2018 NACo Achievement Award Winner

El Paso County, Colo., CO

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About the Program

Category: Health (Best in Category)

Year: 2018

Persons who have Tuberculosis (TB) disease must be treated with the correct medications and, in certain cases, the treatments must be directly observed by trained nurses. If the medication is stopped too soon, or is taken incorrectly, the TB bacteria that are still alive may become resistant to the medications. The requirements of traditional, in person directly observed therapy (DOT) require a trained nurse to observe the patient taking the medication. DOT are cumbersome, costly and can extend the time of treatment because DOT can only take place on business days. El Paso County Public Health’s (EPCPH) Communicable Disease and TB Program implemented a novel approach to TB DOT that saved time and reduced barriers to care for patients, increased staff efficiencies and reduced costs; all while improving patient care and adherence to TB treatment. This innovation was the implementation of video recorded directly-observed therapy (VrDOT) for TB patients. VrDOT utilizes a smart phone application to view live or recorded sessions where a patient is shown to be taking TB medication according to the treatment plan. VrDOT technology for virtual home visits is a new practice that achieves better outcomes for the patient, the community, and for EPCPH. VrDOT reduces barriers to treatment because it accommodates work and school schedules, religious holidays and observances and travel, and offers a convenient way to record treatment when it occurs after EPCPH business hours. VrDOT is already showing success for patients and for EPCPH. Of the patients enrolled in the VrDOT program, 100% have completed treatment in the prescribed time frame without having to drive to the EPCPH or have a nurse visit their home. Patients and nurses have expressed satisfaction and gratitude for this less invasive and more convenient treatment.

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