Single-Lesion Skin Cancer Risk Stratification Triage Pathway

Area of Science:

• Dermatology
• Health Informatics
• Quality Improvement

Background:

• Timely dermatologic care is crucial for new skin lesions.
• Efficient triage pathways can improve resource allocation and reduce wait times.

Purpose of the Study:

• To evaluate a rule-based triage system for skin cancer risk stratification.
• To assess the impact of the system on patient wait times.

Main Methods:

• Retrospective quality improvement cohort study (November 2017-January 2023).
• Implementation of a rules-based triage system for high-risk lesions.
• Analysis of referral reasons, risk factors, and biopsy outcomes.

Main Results:

• The rules-based pathway expedited care for high-risk patients (26-day reduction).
• Patients seen through the pathway had higher risk of malignant biopsy results (aRR, 1.6) and melanoma (aRR, 2.0).
• Clinician concern for skin cancer correlated with increased malignancy risk.

Conclusions:

• An automated, rules-based referral pathway expedited care for high-risk skin cancer patients.
• This system improved patient stratification and reduced wait times while maintaining diagnostic accuracy.
• Findings suggest optimizing resource allocation through better patient risk stratification.