In 2014, Harris County Public Health started using emocha’s video Directly Observed Therapy application to support patients through tuberculosis treatment. In 2017, the application also served as a key component of the county’s hurricane preparedness plan and helped patients successfully continue treatment in the wake of a devastating storm.
Directly observed therapy (DOT) -- when a provider watches a patient take every dose of their medication -- is the U.S. Centers for Disease Control and Preventions’s standard of care for tuberculosis treatment. It is highly effective at securing adherence, but incredibly expensive and burdensome for both the provider and the patient when done in person. emocha’s video DOT application serves as a complement to in-person DOT by allowing patients and providers complete this practice remotely and asynchronously. Using the emocha smart phone app, patients record themselves taking their medication and note any side effects. Healthcare workers watch the videos and confirm that the medication was taken correctly.
Mobile Technology Secures Medication Adherence
Last August, Harris County and the Houston Texas area were hit by Hurricane Harvey. The storm brought winds greater than 125 miles per hour and up to 60 inches’ of rain. This caused devastating flooding and made travel impossible in many areas. The hurricane lead to a reported 82 deaths and $180 billion worth of property damage, making it one of the costliest storms in U.S. history.
When Hurricane Harvey made landfall, Harris County had 61 TB patients on video DOT, and 47 on in-person DOT. Of the patients who used emocha’s video DOT, 59 of them maintained 100 percent adherence throughout the storm. The 47 patients who completed DOT in-person were unreachable by health department staff, and therefore medication adherence was not confirmed. Even after the flood waters subsided and the region started its slow recovery, in-person DOT was still difficult. Patients using emocha continued to take their medication without issue.
Even though many of the health department staff were personally affected by the hurricane, they used innovation to overcome the devastation, and continued uninterrupted treatment of patients who had with a highly infectious disease. It is a true testament to their commitment to the public good -- and their embrace of a technical solution -- that made video DOT so successful in overcoming the devastation of a hurricane.