GHP August 2015

ghp August 2015 | 25 industry insight Redefining the Melanoma Care Process Through a Multidiciplinary Telemedicine Platform Background Telemedicine - the use of telecommunications tech- nology for the support of health care at a distance - can be traced to the early 1900s, when ship captains used radio to receive medical advice. Dermatology is perfectly suited for this care model since imaging technologies easily captures skin disorders. Teleder- matology is effective in the treatment of both pae- diatric and adult populations. It is also used in the management of chronic conditions, such as psoriasis and non-healing ulcers. In addition, teledermatology offers educational benefits to primary care providers and dermatologists (1). M-Health is an emerging concept that represents the evolution of e-health systems from traditional desktop “telemedicine” platforms to wireless and mobile configurations. M-Health can be defined as “mobile computing, medical sensor, and communications technologies for healthcare.” M-Health solutions address increasing problems on health services, including the rising number of chronic diseases and high costs of existing national health services (2,3). Malignant melanoma During the past 10 years, the incidence of melano- ma in Sweden has increased by almost 6 percent annually. Since 2000, the number of cases among women has doubled. In 2012, there were 3.343 new cases of invasive melanoma, and 2.620 new cases of in situ melanoma reported in Sweden. Nearly 85 per- cent of all patients with melanoma are cured thanks to early detection and control of the disease. Today, about 35.000 individuals with the diagnosis of mel- anoma are living in Sweden (4,5,6). Over 150.000 excisions of melanocytic lesion are performed on approximately 100.000 individuals each year in order to identify the number of melanomas above. The cost for these excisions was in 2005 calculated to exceed 30 million euros (7). The total cost for skin cancer care in Sweden is estimated to 177,6 million euros and cutaneous malignant melanoma accounts for more than 50 % of these figures (8). Mobile teledermatoscopy Early and accurate diagnosis of melanoma is crucial for the disease prognosis. However, the accuracy of the clinical diagnosis of melanoma with the bare eye is only about 60 %. By using dermatoscopy, a non-invasive in vivo technique for the microscopic examination of pigmented skin lesions, the diagnos- tic performance can be improved by up to 50 % for an experienced examiner (9). New-generation mobile phones have made it possible to obtain high-quality microscopic digital images by connecting modern dermatoscopes to such smart phones. In the last few Cutaneous malignant melanoma is the most aggressive form of skin cancer and a significant cause of death worldwide. Sweden, with a population of 9,6 million, has one of the highest incidence rates of melanoma. More than 75% of the melanomas are ex- cised or referred by primary care clinicians. Early detection of melanoma is crucial for disease prognosis. Melanoma specialist skills should therefore be in reach for the general practitioner at patient’s first consultation. In order to meet the challenges of the melanoma care process the telemedicine platform Dermicus™ and a novel work strategy are introduced in the Stockholm area of Sweden.