Exploring patient experiences in pre-hospital planning for skin cancer surgery.

Abstract

Non-melanoma skin cancer (NMSC) is the most common cancer in Denmark, with increasing incidence and referral rates to plastic surgery departments. To optimize treatment pathways and reduce outpatient visits, a pre-hospital intervention using the "Mit Sygehus" application was introduced, enabling patients to participate in treatment planning by submitting information and photographs of their lesions for triage. We aimed to explore patient experiences and satisfaction with photo-assisted triage. We conducted a single-center, explanatory mixed-methods study at Lillebaelt Hospital, Denmark. Patients referred with suspected NMSC between March 2023 and February 2025 were included. Those with insufficient referral details were invited to submit photographs and complete a medical survey via the "Mit Sygehus" application. Experiences were assessed through electronic surveys inviting all patients and semi-structured interviews with non-participants. Quantitative data were analyzed using descriptive statistics and comparative tests, and qualitative data were examined using thematic analysis. Among the 201 eligible patients, 95 (47%) submitted photographs and 69 (73%) of these patients completed the survey. Among the non-participants, 52 (49%) responded to the survey. Satisfaction was high across all groups (≥96%). Participants reported a clearer understanding of their role (83% vs. 46%) and better information (93% vs. 49%) compared to non-participants. Evaluation interviews revealed barriers such as technical challenges, lack of understanding of the study, and emotional factors. High satisfaction among patients was maintained using photo-assisted triage. Telehealth interventions can enhance efficiency and resource use without compromising patient experience, but addressing technical and emotional barriers is essential for broader integration.