Multimodal approach in treatment of skin cancer

It has been established that the patient's pathways may differ from their formal routing. The multimodal interdisciplinary approach to skin cancer treatment mitigates the risks of medical care delay, helps to develop patients' adherence, use personalization treatment approach and safe human resources. Purpose of the study was to describe the state of skin cancer care at the oncology dispensary, reveal risks of medical care in time provision, formulate requirements for the optimal organization of oncological care and propose its improvement taking into account quality, accessibility, and patient adherence. Materials and methods. Patient routing was assessed using observation, description and measurement methods. Based on the medical site statistics, the main risks of compliance with the requirements for routing and the timing were identified. Using the methods of system analysis, a model of the optimal organization of skin cancer medical care in the region was built. Results. Due to the high incidence of skin cancer, the improvement of the oncodermatological service in the region and the optimization of patient routing can be considered as a priority task. The main risks of the existing organization of the patients flow are the risk of exceeding the period of diagnostics, the risk of exceeding the treatment start, the risk of low patient adherence and the poor follow-up, inability to provide a personalized medical care which corresponds to patient's individual needs. Excessive patient's logistic during the entire cycle of diagnosis and treatment, excessive costs of highly specialized human resources and their remoteness from the main patient flow are considered as the basis for organizing a multimodal skin cancer oncology care. Discussion. The developed model is based on a value-oriented approach, risk-oriented approach and contributes to the achievement of a synergistic effect at the regional level through a comprehensive solution to the problems of introducing innovations in the industry. Conclusion. The presented multimodal design of the skin cancer care is aimed to achieve a synergistic effect due to the maximum concentration of competencies and resources. Allocation resources in accordance with the patients needs should contribute to improving the healthcare quality and accessibility, and develop patient adherence. (author)