Evaluation of the Teledermatology Consultation Service via the LINE Application for Primary Care Physicians in the Health Service Regions of Thailand
Keywords:
Implementation research, Teledermatology consultation serviceAbstract
Background: Dermatological diseases were a significant health issue. In 2023, the morbidity rate was 85.67 per 1,000 population, while the dermatologists remain limited, with 25 provinces lacking dermatologists in the government sector. The Institute of Dermatology had the policy of Teledermatology Consultation Service via the LINE Application for Primary Care Physicians in 2017 and was implemented nationwide. However, the number of case submissions declined annually, and no systematic study has been conducted on the policy implementation. Objective: This study aimed to identify objectives in policy implementation from the perspectives of stakeholders and develop recommendations to enhance its effectiveness. Methods: This study used the Consolidated Framework for Implementation Research (CFIR) and divided into 3 phases; identified operational barriers, designed recommendations, and assessed acceptance from executives. The research includes an analysis of historical consultation data, a survey of 215 consult physicians, an interview with 40 stakeholders, a brainstorming with 7 key stakeholders, and an interview with 2 executives. Results: Community hospital physicians represented the highest usage rate of the system (57.34%), with 32.56% becoming aware of the policy through peer recommendation, and dermatologists provided recommendations in 98.85% of cases. However, physicians expressed concerns about data security and incomplete information in case submissions. Key recommendations from brainstorming included increasing system promotion, using a secure platform, and implementing a checklist for information submission. These recommendations received administrative support, including a proposal to compensate consulting physicians. Conclusion: an enhanced policy awareness channel, and the development of a standardized and secure system that meets user needs, will improve the efficiency of policy implementation.
References
Strategy and planning division of Office of the Permanent Secretary Ministry of Public Health. Summary of Illness Reports for the Year 2023 bangkok 2024 [cited 2024 1 Nov. 7]. Available from: https://spd.moph. go.th/wpcontent/uploads/2024/10/ill_2023_full_08102567.pdf.
Dermatological Society of Thailand. A dermatologist who has completed a board certification or received official approv 2022 [cited 2022 Dec 22]. Available from: https://dst.or.th/Member/Login.
Institute of Dermatology. Distribution of Dermatologists in Thailand, 2023. [Internet] 2023 [cited 2024 Oct 15]. Available from: https://www.iod.go.th/การกระจายตัวของแพทย์ผิ
TDR: For research on diseases of poverty. Implementation research training materials 2024 [cited 2024 Nov 4]. Available from: https://tdr.who.int/home/our-work/strengthening-research-capacity/implementa- tion-research-training-materials.
Srithamrongsawat S, Suriyawongpaisa P, Kasemsup W, Aekplakorn W, Leerapan B. Research project for the development of a long-term care system for elderly dependent persons under The National Health Security System. Bangkok: Decembery Co., Ltd; 2018.
Böhm da Costa C, da Silva Peralta F, Aurelio Maeyama M, Goulart Castro R, Lucia Schaefer Ferreira de Mello A. Teledentistry system in dental health public services: a mixed-methods intervention study. Int J Med Inform 2021;153:104533.
Shea CM, Tabriz AA, Turner K, North S, Reiter KL. Telestroke adoption among community hospitals in North Carolina: a cross-sectional study. J Stroke Cerebrovasc Dis 2018;27(9):2411-7.
Allison MK, Curran GM, Walsh WA, Dworkin ER, Zielinski MJ. Factors affecting telemedicine implementation in emergency departments and nurses' perceptions of virtual sexual assault nurse examiner consultation for sexual assault survivors. J Forensic Nurs 2023;19(1):41-9.
Stevenson L, Ball S, Haverhals LM, Aron DC, Lowery J. Evaluation of a national telemedicine initiative in the veterans health administration: factors associated with successful implementation. J Telemed Telecare 2018;24(3):168-78.
Naka F, Lu J, Porto A, Villagra J, Wu ZH, Anderson D. Impact of dermatology eConsults on access to care and skin cancer screening in underserved populations: a model for teledermatology services in community health centers. J Am Acad Dermatol 2018;78(2):293-302.
Dovigi E, Kwok EYL, English JC, 3rd. A framework-driven systematic review of the barriers and facilitators to teledermatology implementation. Current dermatology reports 2020;9(4):353-61.
Williams KM, Kirsh S, Aron D, Au D, Helfrich C, Lambert-Kerzner A, et al. Evaluation of the veterans health administration's specialty care transformational initiatives to promote patient-centered delivery of specialty care: a mixed-methods approach. Telemed J E Health 2017;23(7):577-89.
Morrissette S, Pearlman RL, Kovar M, Sisson WT, Brodell RT, Nahar VK. Attitudes and perceived barriers toward store-and-forward teledermatology among primary care providers of the rural Mississippi. Arch Dermatol Res 2022;314(1):37-40.
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