Thursday 26 March 2015

Intelligent signposting to sexual and reproductive health services in

SXT Health CIC is a social enterprise with a mission to improve access to sexual and reproductive health services. Its website signposts members of the public to the right SRH service, in the right place, at the right time, and is designed to meet the needs not just of patients, but of providers and commissioners too.  Patients are missing out on time sensitive services, providers find it a challenge to communicate their level of service detail and commissioners have difficulty mapping gaps of provision and marketing services to their population.  

The root cause of the problem is the asymmetry of information and difficulty communicating what services are being offered by day/time and location.  Most of the databases regarding sexual & reproductive health services do not have enough information to reassure patients that they are going to the correct provider.  The result is that many attend the nearest biggest service because they do not want to wait in vain.  Difficulties communicating about service provision lead to bottlenecks at the big clinics whilst other appropriate providers with capacity are being overlooked.

SXT Health CIC has created a robust solution to deal with this problem: works well for patients, and it also allows providers to advertise their services with the level of detail required to support intelligent signposting.

The link between the two is a decision tree that converts what the patient needs into information that they can act upon.  For example, if the client has symptoms that could be due to a sexually transmitted infection (STI) and they use and select ‘Same day results (problems)’, they will be directed to those services that offer microscopy and can give them a more accurate diagnosis on the day. also distinguishes between simple & complex STI treatment so that clients visit a provider who can accurately treat their infection.  

This decision tree supports higher risk clients (such as men who have sex with men) by ensuring that they are directed to those clinics that can offer HIV point of care tests, triple site testing and Hepatitis B vaccination.  

It can also support signposting to more specialist services such as Transgender and Fetish clinics as well as support online HIV testing initiatives or flag new problems affecting the community such as Shigella causing severe diarrhoea.

For the provision of emergency contraception, always promotes the best treatment which is the copper intrauterine device and can direct the women to the nearest open provider; however, it also knows which services offer Levonorgestrel (effective <72hrs) and Ulipristal acetate (effective <120hrs) so that a client who opts for a hormonal method is directed to the most appropriate local provider. uses the decision tree to categorize contraception by its efficacy.  Under the most effective methods (typical failure rate < 3/100 per year) it provides information and sign posts to local services for implants, the intrauterine system / device and injectable methods.

Pills / Patch / Ring have their own category because they are the most popular method of contraception and their failure rate is 8/100 per year with typical use.  The least effective methods (> 8/100 per year failure rate) have their own category with information about these methods and, if appropriate, where the client can find the service or advice.

Intelligent signposting is key to optimizing access to sexual & reproductive health care services and is the only platform with the necessary level of detail to deliver this requirement.

If you are a provider and would like to help improve access to sexual & reproductive health services please visit to join.

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