Multisite Implementation of a Sexual Health Survey and Clinical Decision Support to Promote Adolescent Sexually...

Area of Science:

• Adolescent health
• Public health informatics
• Digital health interventions

Background:

• Adolescents face high risks for sexually transmitted infections (STIs).
• Emergency departments (EDs) are frequent care sites for adolescents.
• Electronic screening offers a confidential method for STI risk assessment.

Purpose of the Study:

• To implement a patient-facing electronic survey for adolescent STI risk assessment and testing consent.
• To integrate provider-facing electronic clinical decision support (CDS) across multiple pediatric EDs.
• To evaluate the implementation using survey and CDS usage metrics.

Main Methods:

• A pilot-provided electronic survey and CDS code were deployed across six pediatric EDs.
• Institutions adapted the system to local workflows with IT and informatics support.
• Electronic health record (EHR)-embedded CDS was successfully implemented.

Main Results:

• 6,165 adolescents completed the survey out of 79,780 eligible.
• CDS was triggered 2,058 times across six sites.
• Providers acknowledged CDS 81.6% of the time, ordering STI tests 47.3% of the time.

Conclusions:

• Patient-facing screeners with integrated electronic CDS are feasible across multiple institutions.
• Successful implementation requires a blend of IT, informatics expertise, and clinical workflow knowledge.