the asica project current progress achieving self-directed integrated cance aftercare tdufgroup...
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The ASICA ProjectCurrent progress
Achieving Self-directed Integrated Cance Aftercare
TDUFGroup
Thursday 5th December
Dr Peter Murchie
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Project Team
• Computing Science– Dr Judith Masthoff (Senior Lecturer)– Matt Dennis (Project Researcher)
• Primary Healthcare– Dr Peter Murchie (GP and Senior Lecturer)– Susan Hall (Project Researcher)
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What’s it about
• ASICA Project being conducted as part of the dot.rural healthcare theme
• Aims to use technology to improve health services in remote and rural areas
• The project has two overlapping elements
• 1. Seeks to develop a novel tablet-based intervention to prompt and support skin self exam in people with melanoma
• 2. Explore integration with a developing tele-dermatology service in NHSG to enable a prompt response to concerns
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Patient Total Skin Self Exam (TSSE)
• All patients treated for melanoma as risk of recurrence
• Evidence that monthly TSSE can aid early detection of curable recurrence
• Intention of most patients to conduct TSSE decays with time
• Evidence that reminders and instructional videos can increase the practice of TSSE
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Responding to concerns
• Technological opportunity to respond promptly where patients with melanoma have concerns
• Current system would mean anxious delays and travel for patient (appointment with GP, referral, travel for appt (etc)
• Can tele-dermatology sort this more quickly in one or two stages?
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Preparatory Literature Review
• Systematic review of existing literature
• Identified 9 randomised trials of digital methods in cancer follow-up
• Demonstrate that it is feasible, safe and cost effective
• Nothing in melanoma/TSSE to date
• Submitted for publication
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Preparatory interviews with potential end-users
• 23 potential recipients interviewed
• All cite access difficulties with current follow-up
• Some caveats expressed
• Generally supportive of concept
• Submitted for publication
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Audit of melanoma recurrence to support targeting of intervention
• All recurrent melanomas in Grampian in last 10 years (>90 events)
• Patients within 12 months of diagnosis significantly less likely to spot own recurrence
• Suggests intervention should be instituted at point of diagnosis
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International Steering Group
• 6 monthly meetings – 4th in October 2013
• Patients
• GPs
• Hospital Specialists
• NHSG IT
• Potential international collaborators
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Experience Protoyping Event – May 14th
• GSA design experts
• Potential industry partners
• Patients, clinicians, researcher
• “Acted out” intervention in realtime
• Filmed for subsequent reflection
• Video by Maverick TV available for viewing
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NURSE
SPECIALIST
ASICA? A DIGITAL ALTERNATIVE?TSSE Supported by a tablet-based app
Email/phone ReminderEmail/phone Reminder
Confirm NoChangeConfirm NoChange
Self ExaminationsSelf Examinations
Examination App
Video Content
Personal Care Plan
Email/phone ReminderEmail/phone Reminder
Self ExaminationsSelf Examinations
Examination App
Video Content
Personal Care Plan
Spot ChangeSpot Change
Three-way dermoscopy consultation via weblink (Patient, GP, Specialists Nurse)
Three-way dermoscopy consultation via weblink (Patient, GP, Specialists Nurse)
?Consultant Review?Consultant Review
?Clinical Procedure?Clinical Procedure
No further Action required.
No further Action required. No Change
Change Detected
NURSE SPECIALIST
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Application development
• Dummy proto-type produced for EP day
• Revised in light of EP outcomes
• Requirement analysis drafted and revised
• Currently under development by computer science CO-Is
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Embedded instructional Video
Under-development – Muckle Hen productions
Animated rather than live action (screenshots here)
Will comprise 12 chapters for selected and repeated viewing
Brief written based on patient feedback and health psychologist advice
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Practice Recruitment – 19th August
• 8 local GPs
• Evening information meeting
• ASICA presented followed by Q&A
• 6 sign-ups to participte in pilot
• Patient recruitment underway
• 6-month pilot to commence Feb 2014