1. From the Field: Perspectives on Maximizing Patient Contact Success for Enhanced Gonorrhea Surveillance From the Field: Perspectives on Maximizing Patient Contact Success for Enhanced Gonorrhea Surveillance Locating and Contacting Patients Reported with Minimal Contact Information SSuN Principal Collaborator’s Conference Call July 2010 Kim Ingram and Colleagues AKA ‘The DIS Dream Team!’ Tacoma-Pierce County Health Department Tacoma, Washington

2. Background Many gonorrhea cases are reported through laboratories or from providers with missing or minimal contact information to facilitate public health follow-up – Non working phone number(s) – Non-existent or wrong addresses – Out-of-date employer or other information – Undocumented patient “The most frequently reported risk factor for gonorrhea infection is an ‘out-of-service’ cell phone number!” Merilee DelAquila, Snohomish Health District, Washington State

3. First things first… The diagnosing provider is the best (sometimes ONLY) source for patient contact information: – Billing – providers usually want to get paid/reimbursed for services – Office staff usually have most up-to-date phone numbers for patients and have an emergency contact number If provider is missing / unclear from the lab report, call the reporting laboratory and request the ordering provider’s contact information – Health Departments usually have authority in their notifiable reporting laws to contact labs or providers for additional information – HIPPA has a robust exemption for release of information for public health activities

4. Public Health Partnerships Develop relationships with high-volume providers in your area: – Physician groups/private practices Get to know the receptionist, nursing staff, etc. (the people who really know how to find things!) – Hospitals Introduce yourself to the facility’s Infection Control Practitioner (ICP) – Provide clear documentation of your Department’s authority to request patient contact information, explain the importance of SSuN at the local, state and national level – Address provider’s concerns about patient confidentiality Develop a fact-sheet they can provide to patients

5. Partnerships… Consider faxing requests for specific information to the provider with a ‘fax-back’ form – This may be more effective than waiting for a call back – Respectful of busy office staff time – Providers use fax frequently for laboratory, insurance and other billing requests – Request patient’s emergency contact information as well as their primary home & work phone/address Consider asking high-volume providers to obtain patient ROI for public health follow-up

6. Other Information Providers May Have If the index patient is < 18 years old, the provider may know other valuable locating information – School name – School nurse’s contact information – Custodial parent/guardian contact information Providers may also have missing clinical information such as site of infection, symptoms and treatment information – all of which can help supplement the SSuN record if the patient is not subsequently located for interview

7. Official Record Searches Health departments can get access to search driver’s license information Search disease registries (STD, Childhood Vaccine, HIV, etc.) Search vital records (birth, death, etc.) Voter registration databases Court records If your department does not have access to these databases consider requesting access with an inter- governmental agreement

8. Detention Facilities, Jails, Etc. Develop relationships and get connected with: your city jail local juvenile detention center Homeless shelters School nurses and campus clinics

9. Social Media Internet and social media site searches: ‘411’  internet white pages, reverse look-up, etc. Face book My Space Google search

10. Use alternative contact methods/times Sometimes the only way to get young people to respond is to contact them on MySpace, their Facebook page, to tweet them or send a text message to their cell phone. Use innocuous texts like “Call me @ 555.2323!” Use a designated / dedicated cell phone for these purposes that does not show up on caller id as ‘Health Dept., etc.’. Consider calling/texting in the evenings after work hours

11. Questions?

12. Kim Ingram Tacoma-Pierce County Health Department HIV/STD Services- Clinic Lead 3629 S D ST MS 438 Tacoma WA 98418 253-798-2939 kingram@tpchd.org For additional information: