How a Hungarian Hospital Cuts Melanoma Care Delays With a Digital Patient Pathway System

When a suspicious mole turns out to be melanoma, every day between suspicion and treatment matters. A study published in BMC Health Services Research describes how Hungary’s first oncology patient pathway management system, the OnkoNetwork, organizes the journey of melanoma patients from the first moment of suspicion through diagnosis, treatment, and follow-up, and how it enforces strict time targets at every step of that journey.

The OnkoNetwork system was developed and implemented in 2015 at Moritz Kaposi General Hospital in Somogy County, Hungary. The research team, led by Gabriella Szörényiné Ványi of the University of Debrecen together with colleagues from the hospital’s OnkoNetwork office, dermatology department, and oncology services, followed the care of 670 melanoma patients within a much larger population of oncology patients managed by the system. Their goal was to document how a structured, protocol-driven pathway performs in real clinical practice.

The architecture of the system is built around defined time windows. From the moment a patient enters the pathway with a suspicion of melanoma, the system ensures that the patient is seen and diagnosed within 21 days. Once the patient’s data are in the system, a multidisciplinary Oncoteam must decide on further investigations and treatment within 30 days of entry. After that decision is made, treatment begins within 14 days. These three intervals—21 days to diagnosis, 30 days to a treatment decision, and 14 days from decision to the start of therapy—form the backbone of the pathway’s time management.

Standardization is the second pillar of the system. The diagnosis, oncological treatment, and follow-up of melanoma patients are governed by standardized protocols, which means that every patient moves through the same evidence-based sequence of steps regardless of which physician they first encounter. This uniformity is intended to eliminate the variability that arises when care depends on individual referral habits or departmental routines, and it gives clinicians a shared framework for decisions about excision, staging, systemic therapy, and surveillance.

The authors identify several problems that the pathway system is designed to solve. Its importance lies, first and foremost, in providing uniform, protocol-driven care. It also redirects so-called lost patients—people who would otherwise fall through the cracks of a fragmented healthcare system—and reduces delays caused by anomalies in how care is organized and delivered. In a conventional referral chain, a patient with a suspicious lesion may wait weeks for a dermatology appointment, then further weeks for histopathological confirmation, and still more time before an oncologist decides on therapy. Each handoff is an opportunity for delay, and the OnkoNetwork is engineered to compress those handoffs.

The rising incidence of melanoma is what makes this kind of pathway management a priority. Melanoma is among the most aggressive skin cancers when detected late, but outcomes improve substantially when diagnosis and treatment occur early. Health services research has long shown that delays in cancer care are associated with worse survival, and melanoma’s rapid progression potential makes time-to-treatment a particularly sensitive metric. By monitoring the process and time management of every melanoma patient from suspicion to closure of the care episode, the system turns waiting times from an unmeasured byproduct into a managed, auditable quantity.

The study was conducted with the permission of the Moritz Kaposi General Hospital Institutional Ethics Committee, and all procedures complied with the Declaration of Helsinki. Participation in OnkoNetwork-supported care pathways required written informed consent: patients acknowledged that they had received adequate information about the purpose and operation of the system and granted permission for all data and results recorded during their treatment to be used for scientific, research, and educational purposes. The authors declared no competing interests, and the research received no external funding.

From a health services perspective, the OnkoNetwork represents a model of integrated oncology care that other institutions could adapt. A central coordination office tracks each patient’s position in the pathway, flags bottlenecks, and enforces the protocol-defined intervals. The multidisciplinary Oncoteam structure ensures that dermatologists, pathologists, surgeons, radiation oncologists, and medical oncologists review each case together rather than sequentially, which shortens the interval between diagnosis and a definitive treatment plan. The system also prioritizes follow-up, so that surveillance after treatment is not left to ad hoc arrangements.

The concept of patient pathway management is part of a broader international movement toward organized cancer care, in which countries and hospitals define maximum waiting times from referral to diagnosis and from diagnosis to treatment. What distinguishes the Hungarian implementation is its explicit monitoring of the entire trajectory—from the time of suspicion to the time of closure—for a specific tumor type, within a single regional hospital network. The 670 melanoma patients followed in the study represent a substantial real-world cohort managed under one coherent set of rules.

For patients, the practical meaning of the system is straightforward: a defined maximum wait for each stage of care, a team that meets to decide on treatment, and a guarantee that therapy starts within two weeks of that decision. For health systems, the study offers evidence that pathway management can be operationalized outside high-income flagship centers, using a regional hospital as the coordination hub. As melanoma incidence continues to climb, the OnkoNetwork experience suggests that the tools for shortening the distance between a suspicious lesion and effective treatment are organizational as much as they are medical—and that disciplined time management, enforced by software and multidisciplinary teamwork, can be replicated wherever the will to standardize exists.

Subject of Research: Oncology patient pathway management for melanoma care coordination and time optimization in the OnkoNetwork system

Article Title: Optimizing time and care coordination for melanoma patients in the Onkonetwork system

Article References: Szörényiné Ványi, G., Szigeti, A., Battyáni, Z., & Repa, I. (2026). Optimizing time and care coordination for melanoma patients in the Onkonetwork system. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15581-0

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15581-0

Keywords: melanoma, OnkoNetwork, patient pathway management, oncology care coordination, time management, Hungary, integrated oncology care, health services research, patient-centred care, dermatology, cancer diagnosis delays, multidisciplinary Oncoteam