134 CHAPTER 7 Finally, responses that were coded differently or assigned to a different dimension were discussed until consensus was reached (ET and Bibiche Groenhuijzen). Several iterations were conducted to reach consensus in assigning codes to responses and to modify the descriptions of the original 8 sociotechnical dimensions in the telemedicine context (Table 7.1). Finally, based on this complete analysis, we extracted the facilitators of and barriers to digital dermatology care from the 8 sociotechnical dimensions. Table 7.1: Definitions based on the 8-dimensional sociotechnical model by Sittig and Singh modified to the telemedicine context [25,26]. Sociotechnical dimension Definition in the model Hardware and software All technical remarks about the hardware and software used on the (teledermatology) consultation platform, for example, the ease of use of the photography equipment, uploading images, and interoperability issues. Clinical content All remarks about the structured, unstructured, textual, or numeric data; information; and knowledge that are stored on the (teledermatology) consultation platform. Also remarks about (the feedback received from the dermatologist about) the quality of images in the consultation or the quality of responses of the dermatologist. Human-computer interface All remarks about the software’s interaction with the user, for example, about the platform layout or front-end features. People All remarks about individuals who interact with the platform or related to training and learnability. Workflow and communication All remarks about how teledermatology is used in the workflow, impact on workload, tasks required to provide appropriate care, and communication with the telemedicine organization. Internal organizational policies, procedures, and culture All remarks about structures, policies, financial aspects, and procedures of the telemedicine organization that influence technology management. External rules, regulations, and pressures All remarks about external forces outside the telemedicine organization that facilitate or impede efforts to design, implement, use, and evaluate technology and remarks indicating that the use has changed owing to the COVID19 pandemic.
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