Creating a Sustainable Future for Sexually Transmitted Infection Services

Background:  The passage of the ACA and the changing landscape of medical coverage and clinical care make it increasingly important for agencies to work collaboratively to implement sustainable approaches to STI clinical services for vulnerable populations.

Methods:  To assist LHD STI programs in their efforts to be sustainable, the Maryland Department of Health and Mental Hygiene’s Center for STI Prevention, and Training 3, the Region III STD-Related Reproductive Health Training and Technical Assistance Center, convened a two-day training for fiscal, administrative, and clinical representatives from15 participating LHDs. The objectives included: educating participants on revenue cycle management and its impact on clinic operations; assessing the current status of clinic operations using 2012 data collected by each LHD before the training, including service utilization, cycle time, and cost analysis; and assisting LHDs in developing action plans addressing all aspects of operations to support program sustainability.

Results:  Service utilization, cycle time, and service delivery costs varied by site. Preliminary analyses indicated an average of 2065.53 total annual visits per clinician; 3.93 total visits per hour; cycle time of 1:08, contact time of 0:43, and $120.81 cost per STI visit. An examination of county-specific and summative data supported a need for short- and long-term action-planning. Action plans included increasing regular staff communication, improving physical or staffing infrastructure, taking steps to implement or improve electronic health records systems, and establishing or continuing routine cost and cycle time analyses.

Conclusions:  Routine LHD STI clinic data analysis and collaborative action-planning may be used as a tool to improve clinic sustainability. Analysis of a six-month post-training survey, available in April, will be used to determine improvement in sustainability of STI clinical services in participating LHDs, as a result of this training and follow-up TA.