Innovative approach to designing user-centred digital solutions for plastic surgery patients with non-melanoma skin cancer

Non-melanoma skin cancers (NMSCs) are the most common malignancy in fairskinned patients. NMSCs incidence increases with age, and as the worldwide population is constantly ageing, the management of patients with NMSCs poses a considerable burden on healthcare systems. This study aimed to identify key digital solutions addressing the unmet needs of individuals with a NMSCs profile, through an adaptation of the “Blueprint on Digital Transformation in Health and Care in an Ageing Society” (Blueprint) user-centred design methodology. A phone survey was administered to 87 patients treated at the Plastic Surgery Unit of Federico II University Hospital from 2022 to 2023, to analyse the demographic, clinical and social characteristics of NMSCs patients. The theoretical elaboration of NMSCs personas was developed by an interdisciplinary Focus Group (FG). Seventy patients agreed to participate in the survey when contacted by phone, 55% were males. Only 4 patients had primary education. 52 patients (74%) had BCC, and 18 patients (26%) presented SCC. Most frequently referred comorbidities were diabetes (17%), hypertension (28%), overweight (41%) and obesity (13%). Patients’ primary concern was the possible need for extended hospitalization and not having easily accessible information and medical assistance. 92% of our patients declared that they could rely on someone to assist them in using a smartphone or a tablet. The FG elaborated a “Persona” named Pino, a 67-year old retired man living in the suburban Neapolitan area. He suffers from diabetes and hypertension. Pino is also overweight, smokes a few cigarettes a day and occasionally drinks wine or spirits. He has a diagnosis of an invasive basal cell carcinoma of the scalp. Pino has trouble keeping track of all the preoperative and postoperative prescriptions and would like to have direct contact with the healthcare practitioners. He has difficulties adhering to his therapy. Pino is unable to reproduce postoperative dressings correctly. The digital solution proposed y the FG is a mHealth solution that supports the patient with a shared digital calendar for medical appointments, connected to a smart pillbox. The solution must support patients through a digital education package that includes tutorials on dressing and dressing prescriptions. An AI-supported chatbot would allow patients to quickly access the information they need. The Blueprint “Persona” methodology is a powerful tool to help healthcare professionals identify the unmet needs of specific patient subsets. Further studies are necessary to evaluate the ctual feasibility of implementing therapeutic pathways for patients with NMSCs through mHealth solutions.