5 advantages of using telehealth to battle tuberculosis

Tuberculosis was once a disease deemed ultimately fatal once contracted but thanks to modern medicine TB is curable, yet over 1 million people die annually from the disease. With 22 percent of all TB cases occurring in California the CDC recommends the high cost, travel dependent and labor intensive directly observed therapy (DOT) as the most effective treatment. The Center for Connected Health Policy has released a report on what benefits telehealth could bring to the treatment of TB.

The California Health Care Foundation funded two companion grants in an attempt at bringing telehealth into the fold of monitoring TB patients medication adherence. The first grant will evaluate the efficiency of electronic DOT (eDOT) led by the University of California, San Diego School of Medicine, and the second to evaluate the barriers to the implementation of technology in California face.

The CCHP report, which evaluated eDOT studies that examine the current policy and procedures of current TB treatments on a state and federal level, came to many conclusions regarding the benefits and concerns of eDOT on the treatment of TB.

These results included:

• eDOT reduces travel and staff time when treating patients.
• eDOT flexibility lead to better medication adherence and patient acceptance.
• Concerns about the implementation on the technology included privacy, security, reimbursement and lack of guidelines.
• DOT performed in-person is reimbursed under Medi-Cal, but telehealth polices conflicted with eDOT utilization in rural health departments making the tech not usable.
• Current DOT policy’s frim the CDC and the US Department of Health and Human Services were found to be outdated and did not include technology.

The report gives solutions to the barriers eDOT faces in implementation on both the national and California level:

National Level

• DOT guidelines set by the CDC need to be updated
• These DOT and eDOT guidelines need to be in accordance with HIPPA, privacy and security
• More information from studies on the use of eDOT on infectious diseases is needed

California Level

• The reimbursement program from Medi-Cal needs to be expanded to include DOT providers
• The reimbursement list also needs to be expanded for more eligible locations and allow for the home to qualify when a healthcare provider is not present
• Medi-Cal and other systems need to provide reimbursement for eDOT