Expanding Sexually Transmitted Disease No-Reply Text Messaging Services Using Quality Improvement Processes


Impact Statement: 
The Specialty Care clinic at the Florida Department of Health in Seminole County sought to notify clients more quickly of the results from their tests at the sexually transmitted disease clinic. A QI project led to implementation of a confidential no-reply text messaging system which resulted in faster notification and streamlined department services.
The Specialty Care clinic at the Florida Department of Health in Seminole County (DOH-Seminole) provides sexually transmitted disease (STD) and HIV/AIDS services. DOH-Seminole started offering no-reply text messaging STD results for gonorrhea, chlamydia, and negative syphilis to clients in January 2012 as part of a state-supported pilot program. Initial client feedback and program success promoted expansion of this service to additional programs offering STD testing, including Family Planning and Prenatal clinics. To notify clients quickly and reduce the number of clients who need to return to the clinic for test results, clients can opt to receive results via text message. The message is confidential and delivered encoded. Clients consent to this service and provide their cell phone information when they are tested. An instruction card is given to the client that explains the codes and follow-up procedures. Clients are encouraged to contact the clinic with any questions. The STD surveillance clerk collects all test results as they are received. A field record is created, and results are attached and submitted to an administrator through the state surveillance system, Patient Reporting Investigation Surveillance Manager (PRISM). The message is generated through PRISM and sent to the client. Seminole Code 1 followed by a phone number indicates that the client should call the disease intervention specialist for a positive result and follow-up. Seminole Code 2 indicates that the results were negative and no further action is necessary. A customer survey indicated that clients are overwhelmingly satisfied with this service. They appreciate the timely notification and convenience. The service also improves departmental performance in state requirements for notification, treatment, and closure of field records related to positive STD results. Analysis of implementation in Family Planning and Prenatal clinics is ongoing to determine the effect on health outcomes for contacts and congenital and newborn exposures.
Organization that conducted the QI initiative: 

Walsh, D. Public Health Quality Improvement Exchange. Expanding Sexually Transmitted Disease No-Reply Text Messaging Services Using Quality Improvement Processes. Wed, 03/08/2017 - 14:54. Available at https://www.phqix.org/content/expanding-sexually-transmitted-disease-no-reply-text-messaging-services-using-quality. Accessed August 19, 2018.

Submission Status: 
2 users have voted.


Submitted by walshd on

We truly appreciated the whole QI project. The training, coaching and implementation.
We will be utilizing many of the tools we learned in our future QI projects

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Submitted by marni on

The prevalence of social media today makes it an exciting and effective method of communication to many public health clients, including notifying them of confidential test results. This QI project expanded the use of texting STD test results to clients, with their consent, and shows high levels of client satisfaction and increased efficiency in getting test results to specific individual clients. A good communication process to consider adopting in your STD or other PH program! Marni Mason

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Submitted by JessKing on

What a great initiative! Eliminating a major barrier in returning for results in a safe, confidential manner is just what was needed. I would like to see information about the number of individuals who return for follow up with this as compared to other notification methods. I also look forward to hearing more about how this works in other contexts!

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Submitted by Dan Partridge on

We have been talking with our staff about how to do this. We are not on PRISM and our EHR does not have that feature. What off the shelf technology exists to allow us to implement?

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Dan Partridge

Submitted by dmhunter on

I don't think HIPAA is a concern in the sense that the patient has to give consent to the method of notification, just as he/she would for mail or telephone results. If anything, this is a great opportunity to be more compliant with confidentiality provisions, particularly where there are services provided to minors, by getting them results directly rather than sending them to whomever holds the insurance policy (usually the parent).

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Submitted by mthorne on

I see that this was submitted a while back and is still in progress.  Any updates on how this issue is progressing?  Any new lessons learned?

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Submitted by prusso on

So glad to see this posted on PHQIX.org!  I heard this project presented a few COPPHI Open Forum meetings ago, and throught it was a very exciting and promising practice for replication

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