A Staff-Directed Electronic Medical Record Alert to Increase Chlamydia Screening: A Randomized Clinical Trial

Area of Science:

• Public Health
• Infectious Diseases
• Healthcare Technology

Background:

• Chlamydia is the most common sexually transmitted disease (STD) in the US.
• Screening is recommended for sexually active females 24 years or younger to prevent pelvic inflammatory disease.
• Current screening rates remain suboptimal.

Purpose of the Study:

• To evaluate if an automated electronic medical record alert increases chlamydia screening rates.
• The alert targeted medical assistants preparing patients for visits.

Main Methods:

• A cluster randomized clinical trial (STD Testing in Outpatient Practices - STOP STDs Study) was conducted.
• Primary care and obstetrics-gynecology offices in western Pennsylvania participated.
• Offices were randomized to receive an electronic alert or usual care.

Main Results:

• In primary care, chlamydia tests were ordered more frequently in alert practices (13.2%) vs. control (3.8%).
• The alert was associated with a 2.74-fold increased odds of test orders in primary care.
• The alert did not significantly impact screening rates in obstetrics-gynecology practices.

Conclusions:

• An electronic alert to medical assistants increased chlamydia test orders in primary care.
• This intervention may improve screening proportions and reduce STD sequelae.
• Further implementation in primary care settings is warranted.