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Researchers at Children's Hospital of Philadelphia (CHOP) found that a systematic, electronic health record-enabled quality improvement initiative was associated with a large increase in chlamydia and gonorrhea screening among adolescents and led to the detection of more infections. The findings, published in the journal Pediatrics, suggest a feasible approach to building screening into routine well visits.

Chlamydia and gonorrhea are common bacterial sexually transmitted infections (STIs). Most infections cause no symptoms, and they are often undetected without screening. Infection rates for both are higher in adolescents and young adults than in other age groups, and people ages 15 to 24 account for about half of new STIs in the United States. Early detection and treatment can prevent complications and further spread.

Pediatricians and other pediatric providers serve as a trusted source for screening and counseling for adolescents. However, many adolescents are not screened for these infections, and fewer than one-third are asked about sexual activity at their well visits.

To increase screening rates, the team introduced changes in stages across 33 CHOP Care Network primary care practices. The effort began with the Adolescent Health Questionnaire , developed and piloted by the Possibilities Project (TPP) at CHOP, which is led by pediatricians, researchers at Clinical Futures, and technology experts. This pre-visit questionnaire prompts discussion of key adolescent health topics and helps identify adolescents who may benefit from further care.

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