210 APPENDICES for example by means of artificial intelligence (AI), verify whether the correct number of photographs are uploaded and if their quality is sufficient. Chapter 8 discusses the main findings of this thesis and elaborates on the added value and challenges that contribute to the successful implementation and use of digital dermatology services in Dutch GP practice. Furthermore, this last chapter points out the strengths and limitations of the studies in this thesis and provides recommendations for the future practice and research. Several Dutch healthcare organizations jointly established the Integral Care Agreement (Dutch: Integraal Zorg Akkoord (IZA)) with the aim of enhancing the long-term viability of the healthcare system. In this IZA, healthcare organizations specify how to deal with major healthcare challenges, such as increasing costs of healthcare and the shortages of personnel working in healthcare. One of the goals outlined in the IZA is to reduce the workload of healthcare providers while maintaining high-quality care that is accessible and affordable. Furthermore, the IZA reports that investigation is necessary to determine which care paths are suitable for digital and hybrid care. This thesis showed that dermatology services are suitable for digital and hybrid care and align seamlessly with the premise of appropriate hybrid care as established in this IZA: perform care yourself if possible, perform care at home if possible, perform care digitally if possible, and visit the hospital only for specialized care. In essence, digital dermatology services offer the right low-complex (diagnostic) care in the right place at the right time with the right expertise. This thesis has shown that education and training of GPs to enhance their dermatology knowledge and proficiency with photography equipment are vital aspects for effective teledermatology and teledermoscopy use. We recommend to further encourage (tele) dermatology and (tele)dermoscopy education in the GP training curriculum. Furthermore, teledermatology and teledermoscopy usage is limited by the quality of photographs taken by GPs. Therefore, accredited continuous online and practice training sessions and video instructions are recommended to refresh GPs’ knowledge about the use of (dermoscopic) photography equipment and in obtaining adequate photographs. However, GPs also have to keep track of their knowledge in other medical disciplines, have limited time, and perform several non-medical tasks. AI solutions may be suitable to bridge this tension field. Future studies could explore whether AI could be used in the digital dermatology service to validate the quality of photographs taken by GPs and patients beforehand and to supply real-time feedback and guide them if the taken photographs are of inadequate quality. Furthermore, investigations should persist in examining the educational purpose of AI for GPs and exploring whether AI solutions may reduce the training requirements for GPs performing digital dermatology consultation. This may require GPs to spend less time on the training of their photography skills. Finally, future studies could explore whether AI photo recognition algorithms could support GPs to diagnose skin conditions and in which way AI chatbots can be applied in the digital dermatology services.
RkJQdWJsaXNoZXIy MTk4NDMw