142 CHAPTER 7 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]. Dimension Facilitating quotes (%) Neutral quotes (%) Impeding quotes (%) Exemplary relevant quotes Hardware and software (n=38) 2 (5) 2 (5) 34 (89) • “The conversion lens on the phone for dermoscopic photographs does not meet the quality of the photographs that we had previously with the dermoscope. I often hear from dermatologists that they cannot interpret the photographs properly and patients still have to go to the specialist.” [ID 1625]a • “Uploading photographs [from my phone to my desktop] takes a lot of time and often has to be done again because the amount of MBs is exceeded.” [ID 1376]a • “Teledermoscopy remains difficult, ‘every phone [requires] a new [dermoscopy] attachment.’” [ID 1259]a Clinical content (n=97) 24 (25) 42 (43) 31 (32) • “Many skin problems, spots, and rashes can often be easily assessed via [a] photograph.” [IDs 1637 and 1804]b • “Fast responses, good content and practical responses from specialists with clear and adequate diagnoses and treatment advice.” [IDs 109, 1373, 1479, and 1344]b • “Images [taken by patients] are often not sharp enough, bad lightning, wrong distance.” [DHCc; ID 1638]a • “I find the quality and sharpness of the patient’s photographs extremely poor. For example, [there is] only a detailed image or [the image is] too out of focus. I prefer to take my own photographs and send them in with an adequate anamnesis.” [DHC; ID 1373]a Humancomputer interface (n=16) 1 (6) 3 (19) 12 (75) • “Only allow patients to send in a [dermatology home] consultation when all photographs have been taken and loaded.” [DHC; ID 1691]d • “Less change in well-intentioned updating of layout.” [ID 1660]a • “The patient found it [dermatology home consultation] extremely difficult and user unfriendly.” [DHC; ID 1692]a
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