A process modelling approach to assess the impact of teledermatology deployment onto the skin tumor care pathway

Tu Duong (), Guillaume Lamé (), Ouidad Zehou, Charbel Al Skayem (), Patricia Monnet, Mohammed El Khemiri, Sonia Boudjemil, Gaëlle Hirsch, Pierre Wolkenstein () and Marija Jankovic ()
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Tu Duong: CASN - Chaire Avenir Santé Numérique [Créteil] - IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CHU Henri Mondor [Créteil], Service de dermatologie [Mondor] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
Guillaume Lamé: LGI - Laboratoire Génie Industriel - CentraleSupélec - Université Paris-Saclay
Ouidad Zehou: CHU Henri Mondor [Créteil], Service de dermatologie [Mondor] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
Charbel Al Skayem: CHU Henri Mondor [Créteil], UPD7 - Université Paris Diderot - Paris 7, Service de dermatologie [Mondor] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
Patricia Monnet: CHU Henri Mondor [Créteil], Service de dermatologie [Mondor] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
Mohammed El Khemiri: LGI - Laboratoire Génie Industriel - CentraleSupélec - Université Paris-Saclay
Sonia Boudjemil: LGI - Laboratoire Génie Industriel - CentraleSupélec - Université Paris-Saclay
Gaëlle Hirsch: CHU Henri Mondor [Créteil], Service de dermatologie [Mondor] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
Pierre Wolkenstein: Service de dermatologie [Mondor] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CHU Henri Mondor [Créteil], EpiDermE - Epidemiology in Dermatology and Evaluation in Therapeutics - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
Marija Jankovic: LGI - Laboratoire Génie Industriel - CentraleSupélec - Université Paris-Saclay

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Abstract: Background: In dermatology, telehealth was raised as a potential answer to increase access and decrease delay for skin cancer management, especially in the elderly population. However, the influence of teledermatology in the care pathway of non-melanoma skin cancer (NMSC) has never been studied. Objectives: To evaluate teledermatology (TD) deployment implications in NMSC care pathways by comparing a conventional care pathway prior to TD integration to the pathway after TD implementation using a process modelling approach. Patients and Methods: Two retrospective studies were conducted in a department of dermatology with an ongoingTDprogram with geriatric institutions. One study (study 1) mapped NMSC care pathway prior to TD integrationfrom January to February 2013. Another determined NMSC care pathway (study) for patients managed afterTDdiagnosisfrom September2016 to October 2018, during thesame period patients managed by conventional care process were used as controls. Patients characteristics, type of tumors and processes were compared using time as a key performance indicator. Results: 89 NMSC patients were managed in the department (mean age= 76 yr old ± 13) during the study 1 period while from September 2016 till October 2018, 36 patients NMSC were managed after TD, mean age of 89 years old ± 6 and 681 patients were managed in a conventional process, mean age of 78 years old ±12. There was no significant difference in delays between: first in-person or TD consultation and biopsy, biopsy and multidisciplinary consultation, or biopsy and surgery. NMSCpatients consulting through TD had significantly longer delays between: first consultation and multidisciplinary consultation, multidisciplinary consultation and surgery, and first consultation and surgery (p=0.037, p=0.02, p

Keywords: care pathway; teledermatology; evaluation; access to care; telemedicine; Processmodelling; telehealth; non melanoma skin cancer (search for similar items in EconPapers)
Date: 2021-02
Note: View the original document on HAL open archive server: https://hal.science/hal-03035103v1
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Published in International Journal of Medical Informatics, 2021, 146, pp.104361. ⟨10.1016/j.ijmedinf.2020.104361⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-03035103

DOI: 10.1016/j.ijmedinf.2020.104361

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