Last week, the CDC announced that video Directly Observed Therapy (video DOT) is equivalent to in-person DOT for persons undergoing treatment for tuberculosis. The announcement cites studies from our partners, Johns Hopkins University and the Alameda County Public Health Department and the Rhode Island Public Health Department, in the summary of evidence.
“This is incredible news,” said Sebastian Seiguer, founder and CEO of Scene Health. “When we first sought to augment a decades-old in-person process with asynchronous video in 2014, some called us crazy. At the end of the day, evidence ruled as it should. We had great academic partners to demonstrate results with research and innovative public health departments on the leading edge of this concept to put our vision into real-world practice.”
Since our beginning, we’ve used video DOT to secure adherence for patients with tuberculosis and hepatitis C. Now, we support diverse populations across multiple chronic and infectious conditions, including diabetes, asthma, cholesterol, opioid use disorder, hepatitis C, tuberculosis, hypertension, solid organ transplants, and sickle cell disease.
We have long advocated for video DOT as an incredibly efficient, convenient, and cost-effective alternative to in-person DOT in the outpatient setting.
If you’ve ever had a hospital stay, you’re familiar with DOT — when a trained healthcare professional watches as a patient takes each dose of a medication. It’s the standard of care for medication administration in clinical settings and the best way to ensure patients take their medications.
But DOT comes with challenges.
DOT can be inconvenient, costly, and difficult to implement at scale. Additional concerns around privacy, autonomy, and stigma for patients also come into play. Although these concerns are especially pronounced for tuberculosis patients, patients with all types of chronic and infectious diseases are burdened by the in-person requirements of DOT.
By allowing healthcare workers to observe videos of patients taking their medications anytime and anywhere, video DOT gives patients freedom and gives healthcare workers the ability to streamline their workloads while saving time and money.
“The CDC has become the very first institution in health care to recognize that a virtual visit between patient and provider — through the exchange of recorded video — can deliver the same clinical outcome as an in-person appointment,” explained Seiguer. “Live telehealth removed geographical barriers to care, but Scene Health’s asynchronous video appointments also remove scheduling and synchronicity barriers. This is a groundbreaking moment in digital health where technology-assisted remote delivery of care is demonstrated to be MORE convenient and LESS burdensome while achieving the SAME result. The CDC found equivalence in outcomes, but for patients who struggle with adherence, this is a superior format in terms of travel burden, the time constraints of daily visits, and experience.”
We take video DOT even further by incorporating personalized engagement with our care team of pharmacists, nurses, and health coaches, as well as a host of clinically validated interventions that empower every patient to positively impact their health. Through one-on-one personal interactions, our care team can help patients overcome any social determinants of health that are barriers to their adherence. Our particular approach to video DOT has been validated in 19 peer-reviewed publications and has received multiple recognitions.
In 2020, we received the National Tuberculosis Controllers Association's Joe Ware Partner Service Award for improving the dissemination of tuberculosis treatments. This award recognized our work to shift the burden of care away from in-person care delivery and improve the ability of our partner public health departments to disseminate tuberculosis treatment.
In our increasingly digital world, people are more comfortable using digital devices to access their healthcare now more than ever. Since COVID-19, we’ve seen a meteoric ramp-up in the interest in video DOT, and the newfound endorsement from the CDC will continue to build the momentum.