HANFORD - The Kings County Department of Public Health (KCDPH) is adopting new technology to enable patients with tuberculosis (TB) in Kings County to access support and increase medication adherence. The County’s new technology will use emocha’s video Directly Observed Therapy (DOT) platform to connect public health staff members to their patients. This technology and personal engagement will empower patients with TB to take every dose of their medication throughout their treatment, at a time that is convenient for them in their own home.

The U.S. Centers for Disease Control and Prevention endorses DOT as the most effective strategy to ensure medication adherence. DOT involves watching a patient take every dose of medication and is the standard of care for TB treatment in the United States. Prior to the adoption of this new technology, patients with TB in Kings County had to receive their medication via a daily visit to the health department or through an in-home visit from the health department staff. Conducting their DOT visits through emocha’s asynchronous mobile app helps patients to complete their treatment more conveniently.

With emocha, patients with TB in Kings County will be eligible to use a secure mobile application on their smartphone to video record themselves taking their medication, report side effects, and receive medication reminders. They will also have access to two-way, secure messaging to communicate with their healthcare provider. Kings County Health Department workers can assess the data collected on the secure emocha web portal, engage directly with their patients, and intervene swiftly in the event of reported symptoms, side effects, or medication nonadherence.

Research illustrates that emocha’s video DOT platform saves public health resources and eases burdens for both patients and providers. Compared to in-person DOT, emocha saved public health departments an average of $1,400 per patient over a standard six-month tuberculosis regimen, according to a NIH-funded study conducted by researchers at the Johns Hopkins University. Patients using emocha also achieved 94 percent medication adherence, on average.

In 2017, approximately 9,000 TB cases were reported across the U.S. TB remains the world’s deadliest infectious disease, causing 1.6 million deaths worldwide in 2017. There were six cases of TB in Kings County in 2017 and eight total cases that required DOT, which cost the county an estimated $32,257.

“Using technology will enable the County to provide more convenient options for people in treatment for TB,” said Edward Hill, Director of the Kings County Department of Public Health. “This solution will also save staff time and resources that would otherwise be needed to schedule and conduct daily appointments.”

The United Nations recently approved a political declaration that called for an increased use of technology to help end TB across the globe. New billing policies indicate that these types of daily interactions with patients through technology would be beneficial for patients who have conditions other than TB. For example, Medi-Cal and Medicare recently approved the reimbursement of providers for their time reviewing pre-recorded videos and images sent by their patients. Providers can be reimbursed for a five-minute encounter and follow-up with the patient.

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