Abstract

emochaMobileHealth,IncandJohnsHopkinsinvestigatorshavedevelopedauser-friendly, HIPAAcompliantapplicationforasynchronousvideodirectlyobservedtherapy(DOT)?miDOT. ThemiDOTplatformconsistsofapatient-facingmobileapplicationwherepatientscanrecord videosofthemselvestakingmedicationattheirconvenienceandaprovider-facingwebportal thatallowsproviderstomonitoradherenceandprogress,visualizedata,generatereports,view sideeffectsreports,andautomaticallysendSMSmedicationreminders.Theplatform representsapatient-centeredstrategyforimprovingadherencesupportandovercomescost andlogisticalbarrierstotraditionalDOTwhilemaintainingpatientautonomyandrespect. OurSBIRPhaseIeffortssuccessfullydemonstrated:1)technologicalfeasibilityofusingmiDOT forTBtreatmentmonitoring2)miDOTisacceptableandpreferredbypatientsandprovidersfor TBtreatmentand3)miDOTiseffectiveatensuringhighlevelsofadherenceandtreatment completion.However,severalkeyknowledgedeficitsexist.First,ourPhaseIeffortsfocusedon patientswithpriordemonstrationofgoodadherenceinonestate.Itisnowimperativeto demonstratethatmiDOTwouldbeusedandeffectiveinabroaderpatientpopulation.Second, currentvideo-DOTeffortshavefocusedonactiveTBpatients;?however,publichealthauthorities havealsoprioritizedtreatmentfortheestimated13millionpeopleintheUSlivingwithlatentTB infection(LTBI).AshortcourseregimenforLTBIisrecommendedtopreventprogressionto activeTB,andconsistsof3monthsofweeklyisoniazid(INH)andrifapentine?or3HP- administeredunderDOT;?however,uptakehasbeenlimitedduetothisDOTrequirement,which isnotlogisticallyfeasiblewithsuchhighpatientvolumes.Alternativeself-administeredLTBI treatmentscanbeprescribed,butarelengthy(4-9months)andhavepoorcompletionrates. Finally,thereisaneedtodefinebestpracticesformiDOTintegrationandadoptionintocurrent TBprograms.OurSBIRPhaseIIgoalistoguideprogrammaticscale-upthrough implementationresearchwhilebuildingthenecessarytechnicalinfrastructuretoallowthe systemscalecommerciallytomeettheneedsoflargerpatientpopulations.

Public Health Relevance

Theproposedstudywillevaluateanationallyrepresentativeimplementationstudyonvideo directlyobservedtherapy(DOT)amongtuberculosis(TB)patients.VideoDOToffersthebenefit ofpatientandproviderconveniencebyremovingtheneedforfrequent,in-personvisitsandhas thepotentialtoreducestigmawhileimprovingtreatmentcompletioninamorecosteffective mannerthantraditionalin-personDOT.Theproposalwillbuildthetechnicalarchitecture necessarytoscalethetechnologyinpublicandprivatecommercialsectors.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
Project #
5R44MD010521-04
Application #
9756227
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Hailu, Benyam
Project Start
2015-09-25
Project End
2021-03-31
Budget Start
2019-04-01
Budget End
2021-03-31
Support Year
4
Fiscal Year
2019
Total Cost
Indirect Cost

  Institution

Name
Emocha Mobile Health, Inc.
Department
Type
DUNS #
079307582
City
Owings Mills
State
MD
Country
United States
Zip Code
21117