Prevention/Care Management, 2004

Aetna, Inc.

December 2003

Aetna is making a Chlamydia Internet Intervention Tool available to its providers in all six Aetna regions. The tool was developed as result of AHRQ-funded research at the University of Alabama at Birmingham (UAB) and is based on a series of four interactive, Web-based modules designed to improve the performance of community physicians in screening for Chlamydia.

Aetna disseminated the modules in its six regions: Northeast, Mid-Atlantic, Southeast, North Central, Southwest, and West. All Aetna providers have access to the tool via the Aetna provider Web site. In addition, approximately 7,100 obstetricians and primary care providers in the six regions received a postcard announcing the tool with information on how to access the Web site, and five of the regions have announced the tool in their newsletters that go to all HMO providers.

The Chlamydia screening tool has been added to the UAB Web site that is available to physicians across the state and nation. Physicians completing the Web-based modules can receive up to four hours of Category 1 CME credits, with the credit being awarded instantly in the form of a certificate printed at the completion of each module. The courses are case-based and are available 24 hours a day, seven days a week.

The AHRQ-funded study, An Internet Intervention to Increase Chlamydia Screening, conducted at UAB, Center for Outcomes and Effectiveness Research and Education, in cooperation with Aetna, involved a randomized trial in 191 primary care physicians' offices. The control group modules were educational materials about women's health in general. The intervention modules were designed to increase Chlamydia screening of at-risk women and decrease the incidence of pelvic inflammatory disease. When comparing screening rates from 2002, the researchers found that three percent more at-risk women in the intervention group were screened for Chlamydia compared to the control group. Thus, widespread use of the tool could result in lowering the risk of secondary Chlamydial complications, resulting in a reduction in health care costs.

Aetna will be able to track the effects in the future by using administrative data and the HEDIS measure for Chlamydial screening. UAB will be able to track the numbers of providers accessing any of the four CME modules. The primary cost of the tool was in the development; marketing costs to Aetna were minimal as the company used existing media. Thus, the cost to disseminate the tool via the Internet is very small in terms of numbers of physicians that can be reached.

Chlamydia trachomatis is the most common sexually transmitted bacterial infection in the United States, with an estimated three to four million cases occurring annually, but most cases are not recognized. The prevalence of Chlamydial infections among sexually active adolescents is generally reported to be five to 28 percent. Therefore, a five percent increase in Chlamydia screening would detect up to 840 additional cases from a population of 100,000 at-risk women.

Eighty-three percent of Chlamydial infections in women occur in those less than 25 years old. Age is the sociodemographic factor most strongly associated with Chlamydial infections.

While Chlamydia occurs in all socioeconomic groups, increased prevalence has been found in patients who live in inner cities, have a lower socioeconomic status, or are African American.

Aetna is one of the nation's leading providers of health care, dental, pharmacy, group life, disability, and long-term care products, serving more than 13 million medical members, 11.3 million dental members, and 11.7 million group insurance customers as of June 2003. The company has nationwide networks of more than 579,000 health care services providers, including nearly 349,000 primary care and specialist physicians and 3,589 hospitals.

Impact Case Study Identifier: CQUIPS 04-06
AHRQ-Sponsored Activity: Research
Topic(s): Women's Health, Chlamydia Screening
Scope: National

Allison J. An internet intervention to increase chlamydia screening. (HS11124)

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