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标题：Using teledermatology in early detection of skin cancer in three urban primary care centers in barcelona. An integrated approach for skin cancer management
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作者：Ignacio Menacho Pascual ; Maria Moreno Ubiedo ; Núria Gimferrer Artigas 等
期刊名称：International Journal of Integrated Care
电子版ISSN：1568-4156
出版年度：2016
卷号：16
期号：6
DOI：10.5334/ijic.2989
出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction : The skin cancer is a growing pathology in our country because of the sunbathing habits and the everyday more aged population. The general practitioner (GP) has an important role in the early detection of the skin cancer, but needs a specific training in skin cancer clinical detection and in the use of dermoscopy to discriminate between a banal or a suspicious lesion. The current delay for the first dermatologist visit is about 30-60 days in our area, and much more in other areas in Catalonia. With the aim of improving the skin cancer detection and reducing the delay in the treatment of skin cancer, in 2012, in three urban Primary Care Centres (PCC) attending a population of approximately 100.000 inhabitants in the public health system of the centre of Barcelona, it was implemented a program for skin cancer detection and store-and-forward teledermatology (TD) with a dedicated platform. Description : A reference dermatologist assumes the attendance of patients referred from the Primary Care. He/she is responsible for conducting clinical sessions and consulting cases. A specific training in clinical detection of skin cancer and dermoscopy with the “three checkpoint list” was given to GP in the PCC. A dedicated TD platform integrated in the institutional clinical informatics system of the referral hospital (PACS) and of the 3 PCC (MIO) was developed. The dermatology department of the Hospital Clinic of Barcelona implemented a clinical protocol adapted to GP for the selection of “suspicious tumours” based on clinical examination with dermoscopy and TD. The platform was designed to allow the transmission of images, the communication of clinical reports and a quality assurance of the clinical process. The analysis of images by the dermatologist in the referral centre was reported with the following options: 1.Banal lesion. No medical follow up needed; 2. Follow up by GP recommended; 3. Visit with the dermatologist at the PCC (ordinary or priority) for more accurate evaluation or invalid TD; 4.Visit/biopsy in the hospital recommended; 5. Invalid photo.
关键词：teledermatology ; primary care ; skin cancer ; early detection of cancer ; integrated health care