Background:
Computerized medical record systems transform the way patient medical information is stored and the capacity of local STD programs to make programmatic decisions and evaluate clinic operations. NYC's Bureau of Sexually Transmitted Disease Control developed an electronic medical record (STD-EMR) in-house and implemented it in it's10 clinics. Between August 2004 and September 2005, 65,403 visits were recorded in the STD-EMR. While programming and project management of STD-EMR was in-kind, the BSTDC spent $240,000 to purchase hardware and pay stipends to 4 training consultants.

Objective:
To provide examples of how the STD-EMR system increases productivity and generates quality assurance measures that were previously unavailable. To demonstrate how STD-EMRs can guide programmatic decisions and improve the quality of decisions made about healthcare.

Method:
The presentation will include a demonstration of the STD-EMR and discuss ongoing cost and time-saving aspects of a web-based system. Specific examples of how STD-EMR has guided programmatic decisions in NYC will be provided.

Result:
Numerous ‘canned' reports of clinical quality assurance measures are now available including, number (%) of men who have sex with men reporting oral/anal exposure sites that are GC-cultured from those sites, percentage of females less than 30 years of age who were screened for Chlamydia at first MD visit, and incident STD morbidity among HIV positive individuals. Individual staff productivity and patient flow may be assessed at a glance using color coded line lists of patients in the clinic.

Conclusion:
The STD-EMR provided for time and space efficiency, a continuity of care across clinics, more complete and uniform data sets, and the analysis of quality assurance measures.

Implications:
STD programs that use paper medical records can apply this information to guide decision making about conversion to an electronic system and use the lessons learned to evaluate whether a similar initiative is warranted in their jurisdictions.