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Background: The New York City Department of Health and Mental Hygiene (NYCDOHMH) Bureau of Sexually Transmitted Disease Control (BSTDC) conducts a high-school CT/GC screening program which tests 12,000 students annually; students call a single person for test results. During 2007-08, approximately 17% of students called for results. BSTDC clinics service >125,000 patient-visits annually with 7200 results calls/month. Four call center staff respond to 80% of calls.
Objectives: To implement an automated test result reporting system serving students and STD clinic patients.
Methods: BSTDC, with NYCDOHMH Division of Informatics/Information Technology, procured an automated laboratory test result messaging system. Functional requirements, including message content, business rules and algorithms to predict message type were developed. Students accessing CT/GC results receive one of three messages: call BSTDC; results are normal/negative; return to clinic because of inconclusive results. Clinic-based services involve additional more complicated tests; thus patients receive one of four messages: return to clinic; call BSTDC; results are normal/negative; results pending.
Results: The web-based and telephonic results system was implemented for the high-school program November 2008. From November 2008-August 2009, 27% (1982/7484) of students, and 37% (169/463) of positives accessed results. BSTDC is pilot testing algorithm and message assignment for clinic-based services. Testing using a virtual electronic medical record and actual patient data is necessary to validate algorithms used to determine message type. Business rule, algorithm development and testing has taken 9 months. The STD clinic test result reporting system launches in 2009.
Conclusions: Automating results eliminated the staffing need for student result inquiries and increased the number of students accessing results. Developing algorithms and business rules that accommodate multiple test results is complicated and requires extensive testing to ensure appropriate message assignment.
Implications for Programs, Policy, and/or Research: The system is expected to increase patient access to information and reduce staff time.