emocha, a mobile health company focused on medication adherence, deployed its video Directly Observed Therapy (DOT) platform on a pro bono basis to help stop a tuberculosis (TB) outbreak at a remote mental health facility in Puerto Rico, months before Hurricane Maria. The Centers for Disease Control (CDC) released its report of the outbreak today, providing data on how emocha’s video DOT was used to halt the recurring outbreak.
Between the years 2010 – 2017, Puerto Rico was in the midst of a recurrent TB outbreak that could not be contained at a home for men with mental illness, resulting in the deaths of six residents. DOT is considered the gold standard of care for TB treatment and requires that each dose be taken under observation, but can be logistically challenging and burdensome for healthcare providers and patients. Due to the remote location of the facility and staffing shortages faced by the Puerto Rico Department of Health (PRDOH), daily in-person DOT was not feasible and previous attempts to use livestream video options had failed to improve medication adherence.
“When emocha was notified of the outbreak, we knew our technology could be used to help public health officials stop the spread of TB in a place where it is difficult to administer in-person DOT,” said Sebastian Seiguer, CEO of emocha. “We are proud to have worked with such dedicated partners, and play an important role in helping patients complete treatment.”
With conditions worsening for many of the patients, emocha deployed its video DOT platform at the facility one week prior to Christmas 2016. By May 19, 2017, all active TB (11 patients) and latent TB (six patients) patients using emocha’s video DOT solution demonstrated clinical improvements in health over the six-month treatment program and the outbreak was declared contained by the PRDOH. emocha continues to provide the platform to Puerto Rico post-Hurricane Maria.
Among the CDC’s key findings:
- emocha’s video DOT platform was used to bring closure to the outbreak
- PRDOH saved 360 staff hours, allowing time to be reallocated to other needs
- All active TB patients achieved clinical health improvements
- All patients successfully completed treatment
emocha’s mobile video DOT platform, a proven method for ensuring TB patient medication adherence, allows health care providers to apply DOT remotely to ensure medication adherence for patients, leading to better healthcare outcomes for patients at lower cost to providers. emocha’s platform is asynchronous, capturing a video recording of medication ingestion.
emocha uses technology licensed from Johns Hopkins University that delivers video directly observed therapy (DOT) to help people stay adherent to medication. Patients use a smartphone application to record videos of themselves taking each dose of medication and report any associated side effects. Providers assess patient data using a secure web portal and contact patients as needed. emocha works with public health departments, academic medical centers, payers and providers to secure adherence to tuberculosis (TB), hepatitis C, HIV, and opioid use disorder treatment.
National Institutes of Health Statement
Research reported in this publication was supported by the National Institute On Minority Health And Health Disparities of the National Institutes of Health under Award Number R43MD010521. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.