230040 Can the Internet be used to notify Emergency Department patients that they are infected with Chlamydia trachomatis or Neisseria gonorrhea

Monday, November 8, 2010

Elaine Alverez, MD , Internal Medicine, Good Samaritan Hospital, Cincinnati, OH
Edmond Hooker, MD, DrPH , Health Services Administration, Xavier University, Cincinnati, OH
Larry Gray, PhD , Pathology, TriHealth Hospitals, Cincinnati, OH
Jennifer Steinbrunner, BS , E. Kenneth Hatton, MD, Institute for Research and Education, Good Samaritan Hospital, Cincinnati, OH
Background: Sexually transmitted infections are commonly encountered in the emergency department (ED). Test results for infections with Chlamydia trachmatis (CT) or Neisseria gonorrhea (NG) frequently are reported back days after the patient has already left the ED. Objectives: The purposes of the current study were to determine if patients who tested positive for CT or NG were aware of their diagnosis and explore the possible use of the Internet as a tool to deliver test results. Methods: Included in this prospective observational study were patients who had been examined in the ED and had the test return positive for CT or NG. All patients were contacted by phone and administered a structured interview. Results: During a 4 month period, 145 patients tested positive for CT or NG. Only 46 patients were contacted (40 females and 6 males). Ninety-nine could not be reached for an interview (49 were unable to be reached after 3 attempts; 36 had an incorrect phone number; 14 for other reasons). Of those contacted, 89% were aware they had been tested for a sexually transmitted infection, but only 35% were aware they might be infected. Although 57% had received treatment at the time of initial testing in the ED, only 20% of patients had received a letter from the hospital indicating that they needed to contact the hospital about their laboratory results. When asked about accessing their results from the computer, only 33% indicated they could access results from the computer, and many expressed concerns about confidentiality. Conclusions: Many ED patients who tested positive for CT or NG were not aware of their diagnosis and were not treated at the time of the ED visit. Current procedures for notification are not working and the Internet does not appear to be a viable option for patient notification.

Learning Areas:
Administration, management, leadership
Communication and informatics
Public health administration or related administration

Learning Objectives:
Attendees will be able to describe the problems with asking patients to access their test results through the Internet

Keywords: Health Information, STD

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a resident physician who performed this research with Dr. Hooker. Dr. Hooker is an expert in emergency medicine, information technology and public health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.