{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:42:49Z","timestamp":1777858969811,"version":"3.51.4"},"reference-count":56,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Importance:<\/jats:title>\n                    <jats:p>Patients with a primary cutaneous melanoma (PCM) are at increased risk of developing a second primary melanoma (SPM). Earlier stage at diagnosis is associated with better 5-year mortality, yet low compliance with recommended follow-up after treatment for PCM and high rates of patients lost to follow-up are reported in the literature. Strategies to enhance population-based surveillance for SPM have not been well described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine whether the implementation of a systematic automated population-based program (SAPP) to ensure dermatologist total body skin exams (TBSEs) in the PCM population compared to the pre-automated period and pre-database periods improves compliance with follow-up, detects more SPMs, or affects mortality?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Quality Improvement Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Large integrated health care system with internalized Dermatology services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Members with a PCM prior to, or during the study periods of interest, were included in this quality improvement study. There were 6317 eligible individuals with PCMs in 3 study periods: pre-Database (1\/1\/2005-11\/1\/2009), pre-Automation (11\/1\/09-7\/31\/15), and post-Automation (8\/1\/15-12\/31\/2021), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention(s) or Exposure(s):<\/jats:title>\n                    <jats:p>Manual registry for melanoma patients (pre-Automation) and systematic automated population-based program for PCM patients (post-Automation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome(s) and Measure(s):<\/jats:title>\n                    <jats:p>Mean number of TBSE per person-year. Time Between TBSE. Incidence of SPM detection. Stage of SPM at diagnosis. Melanoma Death and All-Cause Mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In patients with PCM, a SAPP to ensure dermatologist TBSE, reduces median time (months) between TBSEs from 12.3 pre-Database to 8.2 post-Automation (stage 0-2a PCM) and from 10.3 to 6.8 (stage 2b-4 PCM; P\u2009&lt;\u2009.0001), improves number of TBSEs per person-year with each successive study period (pre-Database mean [SD] 0.56 [1.07]; pre-Automation 0.80 [1.25]; post-Automation 1.78 [4.17]; P\u2009&lt;\u2009.0001), and improves SPM detection rates per 1000\u2009person-years (pre-Database 20.2 [95% CI 12.2-30.9]; pre-Automation 27.5 [18.2-39.9]; post-Automation 27.5 [26.6-51.8], P\u2009&lt;\u2009.0001 for trend) at earlier cancer stages. There is an associated annual reduction in all-cause (1.4\u2009per 1000\u2009person-years, P\u2009=\u2009.0004) and melanoma-cause mortality (0.2\u2009per 1000\u2009person-years, P\u2009=\u2009.0197).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Implementing a systematic, automated population-based Melanoma program to ensure dermatologist TBSEs improves compliance with follow-up in patients with PCM. More patients received at least annual dermatologist TBSEs and more SPMs were detected at earlier stages. Improvements were sustained and there were significantly lower all-cause and melanoma-cause mortality. The system facilitates prioritization of higher risk patients for intervention and is a unique strategy enhancing patient safety, efficiency, and timeliness of care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319241306298","type":"journal-article","created":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T06:50:49Z","timestamp":1734331849000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Systematic Automated Population-Based Surveillance to Improve Outcomes in Primary Cutaneous Melanoma"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3771-0527","authenticated-orcid":false,"given":"Allison","family":"Ching","sequence":"first","affiliation":[{"name":"Kaiser Permanente Hawaii, Honolulu, HI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Pedula","sequence":"additional","affiliation":[{"name":"Hawaii Permanente Medical Group, Honolulu, HI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Devere","sequence":"additional","affiliation":[{"name":"Hawaii Permanente Medical Group, Honolulu, HI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheryl","family":"Aruga","sequence":"additional","affiliation":[{"name":"Hawaii Permanente Medical Group, Honolulu, HI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacey","family":"Honda","sequence":"additional","affiliation":[{"name":"Hawaii Permanente Medical Group, Honolulu, HI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Ching","sequence":"additional","affiliation":[{"name":"Hawaii Permanente Medical Group, Honolulu, HI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,12,16]]},"reference":[{"key":"bibr1-21501319241306298","unstructured":"American Cancer Society. 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