November 30, 2011 By Sarah Rich
With one of the highest infection rates of tuberculosis (TB) in the country, King County, Wash., has enlisted technology to ensure that its patients take the required medication. The county, which includes Seattle, is using webcams to watch patients take the medication — the drugs must be taken exactly as prescribed and the treatment time can range from six to 12 months.
TB is a disease that often infects the lungs and can spread to other parts of the body, but it can be treated with a series of drug regimens, according to the Seattle and King County Public Health department. The county’s TB clinic started the webcam program a couple months ago and about 10 patients are participating in it.
“TB is an extensive treatment regimen and it’s quite lengthy,” said Denise Genaro Wolf, the nurse manager for the county’s TB control program. “It’s a requirement to have the observed therapy because even for folks who are conscientious, it’s a difficult journey to stay compliant with taking all the medication and then for the length of time they have to take it, it assists them.”
As of 2010, King County’s health department had documented 114 cases of active TB in the county and provides treatment and/or evaluation to more than 1,100 county residents who have active or latent tuberculosis. According to the Centers for Disease Control and Prevention, if the medication isn’t taken correctly, the infection could become resistant to drugs.
“TB control is an essential investment in the health of our communities that helps us fight the local effects of this global disease,” said Dr. David Fleming, director and health officer for the county health department, in a statement.
Jasko Cokic, a county TB clinic medical assistant, said patients call the county’s TB clinic to alert clinic staff when they’re ready to take the medication. Once a staff member has been notified, an email invitation is sent to the patient to sign onto the clinic’s Microsoft Office Live Meeting video-conferencing tool. The patient then accepts the invitation and connects with the TB clinic.
Once connected, the patient takes the medication while a representative from the clinic observes that the accurate dosage has been taken. During the Web chat, patients also can talk to the TB clinic staff about possible side effects they’re experiencing or check in about the status of their treatment, Wolf said.
Cokic said the idea to provide live Web chat for TB patients to comply with taking their required medication stemmed from the patients. For some patients, medical staff must go to the patient’s home to observe that the TB medication has been taken. But with the webcam option, the patient won’t draw attention from his or her neighbors with medical staff from the county department on their property.
“The patients would say, ‘I don’t want you to come to my home,’ because there’s some stigma about the TB disease especially in the wealthy areas of King County,” Cokic said. “So they, for example, don’t want King County Public Health cars in front of their homes.”
To participate in the program, patients provide their own webcam equipment, but there’s no cost for accessing the video-conferencing tool. Once patients download the program onto their PC, they can access email invites for the Web chat meetings, Cokic said.
Before the webcam program launched, patients could borrow video phones from the clinic so they could call in for TB clinic staff to observe them complying with their treatment requirements. Patients can still borrow the video phones, however, Cokic said the phones are outdated and have trouble connecting back to the clinic.
While the new webcam program has produced positive results, according to Wolf, the TB clinic is the only section of the county’s health department that’s utilizing video-conferencing technology to observe patients taking medications and no plans have been made to expand the technology to other sections of the health department.
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