FAQ for Health Care Providers

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1. What is GetCheckedOnline?
   
2. Who operates GetCheckedOnline?
3. Where is GetCheckedOnline available?
4. What can you test for with GetCheckedOnline?​
5. How does GetCheckedOnline work?
   
6. How are specimens collected?
7. Who does the testing?
8. Is testing covered by the Medical Services Plan (MSP)?
9. How are pre-test discussions (counselling) handled?
10. How is informed consent for testing obtained?
11. How are positive results and post-test discussions handled?
12. What should I do if someone comes into my clinic because they tested positive for chlamydia or gonorrhea through GetCheckedOnline?
13. What should I do if someone comes into my clinic because they tested positive for syphilis through GetCheckedOnline?
14. What should I do if someone comes into my clinic because they tested positive for HIV through GetCheckedOnline?
15. What should I do if someone comes into my clinic because they tested positive for hepatitis C through GetCheckedOnline?
16. I’m concerned about treating a patient for an STI without having a confirmed lab report. What does the College of Physicians and Surgeons of BC (CPSBC) and the Canadian Medical Protective Association (CMPA) say?
17. Who can I contact if I have questions about GetCheckedOnline?

1. What is GetCheckedOnline?

GetCheckedOnline is a new way to test for sexually transmitted infections (STIs) and HIV without going to a clinic. Through the GetCheckedOnline website, patients can print a lab requisition for STI/HIV testing and then go to a participating LifeLabs collection centre to give specimens. Patients testing positive for one or more STI will be contacted by a nurse at the BC Centre for Disease Control to arrange follow-up and treatment. GetCheckedOnline is a targeted testing approach with a focus on people that have barriers to accessing STI/HIV testing.

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2. Who operates GetCheckedOnline?

The service is operated by Clinical Prevention Services (CPS) at the BC Centre for Disease Control (BCCDC), an agency of the Provincial Health Services Authority (PHSA). GetCheckedOnline is considered a virtual extension of BCCDC’s provincial STI clinic and people who test through the program are considered to be patients of the BCCDC.

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3. Where is GetCheckedOnline available?

GetCheckedOnline was launched in September 2014 and until recently, was only available as a pilot program in the Vancouver area. As part of the provincial Hope To Health / STOP HIV program, the BC Centre for Disease Control is expanding the service to other communities across BC on a pilot basis in partnership with participating health authorities. The focus of GetCheckedOnline will be on priority populations and under-served communities, as identified by each health authority. Specimen collection for GetCheckedOnline is available through participating LifeLabs collection centres in the following communities:

• Vancouver
• Kamloops
• Nelson
• Victoria
• Langford
• Duncan

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4. What can you test for with GetCheckedOnline?

All GetCheckedOnline patients are offered the following tests:

• Chlamydia (urine)
• Gonorrhea (urine)
• Syphilis
• HIV

Patients who identify as men who have sex with men (MSM) or a have a history of drug injection or sharing drug paraphernalia are also offered a hepatitis C test.

Self-collected rectal swabs for chlamydia and gonorrhea testing are offered to anyone reporting receptive anal sex. Self-collected throat swabs for chlamydia and gonorrhea testing are offered to any MSM who reports giving oral sex.

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5. How does GetCheckedOnline work?

To use GetCheckedOnline, a patient will:

1. Create an account (requires a valid email and collects basic demographics)
2. Complete a risk assessment (including recommendation to seek medical attention if have symptoms or are a contact to an STI)
3. Select the desired tests from the list of recommended tests.
4. Give consent to STI testing.
5. Print the lab requisition.
6. Be notified when results are ready by email (in 7-12 days). If all negative, results can be viewed online. If any result is positive, the patient will be contacted by a BC Centre for Disease Control (BCCDC) nurse. Positive results cannot be viewed online.

BCCDC recognizes that patients may experience anxiety at receiving a message about their test results outside of STI clinic hours. However, this is not a new situation, as it is standard clinical practice for the STI clinic to leave messages asking patients to call the clinic about an important health matter (actual results are never given through voice mail).

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6. How are specimens collected?

