What is SXT?
SXT (http://www.sxt.org.uk/) is a free & anonymous platform for clients to find the right service in the right place at the right time as well as a powerful marketing tool for providers. It started in 2009 when UnLtd & 4iP (http://www.unltd.org.uk/) awarded £5000 to develop a text message services to sign post clients to their nearest, most appropriate, service. During that first year the name SXT was conceived following client and provider engagement, the first website was created and a range of text message providers were identified. During this time Guy’s & St Thomas’ Charity (http://www.gsttcharity.org.uk/) awarded £66,000 to the project and the web company BitZesty (http://www.bitzesty.com/) made SXT possible for both text message & web users.
The first providers initially added information after they registered on the home page (http://www.sxt.org.uk/user/sign_up). SXT started in Lambeth & Southwark and this was the first area of London to be properly mapped; however, SXT was in a ‘chicken or egg’ situation because it did not have enough providers to support its clients and yet providers were not keen to sign up (it takes 20 minutes from start to finish) to a service that do not have a user base and evidence of feedback.
Since the launch of SXT website in 2010 there are have been two upgrades based on feedback from clients, providers and colleagues. The latest upgrade in August 2013 made it possible to upload providers from other databases, share SXT service pages with clients and capture feedback.
Why was SXT formed?
The main driver behind SXT was repeatedly hearing the frustration of patients about their difficulty accessing sexual & reproductive health services. This wasn’t just for time sensitive services such as post exposure prophylaxis following sexual exposure (PEP) or emergency contraception but also for patients who were symptomatic (e.g. first episode of anogenital herpes) who needed prompt access for treatment and relief.
In addition, as a practitioner, I was frustrated meeting patients who were being sign posted to inappropriate services where they were unable to get the care they require; such as triple site or rapid HIV testing for men who have sex with men (MSM) or access to ulipristal acetate emergency contraception for a women who had sex between 72-120 hours ago and she did not want to have a copper intrauterine device. It was clear that higher quality information could reduce the time wasted for patients and services.
The final challenge was the changing number of sexual & reproductive health services and the inability to clearly map who does what, where and when. Services start or close, hours change; websites are not updated or only focus on one geographical area or sub-group of patients (e.g. MSM, young people). The web was becoming littered with partial information that was not in the control of the providers of those services.
The provider database in SXT has grown significantly since these changes. All the PEP providers in the UK have been added from the BASHH database for sexual health clinics (http://www.bashh.org/BASHH/Clinics/clinics.aspx) and the Accident & Emergency departments from NHS Choices (http://www.nhs.uk/Service-Search) for out of hour’s access. This is the most comprehensive PEP database to date in the UK and it is available 24/7 across the UK. SXT has also added all the HIV testing centres, sexual assault referral centres and general practitioners from NHS Choices to support access. All the providers uploaded have been given a minimal service specification (e.g. not all BASHH clinics have been listed as contraception providers) so that they will be visiable to clients in SXT but this information can always be updated and improved. A member of staff who works for an uploaded provider can claim the clinic in SXT (http://www.sxt.org.uk/user/ownership_claim/new) and then adjust the services, hours and upgrade the information about how to find them on their provider page.
During consultations and calls with patients there is invariably a need to share information with them about a medical condition, contraception or the location of a service. How many times have you ran out of the leaflet you want to give a patient? As a growing number have smart phones or access to email there is a need to provide our patients with information in a digital form so that they can read it discretely on the bus going home and save it for later. The following link provides an example of sharing information about Chlamydia via text or email (http://bit.ly/1eWs7ee) and the hyperlink takes them to the NHS Choices page and video about the infection. It is also possible to share the provider page in SXT to give directions to the client or their partner to facilitate attendance for testing and treatment. If the partner lives in another city you can look up the nearest provider in SXT and then share those service details with the client or partner(s).
When an SXT client is looking for sexual or reproductive health information it takes less than one minute to find what they need. It is only when a client requires a service do they have give two pieces of information; (1) their postcode (the first part is sufficient) and (2) when they would like to be seen (the default is in the next three hours). Once they have given this information a list of local providers appears offering the service they have selected (e.g. Find nearest service | Sexual Health | Same day results (problems) http://bit.ly/1lsfBSf). If you try the previous link and add your postcode you will see the nearest provider who offers gram-staining services to give immediate results.
Client feedback has been captured since the last software upgrade in August 2013. In the first six months there were 1009 clients looking for information or a service and 663 (66%) chose a provider and a slide-out feedback form was seen. This form asks the question ‘Did you find this service useful?’ and a score of 1 for not useful and 10 for very useful plus a text box for comments. The types of providers selected were 18 genitourinary medicine clinics, five sexual & reproductive health clinics, seven general practitioners, two sexual assault referral centres, three pharmacies and five third sector providers. A total of 93 (14%) left a score and 80 (86%) gave eight or more out of ten. The slide-out feedback form demonstrates that SXT is adding value to clients and we are now planning to expand this tool to the information pages too.
How SXT works for clients and providers?
The best way to see how SXT works for clients is to go onto the website (http://www.sxt.org.uk/) and try it for yourself. Every piece of information has been written so that it can work on SMS, mobile and web. All the summary information fits onto a mobile phone text message and SXT is keen to limit the digital divide in the access of information. Everything on the website & SMS responses can be edited or changed and if you have any feedback please send it to email@example.com so that the service can be continually improved.
Providers in SXT have the opportunity to accurately represent their service on the web so that clients are fully aware of what is available and when. Each provider can see on, their analytics page, if SXT client activity, which provider they selected and what service they were looking for. The best way to see how SXT works for providers is to claim or register your service in SXT and experience the utility of the software for yourself.
How I, as a Health Adviser use SXT in my work.
Paul Madden is a Sexual Health Adviser at Guy’s & St. Thomas’ Hospital. He works on three different sites within the Trust and uses SXT on a daily basis. Here is a snapshot of SXT in action.
“Where are you?”
- So many times when doing provider referral or someone has called into the Health Adviser office, and they want to attend one of our services and they aren’t one of our patients. They want to know how to find us. With SXT I can send them an email or SMS free of charge, straight to their smart phone and they will get a link to a Google Map for them to locate our clinic [with it’s opening times and public transport information].
“Where’s my local clinic?”
- Doing provider referrals or giving advice on the phone, patients may not know where their local service is. I can ask the callers location and send them an email or SMS with their local clinic details.
“I don’t want a leaflet…I’m going back to work”
- Through SXT you can send the patient infection information via text or email
- No more running out of leaflets or having bad photocopied sheets
- Also, this is very useful when in outreach settings.