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Report

Teaser, summary, work performed and final results

Periodic Reporting for period 1 - Dermtest (An empowering toolkit for general practitioners to prevent, detect and treat melanoma (Dermtest))

Teaser

Summary

The aim of the innovation project Dermtest is to develop a toolkit for general practitioners (GPs) to empower them in taking charge of patient management in melanoma prevention, detection and treatment. Melanoma accounts for 3% of all cancer incidences in Europe and a mortality of 20 000. Only if melanoma is detected and treated early, the chance of cure is high. GPs as the first contact for a patient can help, but currently they do not have the necessary tools to do that. A feasibility study was conducted to assess the Dermtest approach to tackle the problem and prioritize market access and technology development activities of the solution. The specific objectives of the feasibility study were to provide proof of the concepts and input for the technological feasibility in connection with specific markets â€“ what kind of software and hardware is needed and what are the possibilities to achieve interoperability. Additionally, to study the next chosen markets in regard to the specific characteristics (incl organization, regulation, financing) and to assess the different business model(s) by these characteristics and additional data. From that we gained crucial input in terms of which actions and steps are the most suitable in building a network of service providers in the European market and thus a short- to long-term growth strategy plan (with possibility to test the Dermtest toolkit components such as mobile application, e-learning, e-marketplace and decision-support modules) was set through the feasibility analysis actions.

Work performed

The feasibility study validated the technology and business approach taken. Some toolkit components were adjusted or changed based on feasibility analysis and market access activities prioritized in detail and in line with technology development. The highest value bringing business model (teledermoscopy) should be marketed initially (through a country specific approach) and incrementally new technology components added, with implementing the model and building on the experience and using the initially built network to build trust in technology and ensure quality and add additional Dermtest components for better achievement of goals. A benchmarking exercise was used to prioritize development activities (products) and possible business models for them. It showed that the initially planned country-specific approach should be taken and in addition to business-to-consumer model also insurance, region or country based approach is possible with the comprehensive toolkit solution. A sales success model was developed along with evaluations for customer support and marketing requirements. The next steps for different market access activities were analysed and outlined along with cost-estimations for technology development and overall investment need.
The vision for the toolkit was developed further and evolved to the understanding that the whole patient process view is needed and an integrated solution for prevention and detection has to take into account also possibilities to personalize melanoma risk screening with other technologies and health data. Different financing models are still needed to make use of stimuli for keeping patients healthy â€“ in the long run, costs need to be transferred from late stage treatment to early detection. This will help to achieve cost-efficiency and reduce melanoma mortality.

Final results

The study shows that the current operational model has high support from users and it brings value to health system in terms of access, quality, cost-efficiency and care continuity. Furthermore, the business idea is realizable in the tested markets and in whole Europe.

Further developments have been prioritized and will show, what would the impact be on a system/region level and whether Dermtest can further personalize melanoma risk screening with the solution, for even better accuracy and quality.

There are still several barriers in the system with regard to regulations, financing, information systems and organization of different health systems. Based on 4 countries with different health systems, we developed an approach to tackle these barriers in a systematic way in order to disrupt the way melanoma patients are managed and eventually lower melanoma mortality in Europe. The developed business plan prioritized the development and market access activities, as well as proposed indications of need for investments and resources for that with evaluations on scalability, sustainability and break-even expectations.
Dermtest solves a problem many health systems have in terms of melanoma mortality rates due to lack of early diagnosis. The main societal implications from Dermtest are the reduction in deaths to melanoma and other skin cancers and the prioritization of early detection in the dermatologist workflow. From the patient perspective Dermtest removes the need to travel for expert consultation and get the results 2-10 times faster for peace of mind and earlier treatment. Dermtest will be able to improve accuracy and increase cost-efficiency.

Dermtest also provides an example of good communication between primary care and secondary care, a positive business case without excess bureaucracy in healthcare and cross-border care and a novel example of using the technology existent in a sufficient manner. It shows the impact of awareness building and communication in disease prevention and can provide a possibility for specialist second opinion across borders and thus provide higher quality, better access, experience sharing in the fight against melanoma.