The ASICA ProjectCurrent progress

Achieving Self-directed Integrated Cance Aftercare

TDUFGroup

Thursday 5th December

Dr Peter Murchie

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)

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

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

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?

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

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

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

International Steering Group

• 6 monthly meetings – 4th in October 2013

• Patients

• GPs

• Hospital Specialists

• NHSG IT

• Potential international collaborators

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

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

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

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

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