Access to dermatologic care for cancer patients: employment of an oncodermatology referral system

Oncodermatology addresses skin conditions caused by cancer or its treatment, which can affect treatment decisions and quality of life. However, electronic health record (EHR)-related communication gaps and appointment wait times hinder timely care. This study assesses the effectiveness of an oncodermatology referral system implemented on March 1, 2023, within a large tertiary healthcare system.

A centralized email listserv was created to enable oncologists to refer patients with skin complaints for timely care. A retrospective analysis was conducted on 466 patients referred from oncology to dermatology between September 1, 2022, and September 1, 2023. Patients were divided into three groups: Batch 1 (EHR referrals pre-implementation), Batch 2 (EHR referrals only post-implementation), and Batch 3 (all email listserv referrals post-implementation). Key outcomes measured include referral-to-scheduling time, referral-to-appointment time, proportion of underserved patients referred, zip code distribution of referred patients, and success rate of scheduling appointments post-referral.

There was a statistically significant increase in scheduled dermatology appointments post-implementation (Batch 1, 71%; Batch 2, 73%; Batch 3, 88%; P = .0008), as well as significant reductions in referral-to-scheduling (P = 9.82 × 10^-5) and referral-to-appointment times (P = 1.74 × 10^-7). Across Batches 1, 2, and 3, the average referral-to-scheduling time decreased from 19 to 10 to 4 days, while referral-to-appointment time similarly decreased from 51 to 42 to 22 days. Post-implementation, significantly more appointments were created for non-white patients (P < .01) and patients living in peripheral regions within NYC (P < .01).

A centralized email-based oncodermatology referral system significantly improved scheduling efficiency and access for underserved populations, underscoring the importance of streamlined referral processes in improving dermatologic care for cancer patients.