Sweden – Region Stockholm has procured Gnosco's teledermatology platform for the efficient management of skin changes

Gnosco has won a tender for the supply of the teledermatology platform for Region Stockholm. GPs, for all 220 health centres in the region, will be able to document and photograph skin changes with a mobile phone and send them securely to skin specialists for remote expert assessment and diagnosis.

Region Stockholm has signed a six-year agreement with Gnosco to deliver a broad introduction of the region's new care process for teledermatology for more efficient management of patients with skin changes. ^{1, 2} The Region has gradually evaluated teledermatology technology, funded by RCC Stockholm Gotland (The Regional Cancer Centre). The evaluation started with ten health centres 2015³ and the project was broadened, and in 2018 48 health centres used the system. ^{3, 4}

Region Stockholm is one of Europe's largest healthcare providers covering a patient population of 2.2 million. The region has now procured Dermicus to introduce a comprehensive standardized, operating system that will provide a user-friendly, secure and modern IT support for teledermatology for all approximately 220 health centres in the region under Region Stockholm's management and those managed by private care providers. The implementation will start during the Spring of 2021, with health centres gradually receiving training and going live on the teledermatology platform.³

The objective is to facilitate the communication and collaboration between primary and secondary care to enable efficient, safe and secure diagnosis of skin diseases.

The award decision regarding the procurement of the teledermatology platform, was made by the Healthcare Provision in Region Stockholm, the organisation responsible for placing orders for healthcare that is financed by public funds, and stated that:

“Broad introduction of teledermatology is part of the development of the care process for skin cancer and means that the region can offer better care at a lower cost as well as increased safety and accessibility for patients. A prerequisite for the working method is access to adequate IT support."

“We are delighted to have met Region Stockholm's requirements for the introduction of their new care process for teledermatology. The agreement with the Stockholm Region is now be the second tender we have won with an entire Region in Sweden. Stockholm has been working for several years to develop its care process in teledermatology and together with our platform Dermicus, an extremely efficient care process has now been created. Stockholm will have one of the most advanced platforms, taking teledermatology to a new level, together with future proofed AI-based functions being integrated,” said Daniel Eliasson, CEO of Gnosco.

About Dermicus and teledermatology

Dermicus is a digital health platform that consists of a smartphone application, dermatoscope and web application. Patient information and images are collected in primary care and then assessed by one or more dermatologists in the region at a distance. They provide feedback with a description, diagnosis and recommendation on how the patient is best treated.

Dermicus enables patients to be diagnosed with shorter lead times and also contributes to raising the level of knowledge of GPs in particular by first documenting a structured history and taking pictures and then relatively quickly receiving structured descriptive consulting responses from dermatologists, enabling optimized learning with direct support from dermatologists.

In sparsely populated areas and on islands, there are additional benefits to the Dermicus platform. Patients and staff do not have to travel to the same extent to get a diagnosis or education and lead times are shortened.

Sweden and a number of other countries have initiated various national initiatives on the prevention and early diagnosis of skin cancer. In December 2018, the report "Early detection of skin cancer with teledermatology – proposals for further development" was published by The Confederation of Regional Cancer Centres (RCC).⁵ A similar initiative from NHS England came in July 2019 in the form of an NHS report describing the vision and support for the implementation of teledermatology for early diagnosis of skin cancer during 2019/2020.⁶

In 2019, Region Skåne was the first region in Sweden to procure Gnosco’s Dermicus teledermatology platform⁷, and now Region Stockholm is the second.³ A third of the population in Sweden, 3.4 million, lives in these two regions.

Implemented in the UK NHS

In the UK, the Isle of Wight NHS Trust with a population of 144.000, is first to implement the Dermicus teledermatology platform for the early diagnosis of skin cancer. Since May 2020 all the 14 GP practices on the island is using the platform.

Dr Amy Poyner of the Lighthouse Medical, the dermatology service provider for the Isle of Wight and who is responsible for the implementation of Dermicus, said:

“It was clear before COVID-19 how effective the new service had been in improving care for our patients, but the pandemic has demonstrated additional benefits of the remote technology and online collaboration that we couldn’t have predicted when we started this initiative. Without Dermicus, we would have had to temporarily stop some of these services and rapidly plan alternative work arounds.”

