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Usefulness
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Efficacy and time-saving (n=14) |
“It created efficiency. Before it (photo documentation) took maybe three, four, five minutes, and now it takes 30 seconds” [Ia9] “So, it is a lot of time-savings and quality improvements” [Pb15]
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Quality of care (n=8) |
“(the case progression overview) helps to quickly detect if your medical measures are not good. And then instead of treating the patients (with the same treatment) another four weeks or three months, you change. You take action and reflect and you change” [Cc3] “you take photographs, and you see what are the changes over months or not...(these photos) save time for very specific descriptions that you otherwise place in your report” [C5] “In the operating room, the photos are not available. So, the clinician has to either just have a good guess what happened in his memory or get to retrieve the photo somewhere else. (With the app) there is really benefits in the treatments because you have the things available when you need them” [P15]
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General usefulness (n=5) |
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Evidence base (n=2) |
“I think the more people use the app, we have to see whether it’s good for statistics or identifying relevant cases in terms of research” [C5] “We also expected benefits in terms of scientific studies, simplification of treatment algorithms, and networking of inpatient and outpatient treatment pathways” [C18]
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ITd capability and compatibility
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Interoperability and integration (n=13) |
“But there are barriers, mainly the IT integration requirement” [P1] “You can access the app via any mobile device, and logging on with your personal hospital account is possible. The app is then linked to the hospital’s database and allows to identify patients by entering their personal details or to scan a barcode and this will give you the patient” [C5] “The EMR integration in this regard is a challenge both from a cost perspective and the support availability perspective” [I13] “(the app) is much easier than taking an individual camera as it’s directly available within the patient file which is very useful” [C16]
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Technical issues (n=6) |
“of course, an app like this needs a lot of battery. So, we have to load the battery two or three times a day” [C11] “And sometimes, but this is not a problem of the imito app, it’s a problem of the system here, when we have no Wi-Fi, it gets more difficult to make a documentation and to save it” [C16] “I was too frustrated with the log-in process and now that we have the possibility to log in with face ID, it has proved to be a marvel” [C16]
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Data-related factors
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Privacy, security, and liability (n=13) |
“The limitations and problems are rather in the legal area, as the sending of sensitive patient data is very restrictive in Germany. Legal and technical requirements for secure data transfer must be dealt with. Good photo documentation supports the sociomedical and legal issues” [C18] “And altogether you just have to still follow the hospital rules about data security and all that stuff, so that’s also an adoption factor. The data security” [I12]
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Data management (n=3) |
“And the other thing we noticed is that it needs some kind of controlling in the future because it is so well accepted that some users overdo it. And we are not limited in terms of data capacity, storage space” [C5] “We have more pictures in this time we roll out the devices. So, I don’t know if it’s always good to have just more content, if it’s also in the right context and is it useful and that stuff. But we have more” [I9]
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| Ease of use (n=13) |
“I would say the process has to be very easy. So, when you want to have an app like this, it has to be easy, fast, and secure” [I9] “It’s very important to have an easy self-explanatory tool for nurses to use. Otherwise, they won’t do it, understandably” [C14]
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| Monetary factors (cost; n=6) |
“We have a cost in this technological interoperability” [CP8] “Barriers for establishing such tools are the investment costs, eg, set up of a secure WLAN, equipment, and licensing cost” [C18]
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