Digital dermatology in general practice Past, present and future

General practitioners (GPs) serve as gatekeepers for patients seeking specialized dermatology care and play a crucial role in triaging patients with skin lesions. To support GPs in diagnosing these (suspicious) skin lesions in general practice, they can seek the advice of a teledermatologist through digital dermatology services. This thesis aimed to contribute to understand the value of store-and-forward digital dermatology consultation in Dutch general practice. Furthermore, this thesis aimed to provide insights into experienced facilitators and barriers in the uptake of these digital dermatology services by GPs since its introduction in primary care. First, we investigated the status of two decades of teledermatology worldwide by performing a literature review (Part I). Second, we researched the impact and added value of performing store-and-forward teledermoscopy for GPs in Dutch GP practice (Part II). Finally, we developed and validated a quality feedback tool (SAF-TSUQ) to determine GPs’ perspectives about store-and-forward telemedicine services. We applied and extended this SAF-TSUQ to reveal the factors that facilitate or impede the successful implementation and use of teledermatology, teledermoscopy and dermatology home consultation services in Dutch GP practice (Part III). The evidence from this thesis showed that teledermatology and teledermoscopy are of added value for GPs. These services save cost and time compared to traditional dermatology care and support GPs in their referral decisions for benign and malignant skin lesions. Barriers hinder the full potential of digital dermatology services and addressing these sociotechnical challenges is crucial for enhancing and expanding these services in future general practices.