Baltimore, MD (August 9, 2023) — Scene Health (formerly emocha Mobile Health), in collaboration with the University of Washington School of Medicine, was awarded a $1.96M Small Business Innovation Research (SBIR) award from the National Institute on Drug Abuse. The award funds phase two of a project to revolutionize methadone treatment by expanding access to remote monitoring for opioid use disorder (OUD) through Scene’s video Directly Observed Therapy (video DOT) technology.
Clinical investigators Drs. Judith Tsui and Kevin Hallgren at the University of Washington School of Medicine will evaluate video DOT’s impact on clinical outcomes and assess implementation factors across a large, multisite opioid treatment program (OTP).
The award comes as federal legislators consider reauthorizing a set of addiction treatment and recovery services that are set to expire Sept. 30, including funding for programs providing treatment and recovery services, and on the heels of the Centers for Disease Control declaring that video DOT meets the standard of care for patients with tuberculosis, which disproportionately affects people experiencing homelessness.
"Findings from this phase will inform the evidence-based policy changes required to extend the use of video DOT technology for remote monitoring of methadone maintenance therapy, increasing access to care and advancing patient-centric outcomes for individuals with opioid use disorder, " said Dr. Judith Tsui, a professor of medicine at the University of Washington School of Medicine.
Methadone is an effective treatment for OUD, but traditionally, it required in-person dosing at OTPs, and guidelines for allowing take-home methadone doses were rigid to ensure adherence and prevent the diversion or sale of the medication. During the pandemic, the Substance Abuse and Mental Health Services Administration (SAMHSA) allowed more take-home methadone doses at the provider's discretion to reduce in-person contact. While the flexibility was a positive step, many providers did not take full advantage due to concerns or the financial implications of not billing for in-person dosing. SAMHSA has allowed these flexibilities to continue until one-year post-Public Health Emergency, or May 2024.
“Currently, SAMHSA’s regulations differentiate between a ‘supervised dose’ and a ‘take-home dose,’” said Sebastian Seiguer, CEO of Scene Health. “This project explores the possibility of creating a middle ground for patients and OTPs: a supervised take-home dose. With the recent declaration by the Centers for Disease Control that remote/video DOT sessions are equivalent to in-person DOT, the time has come to revolutionize methadone treatment.”
The project’s first phase involved a 60-day pilot study of the feasibility and acceptability of remote observation of methadone take-home dosing using Scene’s video DOT platform. The results demonstrated that video DOT is a practical, credible way to observe methadone dosing while enabling social distancing. Participants using Scene’s technology had an average of 53.15 days with an observed dose, compared to an average of 16.64 days for matched controls, suggesting video DOT can increase assurance about methadone adherence.
A subsequent qualitative study showed that Scene’s video DOT platform helped OUD patients get more continuous treatment by removing the time requirements, travel burden, and stigma associated with in-person care. The research team also found that the platform required a low workload for OUD patients and counselors and was highly usable for patients.
The new project aligns with Scene’s other collaborations to help patients with substance use disorder be more adherent. The HERO study, an eight-city pragmatic randomized controlled trial with results published in The Lancet, evaluated the efficacy of video DOT to help persons who use/inject drugs (PWUD/PWID) to stick with treatment and reach a hepatitis C cure. The INCLUD study conducted by University of Colorado researchers also used Scene’s video DOT technology to verify the dosing of direct-acting antiretrovirals to expand hepatitis C treatment options for PWUD/PWID.
About Scene Health
Scene Health’s 360° model of care enhances Directly Observed Therapy through video technology to address the $500B medication nonadherence problem. Scene currently delivers programs for Medicaid and Medicare MCOs, public health departments, and life science organizations covering multiple chronic and infectious conditions, including diabetes, asthma, cholesterol, opioid use disorder, hepatitis C, tuberculosis, hypertension, solid organ transplants, and sickle cell disease.
National Institute on Drug Abuse (NIDA) Statement
Research reported in this publication was supported by the National Institute On Drug Abuse of the National Institutes of Health under Award Numbers R44DA053081, R44DA044053, and R41DA053081. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
The Bliss Group