“It’s why we think it’s so important to continue to scale the use of technology in our health services and will be looking to extend the teledermatology service further to all dermatology needs on the island. We are also considering introducing Gnosco’s telemedicine service for wound care, so that a much wider part of our community can benefit from these vital services, and importantly, we can continue to safeguard these services now, and in the future. The decision by regional health care providers in Sweden to implement teledermatology with scale, proves that this can be achieved, even with the challenges that COVID-19 brings.”

The implementation at the Isle of Wight NHS Trust started in July 2019, and an independent evaluation report by Wessex AHSN of the platform was published in April 2020⁸ states that the average wait from referral to first consultant review using the traditional pathway was 26 days, for referrals that have been through the Dermicus platform the wait time is 0.6 days. 45% of patients were able to be managed using remote advice and guidance only, reducing unnecessary outpatient appointments and reducing patient anxiety. 30% were able to be booked directly to biopsy, reducing the need for an initial appointment to determine whether biopsy was necessary.

About Gnosco

Dermicus is a Swedish teledermatology platform that has been developed in close collaboration with healthcare and has been used in healthcare for many years. Dermicus is delivered by the e-health company Gnosco AB, which offers products and services for improved care processes, specialist diagnostics, documentation and continuous knowledge development in healthcare. The platform is used for skin cancer, skin lesions diagnostics but also for leg ulcers and pressure ulcers. The development of AI-based features to diagnose skin cancer as early as possible is also ongoing.

For more information, visit: company site: www.gnosco.se/en/, solution site: www.dermicus.com/en

Contact

Daniel Eliasson, CEO Gnosco, +46 76-040 50 12, daniel.eliasson@gnosco.se

References

1. Teledermatoscopy - a successful project that shortens waiting times, RCC Stockholm January 2019: https://www.cancercentrum.se/stockholm-gotland/om-oss/nyheter/2019/januari/teledermatoskopi-ett-lyckat-projekt/

2. Janusinfo Region Stockholm, Evidence number 2, June 2020, theme Skin, Teledermatoscopy provides quick answers to suspected cancer, https://janusinfo.se/nyheter/tidningenevidens/nr22020temahud/2/teledermatoskopigersnabbtsvarvidmisstanktcancer.5.7ca45fe5172509d8dd32bada.html

3. Project for wide introduction of teledermatology, RCC Stockholm, December 2020, https://www.cancercentrum.se/stockholm-gotland/cancerdiagnoser/hud-och-ogon/projekt-teledermatoskopi/

4. Teledermatoscopy at more and more health centres, RCC Stockholm, October 2017, https://www.cancercentrum.se/stockholm-gotland/om-oss/nyheter/2017/oktober/teledermatoskopi-pa-allt-fler-vardcentraler/

5. Early detection of skin cancer with teledermatoscopy - proposal for further development, report published by The Confederation of Regional Cancer Centre, Sweden, December 2018, https://cancercentrum.se/globalassets/vara-uppdrag/prevention-tidig-upptackt/hudcancer/rcc-rapport_tidig_upptackt_teledermatoskopi_11dec18.pdf

6. Rapid Diagnostic Centres Vision and 2019/20 Implementation Specification, NHS Report, UK, July 2019, https://www.england.nhs.uk/publication/rapid-diagnostic-centres-vision-and-2019-20- implementation-specification /

7. Region Skåne has procured Gnosco's teledermatology platform for the efficient management of skin changes. Press release Gnosco, October 2 2019, https://www.mynewsdesk.com/se/...

8. Interim Independent Evaluation of Dermicus Telemedicine Platform in IOW Primary Care, Wessex AHSN, Real World Validation Report, April 2020, https://wessexahsn.org.uk/innovation-insight-library/90/interim-independent-evaluation-of -dermicus-telemedicine-platform-in-iow-primary-care

Notes to Editors:

About RCC, regional cancer centres in Sweden*

“Based on proposals in the official report by the Swedish Government, A National Cancer Strategy for the Future (SOU 2009:11), the Swedish Government introduced the establishment of regional cancer centres (RCC) in each and every healthcare region. The aim of the RCC is to increase healthcare quality and improve care results, as well as increase the efficiency of the use of health and medical care resources.“’

*The development of regional cancer centres, An overall assessment of a four-year follow-up, Article number 2017-10-36, Published www.socialstyrelsen.se, Oktober 2017, https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/ovrigt/2017-10-36.pdf

The Confederation of Regional Cancer Centre homepage: https://www.cancercentrum.se/s...