Implementing a Web-based Resource to Increase Contraceptive Access at a University Health Clinic
Implementing a web-based resource to increase contraceptive access at a university health clinic: The Bedsider Project
Mary Landry, MD, University of Wisconsin School of Medicine and Public Health
University–based student health centers take care of young, media-savvy patients in high demand of contraceptive services. In theory, targeted web-based information is a great way to communicate important facts about contraception to university students. In this study, Dr. Landry at the University of Wisconsin evaluated the effect of incorporating Bedsider into the clinical practice of a university–based health center.
The aim of this study was to improve access to contraception by using Bedsider to help students learn about birth control options and help with their decision making prior to seeing a contraceptive counselor. The researchers felt that Bedsider could also be used to decrease the amount of time clinicians spent counseling patients about general contraceptive information and increase time spent addressing individual questions.
Bedsider was incorporated into the University of Wisconsin’s University Health Service (UHS) clinical practice in several ways. First, the Bedsider link was added to the UHS website for general viewing. Second, the Bedsider link was e-mailed to all patients who had a scheduled UHS appointment related to contraception services. Third, when patients called to schedule IUD insertions, they were given the option of having an “electronic” consultation, which consisted of a link to the Bedsider website and supplementary materials, or the standard in-person consult. Fourth, any student presenting for a contraceptive appointment who had not previously reviewed the Bedsider website was given the opportunity to explore it on android tablet in the exam room while waiting for the clinician. Finally, after all contraceptive visits, students were sent the link to Bedsider for further information and review.
The number of students seen for contraceptive services pre- and post- Bedsider implementation increased by over fifty percent, 557 visits in the fall of 2011 compared to 846 in the fall of 2012. The number of patients seen specifically for IUD consultations increased by 250% (from 46 to 116) after Bedsider implementation. The number of IUDs actually placed at the UHS doubled from 23 in the fall of 2011 to 46 in 2012, and the number of implant insertions went from 1 to 6 in these periods. In a post-appointment patient satisfaction survey, the vast majority of students indicated that they learned about Bedsider from the UHS, and that they intended to use Bedsider for assistance in the future. There was no increase in missed IUD insertion appointments, rescheduled insertions due to insurance or pregnancy concerns, and no increase in post procedure infections.
The results of this project suggest that Bedsider can be used to increase access to contraceptive services in a university setting. This is a low-cost, low-resource, highly effective means of communicating accurate information about contraception to a student population including preparing them for LARC insertion appointments.