Implementation of Mobile Teledermatology: Challenges and Opportunities

Area of Science:

• Health Informatics
• Telemedicine
• Organizational Change Management

Background:

• Teledermatology is established in the Department of Veterans Affairs (VA), but full implementation remains incomplete.
• A mobile teledermatology application (app) was introduced across three VA sites to enhance consultative services.
• This study examines the initial implementation of the mobile teledermatology app.

Purpose of the Study:

• To evaluate the organizational readiness for change (ORC) during the initial implementation of a mobile teledermatology app.
• To identify facilitators, barriers, and contextual factors influencing the app's implementation.
• To assess the effectiveness of the implementation process.

Main Methods:

• A mixed-methods, multiple case study approach was employed.
• Data collection included group interviews, bimonthly reports, semistructured interviews, surveys, and internal document review.
• Thematic analysis of qualitative data and calculation of an ORC score from survey data were performed.

Main Results:

• Forty-three individuals participated across three VA sites.
• A high organizational readiness for change (ORC score of 4.2/5) was observed.
• Facilitators included leadership support and existing telehealth programs, but technical issues (IT infrastructure, user unfamiliarity, internet access) impeded adoption.

Conclusions:

• Strong commitment and confidence in change were present but insufficient to overcome implementation barriers.
• Technical challenges significantly impacted the effectiveness of the mobile teledermatology app implementation.
• Addressing technological and infrastructural limitations is crucial for successful teledermatology adoption.