Houston STD Program's Use of the 'Testing 4 Tickets' Database to Promote Increase Clinic Attendance, Comprehensive Services and Enhanced Disease Intervention

Background:  STD programs are challenged by fiscal and personnel constraints to provide quality and comprehensive clinical services to clients at risk for STDs. 

Objectives:  To describe how the Houston Health Department effectively used a clinic management database to provide comprehensive STD services during the nation’s largest mass HIV testing event.

Project Description:  In 2011, the Houston (TX) Health Department’s Bureau of HIV/STD and Viral Hepatitis Prevention provided a full-service STD clinic at the annual HIP HOP for HIV Awareness event, the largest mass testing event in the nation. The Bureau offered gonorrhea, Chlamydia, syphilis, rapid HIV and, for the first time, rapid HCV testing, utilizing a web-based data management system called Testing 4 Tickets, (T4T). A risk assessment tool in T4T was used to triage clients for abbreviated medical exams, prophylactic treatment, intervention interviews and support services. The T4T database was accessible to all STD clinic components: registration/triage, laboratory, nursing and Disease Intervention Specialist (DIS).

Findings:  The T4T database aided in increasing the number of clients receiving comprehensive clinical services at a time of reduced program resources. The Bureau registered 2,675 clients for STD clinical services and triaged 1,263 (48%) as high risk. The Bureau identified the following new cases: HIV (12); Syphilis (13); Chlamydia (268); gonorrhea (35) and HCV (3).  The nursing staff conducted 532 STD exams and 1,173 prophylactic treatments for syphilis, gonorrhea and/or Chlamydia.

Conclusions:  Using T4T data management system along with traditional STD program protocols is a cost effective method to provide comprehensive clinical services and to enhance clinic attendance.

Implications for Programs, Policy, and Research:  Clinic management databases aid in enhancing STD services during times of limited resources. The Houston STD Program is implementing the T4T database to enhance program operations at its three STD clinics.