(P124) USE OF PATIENT INITIATED ELECTRONIC VISITS (E-VISITS) TO INCREASE ACCESS TO SEXUALLY TRANSMITTED INFECTION TESTING AND PREVENTION SERVICES IN AN INTEGRATED HEALTH SYSTEM

Background:
In the integrated health system Kaiser Permanente Northern California (KPNC), a sexual health electronic visit (E-visit) was launched in 2/2022. In addition to other sexual health services, the E-visit allows users to request sexually transmitted infection (STI) screening, including self-collected extra-genital swabs for gonorrhea and chlamydia and opt-in HIV testing, and referrals for pre-exposure prophylaxis for HIV prevention (PrEP) evaluation. Members with symptoms are referred to a regional call center. Lab orders and PreP referrals are generated automatically at completion of the E-visit.  Treatment of identified infections is undertaken by the user’s primary care doctor.

Methods:
STI testing rates and demographic data were collected for the cohort of KPNC members who obtained STI testing via the E-visit between the launch 2/2022 and 12/2023.  A separate collection over the same date range was performed on members who obtained STI testing via other mechanisms including telephone, video, office, or emergency department visits, between the E-visit launch 2/2022 and 12/2023.

Results:
During the study period, over 120,000 members used an E-visit and over 650,000 members obtained STI testing via other pathways. Younger members (age 18-34 years) were more likely to use the E-visit. Black members appear more likely to use the E-visit to complete testing compared with other ethnicities. E-visit use was similar among men and women and among members from various geographic locations in Northern California, including urban, suburban, and rural locations. E-visit users completed pharyngeal testing for gonorrhea and chlamydia more frequently than rectal testing. Tests ordered from the E-visit had a higher rate of positivity for urogenital chlamydia than those ordered through other mechanisms.

Conclusion:
An E-visit is a feasible adjunctive method to provide STI screening services and reaches a different demographic group than telephone, office, and emergency department-based care.