Patients present at a participating LifeLabs collection centre with a printed copy of their GetCheckedOnline lab requisition. Blood and urine specimens are collected by lab technicians. Patients may also be given a swab kit that contains materials and instructions for self-collection of rectal and/or throat swabs. Patients self-swab at home and then return to LifeLabs to drop off their specimens.

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7. Who does the testing?

Dr. Troy Grennan, the head STI Clinic physician at the BC Centre for Disease Control (BCCDC) is the ordering provider for GetCheckedOnline. All testing is done at the Provincial Public Health Microbiology and Reference Laboratory (PHMRL), located at the BCCDC. All results are received and processed by the Provincial STI Clinic at the BCCDC.

It is not currently possible for a patient’s family physician / GP to be copied on the test results if the patient tests through GetCheckedOnline.

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8. Is testing covered by the Medical Services Plan (MSP)?

Testing through GetCheckedOnline is not covered by MSP - all program and testing costs are covered by the BC Centre for Disease Control, participating health authorities and the Public Health Lab (PHMRL). Patients do not have to provide a PHN in their GetCheckedOnline account and do not need to show ID or their MSP card at the participating LifeLabs locations.

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9. How are pre-test discussions (counselling) handled?

The GetCheckedOnline website has a section that covers pre-test information, including:

• Which infections GetCheckedOnline does and does not test for
• Window periods and when to test for STIs
• What happens when a result is positive for a reportable infection
• How to reduce anxiety when waiting for results
• Tips for STI prevention.

In addition, the website also provides information on privacy and confidentiality, and links to provincial STI and HIV resources.

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10. How is informed consent for testing obtained?

Before downloading a lab form for printing, GetCheckedOnline patients must indicate that they understand the information necessary for obtaining informed consent according to provincial HIV pre- and post-test discussion guidelines.

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11. How are positive results and post-test discussions handled?

Because people who test through GetCheckedOnline are considered patients of the Provincial STI Clinic at the BC Centre for Disease Control (BCCDC), all positive, indeterminate and equivocal results are followed up by STI nurses at BCCDC.

A patient testing positive will be contacted by a BCCDC nurse (if the individual provided a phone number) or will see a message on their GetCheckedOnline account asking them to contact the BCCDC STI Clinic. Once in contact with the patient, the nurse will:

• Determine where the patient resides
• Provide and interpret results
• Discuss treatment options and advise where the patient can go in their area for treatment
• Discuss partner notification and offer to assist the patient with notifying their partners

Each health authority has partnered with at least one clinic in each participating community where GetCheckedOnline patients can go for treatment. The health authorities will give an orientation to and provide additional information about GetCheckedOnline to these partner treatment clinics. Patients are encouraged to seek treatment at the partner clinics, but have the option of visiting their primary health care provider or another clinic of their choice.

Positive test results for GetCheckedOnline patients are reported to the appropriate regional health authority by BCCDC once the correct health authority has been determined.

The nurses at BCCDC work with regional public health nurses as needed to ensure appropriate follow-up occurs.

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12. What should I do if someone comes into my clinic because they tested positive for chlamydia or gonorrhea through GetCheckedOnline?

A GetCheckedOnline patient may present at your clinic, say that they have tested through GetCheckedOnline and request treatment for chlamydia or gonorrhea. Appropriate treatment should be provided, as per the BC Centre for Disease Control (BCCDC) Treatment Guidelines for Sexually Transmitted Infections in Adults and Adolescents (2014)*. You do not need to retest.

The patient may have a chlamydia or gonorrhea treatment information sheet from GetCheckedOnline – this information sheet replicates the information found in the BCCDC STI Treatment Guidelines. The patient will not have a copy of their test results; if you have any questions about the results, please call the BCCDC nurse line at 604‑707‑5603 or 1‑888‑488‑7444.

Partner notification should have been discussed with the BCCDC nurse, but please confirm that this discussion has occurred and that partners are receiving treatment. If the initial conversation was missed, please ask the patient to call a BCCDC nurse at 604‑707‑5603 or 1‑888‑488‑7444.

Once the patient has received treatment, no further action is required. A BCCDC nurse will follow-up with the client to confirm treatment and partner notification.

Click here to see the BCCDC STI Treatment Guidelines

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13. What should I do if someone comes into my clinic because they tested positive for syphilis through GetCheckedOnline?

