translating research to practice video dot in the …...video dot in the field: translating research...
TRANSCRIPT
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Video DOT in the Field: Translating Research to Practice
[email protected] | @emochaHealth | www.emocha.com
Katrina Rios, Director of Strategic Partnerships
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emocha radically improvesmedication adherencewith video DOT
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Directly Observed Therapy works
DOT is the gold standard for medication adherence
Leverages human observation
(Hawthorne effect)
Strengthens the patient-provider
relationship
emocha allows DOT to become a scalable,
tech-enabled service
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How it Works
Patient App Provider Web Portal
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Created to addresshigh priority health challenges
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TB prevalence in Maryland
Montgomery County (6.0 / 100,000 cases)Prince George’s County (5.2 / 100,000 cases)Baltimore City (4.1 / 100,000 cases) Baltimore County (3.4 / 100,000 cases)Anne Arundel / Howard Counties (2.4 / 100,000 cases)All other counties (1.3 / 100,000 cases)
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NIH clinical research | Study design
STUDY DESIGN | Pragmatic, pilot prospective implementation study from April 2016-June 2017
INCLUSION CRITERIA | Adult TB patients in Montgomery Co., Baltimore City, or Anne Arundel Co. at the discretion of local providers + Intensive or continuation phase + No prior adherence requirement + Selected at the discretion of local providers based on individual considerations
PRIMARY OUTCOMESQualitative data: Staff and patients attitudes and impressions, before and after implementation of video DOT Quantitative data:
+ Adherence: defined as the percentage of ‘expected’ doses that are verified by video observation per person during video DOT implementation (compared to before Video DOT implementation) + Percentage of ‘observable doses’ observed: defined as total doses prescribed during phase (DOT doses + self-admin) that are observed before and after Video DOT implementation
COST & IMPLEMENTATION OUTCOMES | Used an ‘ingredients’ approach in which we multiply quantity of consumables / labor utilized by their unit costs + Conducted time motion studies at each site, and obtained local costing information from clinics/clinic managers
+ Divide costs into Labor, Consumables (e.g. supplies), Equipment (e.g. vehicles, computers, etc) + Conducted ‘sensitivity analysis’ to examine different methods of implementation and different program structures
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NIH clinical research study | preliminary results
Patients on emocha maintained high,
comparable levels of adherence
Patients & staff felt emocha was less burdensome & more private than
in-person DOT
emocha led to cost savings
that varied by program structure
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Open Forum Infectious Diseases
To be released April 26, 2018
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emocha experience in Maryland
3 health departments
Anne Arundel CountyBaltimore CityMontgomery County
12,407 sq miles
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emocha experience in Maryland
28 patients enrolled in study
55 patients have used or are using emocha post-study
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7,500+ Videos submitted since April 2016
emocha experience in Maryland
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National traction & global experience
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emocha implementation & success beyond Maryland
Fresno data provided by: Prado J, Vue G, Hernandez M. Use of asynchronous video directly observed therapy to improve the patient treatment experience and reduce greenhouse emissions. Independent program evaluation, January 2018.
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Puerto Rico Hurricane Harvey | Texas
CDC Morbidity and Mortality Weekly Reports
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Thank you!
[email protected] | @emochaHealth | www.emocha.com
Katrina Rios, Director of Strategic Partnerships