）和一名整形外科医生（=1名））进行了一项在线调查，以评估当成像过程由医疗从业者自己或其患者进行时数字图像采集与存储的可用性。该研究确定了这种新兴医疗实践模式的推动因素和障碍。采用主题分析从开放式回答中提取关键主题，这涉及识别参与者内部和之间的主题及模式。
34名医疗从业者（58%）此前在其实践中使用过移动皮肤镜。参与者最赞赏其在实践中用于病变监测（59%）和记录保存（39%）。报告的挑战包括支持额外工作量所需时间增加（45%）、技术问题（33%）和设备成本（27%）。从业者不确定（36%）或不主张将远程皮肤镜检查用于直接面向消费者（41%）。只有23%支持使用直接面向消费者的远程皮肤镜检查。
虽然大多数从业者接受移动远程皮肤镜检查，但对患者发起的使用（即患者控制成像过程）的支持较少。随着技术迅速发展，评估从业者对不断发展的远程医疗服务的接受度和满意度非常重要，推进医疗从业者和其他医疗服务提供者能够自在参与远程医疗服务的实践模式。
