Tuberculosis patients now have a less-intrusive treatment program that will improve the likelihood that they will take all their critical medications, thanks to new treatment-adherence monitoring system that uses mobile-health technology. The work is the result of a partnership between Verizon and the University of California, San Diego.
Available to departments of health in San Diego County, San Francisco and New York, the system is an m-health application that utilizes video-enabled smartphones and cloud technologies to enable health care technicians to remotely monitor patients. The system is support by a Verizon Foundation funding grant and in-king technology donation including the company’s HIPAA-ready cloud services and smartphones.
Creation of the new system, Video Directly Observed Therapy (VDOT), was led by Dr. Richard Garfein in collaboration with researchers at the university, a team of developers from Qualcomm Institute/Calit2, and public health officials from San Diego and Tijuana, Mexico.
VDOT allows TB patients to video record themselves taking their daily medications on smartphones and send the videos to health departments, which then can remotely monitor and document each dose of medication. Because poor compliance with TB treatment regimens leads to ongoing disease, acquisition of drug resistant forms of TB, and transmission of TB to community members, health departments in the U.S. spend millions of dollars driving to patients’ homes every day to watch them take their pills. This often stigmatizes patients, limits their mobility and imposes a financial burden on health departments. VDOT provides the same level of adherence monitoring at a fraction of the cost, and with much greater acceptability to patients than in-person observation.
The San Diego County TB Control Program is already using VDOT for TB patients’ treatment, and health departments in San Francisco and New York City will soon begin using the new system. Last year, a National Institutes of Health-funded pilot of VDOT in San Diego and Tijuana found that nearly all (more than 93%) of prescribed doses were observed using videos made and sent by the patients, and 100% of the patients said they would recommend VDOT to other TB patients. Additionally, the program significantly reduced the transportation and staffing costs for the San Diego and Tijuana health departments.
Other local, state and federal public health agencies, including the Centers for Disease Control and Prevention, and public health agencies abroad have shown interest in VDOT. “MHealth applications like VDOT can be game-changers when it comes to accelerating the pace of TB control and eradication,” said Dr. Garfein.