The Department of Public Health and Social Services recently introduced a smartphone application as part of its tuberculosis program to improve medication monitoring and patient engagement.
Chima Mbakwem, tuberculosis/Hansen's disease control program manager at the DPHSS Bureau of Communicable Disease Control, said the department recently started using a web-based program called emocha Mobile Health.
“Basically, it is a smartphone app, but the phone has to have a front-facing camera. It is designed in a way that the patient can use it without internet access,” Mbakwem said. “It can be recorded and uploaded when you have internet access.”
Public Health offers the Tuberculosis Control Program, which is done under the Directly Observed Therapy program. This involves direct observation and close monitoring to ensure clients take their medication and complete the program.
“When a patient is diagnosed with TB, he will be put in isolation for two weeks. That is the time when we give them medication to prevent them from being infectious. Within that two weeks, they come into the Public Health clinic every day to take their medication or we go to their homes where they are isolated to give them medication,” Mbakwem said.
The clients are taught to use the mobile app to monitor their daily intake. The app is compliant with the federal law restricting release of medical information. With the app, the clients do not have to visit Public Health on a daily basis while undergoing treatment.
“They video their treatment and then send it to us,” Mbakwem said.
On its end, Public Health reviews the video and logs it into the built-in system once daily treatment has been completed. The app interface includes a log of the medication status, date, time and side effects.
When the process is not properly done or the clients forget to take their medication, the TB program staff immediately sends a reminder via text message.
“That way, the patient has full control of the treatment,” Mbakwem said.
TB program participants are given the option of using the smartphone app or the traditional medication intake method that requires face-to-face monitoring.
The app also helps remove the stigma associated with TB treatment. According to Mbakwen, the app eliminates the need for Public Health staff to conduct home visits for clients with transportation issues.
Mbakwen said Public Health was able to tap into a grant by the National Institutes of Health. The grant supports studies evaluating the effectiveness of the app in assisting tuberculosis patients.
"We are just a commercial pilot site for the grant for a one-year period. So for Public Health, this is a pilot program," he said.
James Gillan, former acting director of DPHSS, said, “This is the first application of its type in the Pacific region. It is a pilot project, but it has so many implications for other opportunities to provide treatment.”
“It really makes more sense (with using mobile). It makes it more personal and people tend to be more compliant. They have somebody that they are talking to at the time they are getting their treatment. And they don’t have to come in,” Gillan said.