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Implementation of Mobile Teledermatology: Challenges and Opportunities.

Publication ,  Journal Article
Peracca, SB; Fonseca, A; Hines, A; King, HA; Grenga, AM; Jackson, GL; Whited, JD; Chapman, JG; Lamkin, R; Mohr, DC; Gifford, A; Weinstock, MA; Oh, DH
Published in: Telemed J E Health
December 2021

Background: While teledermatology is well-established in the Department of Veterans Affairs (VA), its implementation is far from complete. To facilitate consultative teledermatology and extend its reach, VA introduced a mobile teledermatology application (app) at three VA sites. Methods: We evaluated the initial implementation process using a mixed-methods, multiple case study approach to assess organizational readiness for change (ORC), which included examining facilitators, barriers, and contextual factors that affected implementation. We conducted: (1) group interviews and bimonthly reports to understand site processes; (2) semistructured interviews and surveys of individual participants representing a range of implementation roles; and (3) a review of internal organizational documents. We identified themes from interviews using an iterative process, and computed an ORC score based on surveys. Results: Forty-three individuals participated in the study. Qualitative data from all sites, corroborated by survey data available from one site, revealed a high readiness for change with an ORC score of 4.2, where 5 = maximal readiness for change. Facilitators included support from leadership and clinical champions, active telehealth programs, and an understanding and appreciation of the program and the resources needed. At all sites, however, technical issues negatively affected adoption; these included a suboptimal information technology infrastructure, which led to the inoperability of the app at two sites, and technical inefficiencies related to users' unfamiliarity with new devices and inconsistent internet access. Conclusions: Although a strong commitment to change and a confidence to effect change existed, these alone were insufficient to surmount barriers to implementation effectiveness. Clinical Trials Registration: NCT03241589.

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Published In

Telemed J E Health

DOI

EISSN

1556-3669

Publication Date

December 2021

Volume

27

Issue

12

Start / End Page

1416 / 1422

Location

United States

Related Subject Headings

  • United States
  • Telemedicine
  • Medical Informatics
  • Humans
  • Dermatology
  • 4206 Public health
  • 4203 Health services and systems
  • 1117 Public Health and Health Services
  • 0903 Biomedical Engineering
  • 0807 Library and Information Studies
 

Citation

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Peracca, S. B., Fonseca, A., Hines, A., King, H. A., Grenga, A. M., Jackson, G. L., … Oh, D. H. (2021). Implementation of Mobile Teledermatology: Challenges and Opportunities. Telemed J E Health, 27(12), 1416–1422. https://doi.org/10.1089/tmj.2020.0500
Peracca, Sara B., Allene Fonseca, Aliya Hines, Heather A. King, Andrea M. Grenga, George L. Jackson, John D. Whited, et al. “Implementation of Mobile Teledermatology: Challenges and Opportunities.Telemed J E Health 27, no. 12 (December 2021): 1416–22. https://doi.org/10.1089/tmj.2020.0500.
Peracca SB, Fonseca A, Hines A, King HA, Grenga AM, Jackson GL, et al. Implementation of Mobile Teledermatology: Challenges and Opportunities. Telemed J E Health. 2021 Dec;27(12):1416–22.
Peracca, Sara B., et al. “Implementation of Mobile Teledermatology: Challenges and Opportunities.Telemed J E Health, vol. 27, no. 12, Dec. 2021, pp. 1416–22. Pubmed, doi:10.1089/tmj.2020.0500.
Peracca SB, Fonseca A, Hines A, King HA, Grenga AM, Jackson GL, Whited JD, Chapman JG, Lamkin R, Mohr DC, Gifford A, Weinstock MA, Oh DH. Implementation of Mobile Teledermatology: Challenges and Opportunities. Telemed J E Health. 2021 Dec;27(12):1416–1422.
Journal cover image

Published In

Telemed J E Health

DOI

EISSN

1556-3669

Publication Date

December 2021

Volume

27

Issue

12

Start / End Page

1416 / 1422

Location

United States

Related Subject Headings

  • United States
  • Telemedicine
  • Medical Informatics
  • Humans
  • Dermatology
  • 4206 Public health
  • 4203 Health services and systems
  • 1117 Public Health and Health Services
  • 0903 Biomedical Engineering
  • 0807 Library and Information Studies