A paradigm shift in testing for sexually transmitted infections

The way in which sexually transmitted infection (STI) services are delivered in the UK is hardly recognisable to those practising 20 or even 10 years ago, and the pace of change shows no sign of slowing. The changes have been driven by the need to modernise services and improve efficiency, and have had three main components: (1) improvements in information/communication technology; (2) new systems or pathways of care in clinics; (3) advances in diagnostic testing. Thus, we see the increased use of mobile phones and email to communicate with our patients, the integration of computer systems in laboratories with clinic computers, the use of the internet for health education and contact tracing, and also look forward to the holy grail of an electronic patient record.1,2 We are also learning to use these information/communication technologies in a more productive way by changing the skill mix of clinic staff and reviewing patient care pathways to allow more patients to be seen alongside maintaining a high-quality service.3

In this changing environment, we must …