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PHO in action: STI Lab Data Decision Support Tool
 
Dr. Vanessa Allen, chief medical microbiologist, and Jim Tom, chief information officer, and the STI Lab Data Decision Support Tool.

How can we improve the health of Ontarians?

To answer this question, health providers in the public health system require sound information and evidence to make good decisions. However, information is sometimes hard to access, is outdated or lacks appropriate context or details. To that end, Dr. Vanessa Allen, chief medical microbiologist and Jim Tom, chief information officer, have led the development of an innovative, award-winning tool to improve clinical and public health decision-making related to chlamydia and gonorrhea, the two most commonly reported sexually transmitted infections (STIs) in Canada.

In collaboration with public health units across the province, and with funding from Canada Health Infoway, Allen and Tom’s team developed PHO’s STI Lab Data Decision Support Tool. It delivers up-to-date laboratory data on gonorrhea and chlamydia for clinicians and management in each public health unit, which can be used to inform decisions at both a local and provincial level.

For more information on PHO’s work related to STIs, check out Research in Action: drug-resistant gonorrhea and Testing and Treatment of Gonorrhea in Ontario.
Total Tests, Total Positives and % Positivity
Total Tests, Total Positives and % Positivity (Combined - Monthly by Health Unit)
     

The user-friendly tool takes lab testing data and displays it graphically, supporting local decisions about treatment, disease management and policy around STIs. Instead of working off outdated and often national-only data, public health officials can see current, relevant local information, updated monthly. The tool can display data according to gender and age of those affected in a particular health region, what treatment they are receiving and how they were tested, as well as differences between rural and urban areas. In addition, the STI decision support tool includes links to the latest guidelines and an updated blog reviewing the most recent science in disease control of these pathogens.

Says Allen: “Our goal is to provide the right information, at the right time, in the right format - to give people an easy way to ask questions and get answers to make better clinical and public health decisions.”

The tool assists in identifying people who may be more at risk, and therefore may require more frequent screening, as well as trends in drug resistance and shortcomings in current methods of treatment. Having the ability to have up-to-date tracking of patterns in the province — particularly of antibiotic resistance and where it is occurrin — is hugely beneficial. “This information will help to combat the spread of drug-resistant infections,” explains Allen. “Antibiotic resistance to STIs is a growing problem, and the more we know about what is happening and where, the more we can work together on solutions.”

“Having a picture of the variability across regions, or rural vs urban patterns, helps inform investments and interventions for more effective prevention and disease control. This includes treatment recommendations, outreach and education to high risk populations, and community programs with local practitioners” adds Allen.

The STI Lab Data Decision Support Tool is being used by a number of health units, and the response has been very positive:

“[The tool] is very user friendly… like an iPhone, it is made up in a way that is easy and fun to use. Quick and interesting, it is really well done. We were looking at percent positivity of pharyngeal CT/GC testing compared to other sites. We were basically trying to figure out how much pharyngeal testing we should be doing in our clinic... [The tool] told us that pharyngeal testing is not going to be very cost-effective/efficient compared to other testing methods and we should only do pharyngeal testing for those at high risk of pharyngeal infection “

— Kingston, Frontenac, Lambton and Algonquin Public Health
“Being able to tie in testing information … helps to provide a bit more context. The tool helps to explain the changes in cases and rates. The resistance piece is something additional and totally new. So, being able to report on that regularly will be valuable.”
 

— Peel Public Health

“[Our Health Unit] is a fairly small jurisdiction but our chlamydia and gonorrhea rates are actually significantly above provincial averages. It could help us establish what risk factors to look at and recruit individuals into those clinics. It has the potential to definitely shape how we deliver care and how and who we’re reaching out to in terms of testing. The fact that we can just go online and it’s already calculated for you is extremely beneficial for surveillance in general.”
 

— Thunder Bay District Health Unit

“I integrate [the data from the tool] into a weekly/biweekly update on gonorrhea that we’re seeing in Ottawa… it is helping to make our responses more appropriate.”
 

— Ottawa Health Unit

The project team received an award in 2013 for "Outstanding Achievements in Project Delivery" from the Ontario Public Service, in recognition of its innovative work with multiple public sector partners. While the tool was developed for application to the two STIs, work is currently underway to apply it to other diseases such as respiratory viruses. “This tool demonstrates our ability to take raw data, capture the scientific and medical interpretations of the data and present the results in meaningful ways that are easily accessible to end users,” says Tom. “We are now applying the same thinking and methods to other communicable and infectious diseases as we work with our public health partners to monitor, detect, manage and control disease.”

Disclaimer: The above reports were developed by Public Health Ontario based on laboratory results of testing performed by the Public Health Ontario Laboratories.

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Page last updated: 16/10/2014 2:33 PM
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