Community photo-triage for skin cancer referrals: An aid to service delivery

Morton, C.A., Downie, F., Auld S., Smith, B., van der Pol, M., Baughan, P., Wells, J. and Wootton, R. (2011) Community photo-triage for skin cancer referrals: An aid to service delivery. Clinical and Experimental Dermatology, 36 3: 248-254. doi:10.1111/j.1365-2230.2010.03960.x

Author Morton, C.A.
Downie, F.
Auld S.
Smith, B.
van der Pol, M.
Baughan, P.
Wells, J.
Wootton, R.
Title Community photo-triage for skin cancer referrals: An aid to service delivery
Journal name Clinical and Experimental Dermatology   Check publisher's open access policy
ISSN 0307-6938
Publication date 2011-01-01
Year available 2011
Sub-type Article (original research)
DOI 10.1111/j.1365-2230.2010.03960.x
Open Access Status Not yet assessed
Volume 36
Issue 3
Start page 248
End page 254
Total pages 7
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing Ltd.
Language eng
Subject 2708 Dermatology
Abstract Background. We wished to investigate the potential for extending the capacity of the specialist service by using community-based photo-triage for suspected skin cancers. Aims. To compare the outcomes and costs of conventional and photo-triage referral pathways. Methods. This was an observational study of conventional and photo-triage referrals. Patients referred for initial photo-triage were invited to visit a medical photographer located in community health centres, who would take high-quality close-up and dermatoscopic images of the patients' lesions. A dermatologist then reviewed the images, and triaged patients to specific treatment clinics. All patients referred by conventional letter were offered initial appointments at the consultant-delivered skin cancer clinic. The difference in costs was assessed by modelling health service use under both pathways. Results. Photo-triage permitted 91% of patients (263/289) to achieve definitive care at first visit to the specialist team, compared with only 63% (117/186) via the conventional referral pathway. The mean waiting time to definitive treatment for patients with skin cancer was slightly reduced with photo-triage. Photo-triage permitted direct booking for 45% of patients to attend a nurse-delivered clinic, 22% to attend directly for surgery, 2% to attend a community general practice clinic and 2% to be referred on electronically to another specialty. This reduced by 72% the number of patients requiring attendance to the consultant clinic, freeing up capacity. Despite the cost of providing medical photography, there was a small cost saving of around £1.70 per patient using photo-triage. Conclusions. Community photo-triage improved referral management of patients with suspected skin cancer, improving the delivery of definitive care at first visit and achieved an increased service capacity. Cost comparison found that the photo-triage model described was marginally cheaper than conventional care, and reduced hospital visits. An integrated primary-secondary care referral pathway that includes photo-triage facilitates a more efficient specialist service while ensuring that all suspicious lesions are viewed by an experienced dermatologist. © The Author(s). CED
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Centre for Online Health Publications
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