Shortening the Time Interval for the Referral of Patients With Soft Tissue Sarcoma to Expert Centers Using Mobile Health: Retrospective Study

Abstract

Background According to guidelines, all patients with sarcoma must be managed from initial diagnosis at expert sarcoma centers. However, in everyday practice, the time interval to an expert center visit can be long, which delays presentation to an expert multidisciplinary tumor board and increases the risk of inappropriate management, negatively affecting local tumor control and prognosis. The advent of mobile health offers an easy way to facilitate communication and cooperation between general health care providers (eg, general practitioners and radiologists) and sarcomas experts. We developed a mobile app (Sar’Connect) based on the algorithm designed by radiologists from the French Sarcoma Group. Through a small number of easy-to-answer questions, Sar’Connect provides personalized advice for the management of patients and contact information for the closest expert center. Objective This retrospective study is the first to assess this mobile app’s potential benefits in reducing the time interval for patient referral to an expert center according to the initial clinical characteristics of the soft tissue tumor. Methods From May to December 2021, we extracted tumor mass data for 78 patients discussed by the multidisciplinary tumor boards at 3 centers of the French Sarcoma Group. We applied the Sar’Connect algorithm to these data and estimated the time interval between the first medical description of the soft tissue mass and the referral to expert center. We then compared this estimated time interval with the observed time interval. Results We found that the use of Sar’Connect could potentially shorten the time interval to an expert center by approximately 7.5 months (P<.001). Moreover, for half (31/60, 52%) of the patients with a malignant soft tissue tumor, Sar’Connect could have avoided inappropriate management outside of the reference center. We did not identify a significant determinant for shortening the time interval for referral. Conclusions Overall, promoting the use of a simple mobile app is an innovative and straightforward means to potentially accelerate both the referral and management of patients with soft tissue sarcoma at expert centers.

The prediagnostic general practitioner care of sarcoma patients: A real‐world data study

“…In France, the initiative of the app Sar'Connect was taken, which aimed at improving sarcoma awareness, increasing the rate of early detection of STS and facilitate patient referral to expert centers within the French network. 30 Furthermore, research conducted in the UK indicates that GPs have improved their accuracy in identifying STS. 31 In the UK, the sarcoma referral guidelines incorporated a 2week wait referral pathway for patients with a soft tissue mass meeting one of the four parameters: size >5 cm (similar to a golf ball), increasing size, deep to fascia, painful or recurrence.…”

Unplanned Sarcoma Excisions: Understanding How They Happen

“…[27][28][29] An app was also recently designed to facilitate the referral pathway, shortening waiting times for patients. 40 The limitations of our study include the retrospective nature of the analyses and obtaining data from secondary sources. In addition, this was a single-institution investigation, and some patients may have pursued treatment of their unplanned excisions elsewhere, leading to an underestimation of the unplanned excision incidence.…”

“… 27 - 29 An app was also recently designed to facilitate the referral pathway, shortening waiting times for patients. 40 …”

Informing Patient-Provider Engagement for Shared Decision Making Through Mobile Health Applications

“… 18 This promotes continuity of care, reduces the likelihood of fragmented information, and enhances collaboration among healthcare professionals, leading to a more comprehensive and coordinated approach to managing chronic conditions. 12 , 13 The convenience, flexibility, and personalized nature of mHealth apps make them valuable tools for promoting collaborative and patient-centered care in managing chronic health conditions. 14 Furthermore, mHealth apps provide a convenient platform for individuals to communicate with their providers, share health information, ask questions, and receive guidance.…”

“…10 By enabling people to access personalized information, monitor their progress, and actively participate in their care, mHealth apps can assist patients to have knowledge of their health and keep track of self-management. [11][12][13][14][15] From the patient's perspective, patients who are knowledgeable about their condition may have better control over their situation and are better equipped to deal with treatment and outcome uncertainties. [16][17][18] Additionally, knowing how chronic health issues and patient characteristics affect the use of mHealth apps might help develop targeted interventions to reduce inequalities and enhance healthcare outcomes.…”