Microsoft powerpoint - poster nhs fv phototriage service summary [read-only] [compatibility mode]
Innovation in Referral Management:
Innovation in Referral
Photo--triage for Skin Cancer Referrals
triage for Skin Cancer Referrals
C Morton, on behalf of the Photo-Triage Steering Group, NHS Forth Valley
• Demand for specialist dermatology services continues to increase
• Following photo-triage, a visit to the conventional consultant clinic was
er 100,000 new
saved in 72% of referrals, with more directly attending for definitive care:
consultation in Scotland during 2008.
• ~40% of referrals concern suspected skin malignancy, challenging us to
Normal Referral Pathway Versus Phototriage
provide a safe timely service to reassure patients with benign growths
whilst efficiently progressing the care of those with skin cancer.
• Limited resources as well as the continued drive towards improved
national cancer and general out-patient access times is placing severe
strain on specialist departments.
• It remains difficult to triage referrals via letter alone and, having
Referrals (%) 60
assessed different models of triage, we developed a community-based
system of high quality image capture.
What is photo-triage?
Photo-triage is the use of a digital image of skin lesions to help the
list team at the time
o vetting GP referrals. The image is used t
help direct patients to the most appropriate clinic as quickly as possible.
•The mean waiting time to definitive treatment for patients with
Superficial Spreading Melanoma identified via Photo-triage
melanoma, squamous cell and basal cell carcinomas were all reduced
allowing for fast-track surgery
using photo-triage: 36, 28, and 35 days respectively, compared with 39,
50, and 58 days for conventional referrals
To use opportunities created by photo-triage for a ‘First Stop, Correct Stop’
experience for patients referred with a suspected skin cancer.
We report an observational study of conventional vs. photo-triage journeys
• ‘First-stop, correct stop’ achieved in 93% of patients, saving on
between Jan-Jun 2008. Data from 188 conventional (where all patients
unnecessary additional hospital visits
were booked onto a consultant clinic on the basis of referral letter only)
• Initial consultant visit avoided in 72% referrals, freeing-up
and 289 photo-triage referrals was available for study.
appointments for other patients to attend the service more rapidly.
• Rapid assessment for skin cancer patients: triage permits patients with
suspicious lesions to be fast-tracked for surgery or clinic assessment.
• Community photo-triage has permitted improved referral management
p ients with suspect
ed skin cancer
• And the final word to a patient comment:
Conventional Patient Journey
Patient Journey Phototriage
Nurse led therapy
• Complete cost effectiveness analysis of standard vs. triage referral methods
Referral to other specialist
• Determine best method for extending community photography
Referral to other
triaged by consultant
• Assess potential for direct reassurance via phone/e-mail/letter to patients
with obvious benign lesions
All patients seen by consultant
Steering Group: Sandra Auld, Scottish Centre for Telehealth; From NHS Forth Valley: Paul Baughan, Lead CancerGP; Karen Bonnar, Cancer Services; Fiona Downie, Project Manager; John Hunter, Medical Photographer; Colin Morton, Consultant Dermatologist;
Mary Orzel, Cancer Services manager; Dave Simpson, e-health; Brenda Smith, Dermatology Nurse Specialist; John Wells. e-health
For more information: [email protected]
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