While many patients have good access to testing for sexually transmitted infections (STIs) through their family physician or a sexual health clinic, this isn’t the case for everyone. Each year in BC many people at higher risk of acquiring these infections face considerable barriers to accessing clinic-based testing. Barriers include having difficulty traveling to a clinic, encountering long wait times for appointments, worrying about negative reactions from health care providers, or experiencing the stigma that is still associated with testing for these infections. 

What is GetCheckedOnline?
The BC Centre for Disease Control developed GetCheckedOnline (www.getcheckedonline.com [12]) as one way for patients at higher risk of infection to overcome these barriers and as a complement to clinic-based testing. The online service offers testing for chlamydia, gonorrhea (urine, throat, and rectal swabs), HIV, syphilis, and hepatitis C. GetCheckedOnline was launched in late 2014 following an extensive development and testing process that included consulting with the College of Physicians and Surgeons of BC, clinicians, and potential users of the service, and ensuring the service was private and secure. As a result the service is aligned with nursing and physician practice standards, which may include obtaining the patient’s informed consent for testing. 

How does it work?
To use the service, patients visit the website, create an account, and complete a brief sexual risk assessment. The service is then tailored to the individual based on the information provided and may include offers for specific tests (e.g., swabs if the patient reports giving oral sex or having receptive anal sex) customized educational messages (e.g., about emergency contraception), or recommendations to go to a clinic instead (e.g., if the patient has symptoms or has a sex partner with an STI). Next, patients print a lab form and take it to a participating LifeLabs location to submit specimens. All test results are managed centrally by experienced STI physicians and nurses at the provincial STI clinic at BCCDC. If all results are negative, patients can access them online. If there is a problem with the specimens provided, patients are directed to call the clinic at BCCDC. Clinic nurses communicate all positive results over the phone in order to arrange treatment, discuss partner notification, and provide support, as needed. The complete process is depicted in the Figure [13]. In the first 16 months of operation, 387 patients were tested using the service, of which eight (2%) had a positive result. Most surveyed participants found the service useful and intended to use it again.

Where is the service available?
GetCheckedOnline started in participation with six LifeLabs locations in Vancouver and is expanding to select communities in the Interior and on Vancouver Island in partnership with the Interior Health Authority, Island Health, and LifeLabs. Currently, each patient requires an access code to create an online account, and the code is provided only via campaigns and other promotional channels. The aim is to eventually make the service available to anyone interested in using it. A map of participating LifeLabs locations is available on the website and will be updated as new locations are added.

Implications for practice
When speaking with patients who have positive results, the BCCDC STI clinic nurse will arrange for treatment through the referral pathways in each community that have been established by the applicable health authority in partnership with local clinicians. In the unlikely event that a patient presents elsewhere for treatment, provincial STI physicians are available to advise through the BCCDC clinic. Information for providers about the service and appropriate treatment options is also available in the For Health Providers section of the website.

If you have a patient who would benefit from the service, direct them to request an access code through GetCheckedOnline@bccdc.ca [14]. 

Contact us
To speak with a BCCDC STI clinic physician about GetCheckedOnline, call the medical lead at 604 707-5606. For all other enquiries, contact the program manager at 604 707-5626 or e-mail GetCheckedOnline@bccdc.ca [14]. 
—Mark Gilbert, MD, FRCPC
Medical Lead, BCCDC
—Devon Haag, MSc
Program Manager, BCCDC
—Troy Grennan, MD, FRCPC
Medical Lead, BCCDC

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This article is the opinion of the BC Centre for Disease Control and has not been peer reviewed by the BCMJ Editorial Board.