Computer reduces wait for women with urinary tract infections

By Vanessa deGier

Ralph Gonzales, MD, MSPH -----

Often, the worst part about getting treatment for a urinary tract infection is the wait to get an appointment with a physician to receive an antibiotic prescription. But UCSF Medical Center has instituted a program so that women can get assessment - and relief - much more quickly. Thanks to a new kiosk in the Screening and Acute Care Clinic, women with uncomplicated urinary tract infections (UTI) can access an interactive computer instead of waiting to see a physician, and as a result, be out the door with a prescription in minutes.

Called the UTI Self-Management Kiosk, the voluntary interactive computer program uses video and a series of touch pad questions to expedite the management and care of women with uncomplicated UTIs. “Many women know instantly when they have a UTI, yet it is often inconvenient, time consuming, and expensive to have to wait to see a health care provider and undergo an examination for a prescription,” said Ralph Gonzales, MD, associate professor of medicine at UCSF.

One in five women will have at least one UTI in her lifetime while 20-30 percent of these women suffer recurrent infections, according to the Infectious Diseases Society of America. Add to that an average wait time of two hours at the clinic, and it is easy to see why this computer kiosk is a valuable tool. This is especially true for women who lack a primary care physician or have inadequate access to their physician for urgent health problems.

Women who report having a UTI upon arrival to the clinic are referred to the kiosk where they watch a video introduction followed by a series of audiovisual questions that help determine the severity of the UTI. Those who successfully meet the criteria for treatment of an uncomplicated UTI receive a printout that includes information on their symptoms, current medications, allergies, and options for an antibiotic prescription. The printout is then given to a health care provider who reviews the information, selects a specific antibiotic and signs the prescription.

To date, 86 women have used the kiosk. Thirty percent of these women were successfully treated by the computer (had an uncomplicated UTI) and were able to leave the clinic without waiting to receive an examination. “Patients who have completed the module report that it is easy to use and that they are highly satisfied with it,” said Eva Aagaard, MD, assistant clinical professor of medicine at UCSF. “Even more exciting, they report they would recommend the kiosk to friends and family, and are interested in using kiosks for other health conditions.”

Gonzales and Aagaard are in the process of completing a Spanish language version of the UTI module as well as validating the efficacy of using the kiosk for sore throats and knee and ankle sprains.

ABOUT URINARY TRACT INFECTIONS—Urinary tract infections occur when bacteria enter the inside lining of part of the urinary system - the urethra, bladder, ureters, and kidneys. Relatively harmless early on in healthy women, UTIs do have the potential to cause permanent kidney damage or life-threatening infection if they are not treated promptly. More than eight million men and women seek treatment for UTIs annually.

ABOUT UCSF’S SCREENING AND ACUTE CARE CLINIC—The Screening and Acute Care Clinic at UCSF Medical Center, 400 Parnassus Avenue, is among the last remaining acute care clinics in San Francisco. Each month, about 1,500 adult patients drop in to the clinic where they are evaluated for an array of urgent, non-life threatening medical problems that need same-day evaluation and treatment.