WI State Report RVIPP, Indianapolis, IN June 9-10, 2010.
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Transcript of WI State Report RVIPP, Indianapolis, IN June 9-10, 2010.
WI State Report
RVIPP, Indianapolis, IN June 9-10, 2010
Wisconsin State ReportRVIPP Meeting Indianapolis: June 9-10, 2010
Timeliness to Treatment Update
State Report Update
Status of Re-testing for Chlamydia
Timeliness to Treatment Update
Status on Wisconsin Action Items Reported Morbidity Positives vs. RVIPP
Positives To be addressed by December 2010
Treatment Rates vs. Data Collection Issues To be addressed through Tx Audits in PPW, FP
and STD clinics WI Planned Parenthood Chart Audit
To be completed July 2010 Family Planning & STD Clinic Chart Audits
To be completed by December 2010
Timeliness to Treatment
WI Planned Parenthood STD Tx Audit STD Treatment Audit Tool to be
completed by the end of June 2010 Will field test tool in one PPW clinic in
early June 25 charts to be reviewed: (20 females, 5
males) Positive CT and/or GC test results for males
and females
Timeliness to Treatment
Conduct Chart Audit July 2010 in all PPW Sites Statewide (27 clinics) using STD Tx Audit Tool WSLH will generate a line list of positive female
and male patients for CT and GC for each clinic site from SLH laboratory positives
Select date range for positive patients to allow 120 days for quality assurance check on practice of re-test
High volume clinics: randomly select maximum of 25 positives from 4th quarter 2009
Medium volume clinics: randomly select maximum of 25 positives from 4th quarter 2009
Low volume clinics: select positives from 2009 up to a maximum of 25 positives
Timeliness to Treatment
Evaluation of Chart Audit for STD Tx Rate
PPW sites will complete the audit tool electronically from chart review
HCET will compile electronic forms into an STD TX audit database
Results available for STD Grant application August 2010
Wisconsin State Report Update
April GYT 2010 Update School Based Clinics in Milwaukee
Update Male FP Medicaid Waiver EPT Update Rural Screening Project Status of Re-screening in Wisconsin
April GYT 2010 Update
Universal testing on 4 days in April 2010 offered at 27 PPW clinics for CT (& GC in Milwaukee clinics only)
In 2009, we were able to offer “free” CT-GC testing for entire month; used data in lieu of planned “Universal Screening” study. Identified approximately 1200 “extra”
tests based on average month.
GYT 2010 PPW Data
Criteria for noting “GYT” on lab slip not consistently defined
Similar proportion met SSC (74 vs. 81%) Higher number reached via GYT? Possibly higher risk patients? Numbers are small…
Met Selective Screening Criteria
Did NOT meet SSC
# Pos # Tested % Pos # Pos # Tested % Pos
“GYT” on LRF
74 505 14.7% 18 177 10.2%
“GYT” not on LRF
206 1863 11.1% 25 424 5.9%
Milwaukee School Based Clinics Update 2010
Testing in 15 SBC began Jan 2009 Low volume of testing/positivity at first Volume and positivity picking up Higher-risk kids more comfortable with health
center presence? Staff efforts?
# Tested #/% Pos CT #/%Pos GC
1-2 Q ‘09 107 10/ 9.3% 0/0%
3-4 Q ‘09 169 24/14.2% 6/3.5%
1-2Q ’10* 185 38/20.5% 10/5.4%
Male FP Waiver Update
Male FP Waiver Effective May 1, 2010 Covers office visit, STD tests,
treatment, condoms for 15-44 year olds, up to 200% poverty, with 30 days to complete enrollment application following presumptive eligibility enrollment
EPT Update
EPT signed into Wisconsin Law May 11, 2010 Becomes effective May 26, 2010 EPT allowed for one dose therapy for CT, GC, Trichomoniasis
No name prescription allowed if partner name not obtainable, in which case, ‘EPT’ required to be written on prescription
An information sheet for patient/partner developed by the Wisconsin DPH must be delivered by the provider with EPT, as required by the new law ready for distribution June 1
WEB site and official DPH letter of announcement to providers launched June 1
Guidance for providers under development, ready for distribution June 15th
Training for implementation for Family Planning Providers scheduled for July and September WFPRHA meetings
Plans for evaluation under development
Rural Screening Project
4 sites in Northern Wisconsin participated in Universal screening for the months of April and May Objective: to estimate CT prevalence in
rural clinic populations Determine if there are risk criteria
outside of the evidence based SSC currently in use in WI FP which add greater sensitivity to the risk assessment for CT and GC infection in men and women attending these clinics
Rural Screening Project
Preliminary Findings Nuances of interviewing patients
important Consider the consistency and how
questions are asked and perceived by the patient
Numbers are small, but prevalence appears to be under 3% threshold
Final analysis pending Will present at Winter RVIPP meeting
Status of Re-Screening
Plan to evaluate rates of re-screening in FP as a quality assurance measure in FP clinics
Plan to include ‘Re-screened?’ field in STD Tx Audit Tool in PPW in July 2010
PPW will add a required field for ‘Re-screened?’ to Electronic Medical Record when ready in July 2011
Re-screening will be discussed during annual WFPRHA meeting in September 2010 as part of Quality Assurance discussion
Specific guidance on writing in re-screened information on the LRF until a permanent field is in place on the LRF will be provided during a November SLH and STD Update Teleconference
Recommendations in guidance to re-screen will include males (any input from RVIPP group during June 2010 meeting?) and females
When have SSC changes from prevalence evaluations finalized, will add these changes and ‘Re-screened?’ field to laboratory request form at SLH