A GetCheckedOnline patient may present at your clinic, say that they have tested through GetCheckedOnline and request treatment for syphilis. A BC Centre for Disease Control (BCCDC) physician or nurse should have previously called your clinic to arrange further testing and treatment for this patient. If you have no information about this patient, please call the BCCDC syphilis nurse at 604-707-5607 or call 1-888-488-7444 and ask for the syphilis nurse.

Partner notification should have been discussed with the BCCDC nurse, but if there is no information about partner notification for this patient, or you are uncertain if this discussion has occurred, call the BCCDC syphilis nurse.

Please follow-up with the BCCDC syphilis nurse after the patient has received their first treatment, and again after their final treatment. The syphilis nurse will need to know that the treatment was administered and may follow-up with partner discussions.

Click here to see the BCCDC STI Treatment Guidelines

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14. What should I do if someone comes into my clinic because they tested positive for HIV through GetCheckedOnline?

HIV follow-up and case management is managed by designated HIV nurses (DNs) in each health authority. The DNs have with an existing network of HIV physicians to which they refer new HIV positive patients. You should not have patients diagnosed with HIV seeking treatment at your clinic. If you do, please call the BC Centre for Disease Control Clinic Nurse Manager at 604‑707‑5613.

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15. What should I do if someone comes into my clinic because they tested positive for hepatitis C through GetCheckedOnline?

A GetCheckedOnline patient may present at your clinic, say that they have tested through GetCheckedOnline and request additional testing for hepatitis C. Follow-up PCR testing is required to determine if the hepatitis C is chronic or active. While the patient has tested anti-HCV reactive, due to laboratory requirements, the patient will need another HCV antibody test and an HCV RNA test.​

The patient will not have a copy of their lab results, but may have a hepatitis C testing information sheet from GetCheckedOnline. Both the anti-HCV and HCV RNA tests can be ordered at the same time. Please write “Hep C anti-HCV” and “Hep C PCR Quantitative” on the lab requisition in the “Other Tests” box.

Once the lab results are available, please follow-up with the patient. The BC Centre for Disease Control will not be involved in the case unless consulted. If the client is an acute case, the health authority may send HCV resources and support materials to be shared with the patient.

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16. I’m concerned about treating a patient for an STI without having a confirmed lab report. What does the College of Physicians and Surgeons of BC (CPSBC) and the Canadian Medical Protective Association (CMPA) say?

We have spoken to the CPSBC about GetCheckedOnline and they are supportive. We met with the CPSBC in person, in preparation for provincial expansion, and they specifically indicated that they had no concerns regarding regulatory issues. We have also had discussions with the CMPA; their advice to any physician calling with this concern will be to make the best decision based on clinical judgment.

There is precedent for treating patients for STIs in the absence of a confirmed lab diagnosis. At the Provincial STI Clinic at the British Columbia Centre for Disease Control (BCCDC), as well as at our satellite outreach sites where we see the largest volumes of STI clients in the province, we routinely provide treatment to clients who self-report being contacts to diagnosed STI cases. The BCCDC STI Treatment Guidelines recommend the treatment of contacts.

Additionally, individuals who have tested elsewhere but cannot provide documentation of their diagnosis, are routinely treated empirically at BCCDC clinics. In these situations, we make the clinical judgment that the risk of delaying therapy in order to retest (e.g. the client not following up, or not being willing to retest as they prefer to remain anonymous) greatly outweighs the risk of immediate treatment.

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17. Who can I contact if I have questions about GetCheckedOnline?

If you have questions related to clinical or medical aspects of GetCheckedOnline, please contact Dr. Troy Grennan, the Physician Lead for the Provincial STI/HIV Program in Clinical Prevention Services at the BC Centre for Disease Control (BCCDC) and the ordering provider for GetCheckedOnline.

Dr. Troy Grennan
604-707-5606
troy.grennan@bccdc.ca

If you have questions related to the overall operation of the GetCheckedOnline program, please contact Devon Haag, the Manager of the Online Sexual Health Services Program in Clinical Prevention Services at BCCDC.

Devon Haag
604-707-5626
devon.haag@bccdc.ca

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