20 CHAPTER 1 have been referred to the dermatologist if teledermoscopy would not have been available, the overall referral percentage in teledermoscopy, and the time GPs and TDs need to send in and respond to a teledermoscopy consultation. In Chapter 4 and Chapter 5, we further examine the merits of teledermoscopy for GPs. Chapter 4 assesses the added value as the GPs’ gained expertise in diagnosing skin disorders after continued use of teledermoscopy. In this chapter, we specifically focus on experienced GPs and compare the GP pre-diagnosed skin disorders to the final provided TD diagnoses. Chapter 5 measures the added value as to whether the availability of teledermoscopy changes GPs’ (non)referral decisions before and after teledermoscopy for skin lesions diagnosed by the TD as benign, premalignant and malignant. Part III: GPs’ perspectives about store-and-forward digital dermatology care Part III elaborates on GPs’ perspectives about store-and-forward digital dermatology care and examines how teledermatology and teledermoscopy are incorporated into GPs’ work practice. Chapter 6 focuses on the development and validation of the Store-and-Forward Telemedicine Service User-satisfaction Questionnaire (SAF-TSUQ). This quality feedback tool monitors health care providers’ experiences with store-and-forward contracted telemedicine services. This means that SAF-TSUQ assesses experiences of both the referring health care providers, such as GPs, and the performing health care providers, such as dermatologists. This quality feedback tool aims to provide insight into why and what motivates health care providers to embrace or reject these innovative telemedicine services and how store-and-forward telemedicine organizations can enhance their services. Chapter 7 uses the quality feedback tool from Chapter 6 and extends the questionnaire with open and closed-ended questions on the use of digital dermatology care in general practice and questions related to the COVID-19 pandemic. This combined questionnaire was sent to GPs to investigate how satisfied GPs were with the three types of digital dermatology consultation in the Netherlands during the COVID-19 pandemic. In addition, we used a socio-technical model to understand the interrelations between the factors that facilitate and hamper the successful implementation and use of the services. Finally, Chapter 8 provides a summary of the main findings, a general discussion, and a conclusion on how teledermatology, teledermoscopy, and dermatology home consultation are integrated and received or rejected in Dutch GP practice. Furthermore, we will discuss the added value and challenges contributing to the successful implementation and use of these services in the Netherlands and provide suggestions for future research.
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