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Video Directly Observed Therapy Toolkit: Practice Guidelines and Legal Considerations

posted on Wed, Mar 30 2016 10:43 am by Brittney Crock Bauerly, J.D.

There is growing interest among local health departments to utilize innovative approaches in the treatment of tuberculosis (TB), including using telemedicine to monitor medication adherence. Some health departments have begun to explore and implement video directly observed therapy (VDOT), in which health care providers observe patients taking their TB medication remotely via a webcam, smartphone, or videophone. VDOT appears to be a convenient and patient-centered alternative to in-person directly observed therapy (DOT) for some patients. Recently, the Network partnered with the Minnesota Department of Health in creating resources for a VDOT Toolkit, which included a legal analysis of VDOT in the Minnesota context.

The complete Minnesota Department of Health VDOT Toolkit is now available online and contains a number of resources which may be helpful to local health departments interested in implementing VDOT. The Toolkit reviews current TB control practices in Minnesota and provides background information on VDOT. The Toolkit also includes a summary of published literature on the implementation of VDOT for TB and related diseases. The sample practice guidelines describe potential patient eligibility criteria, roles and responsibilities, and VDOT practice protocols. The legal component of the Toolkit includes an analysis of Minnesota’s new telemedicine reimbursement law as well as information on HIPAA privacy and security, data practices, and health record issues.

The VDOT Toolkit also includes several example templates to support implementation of VDOT at the local level. Templates include sample consent forms to participate in live and store-and-forward VDOT which can be reviewed and adapted at the local level. There is also a list of technology options and a sample loaner agreement for electronic devices that local health departments may review and adapt in consultation with their legal counsel.

VDOT presents a promising alternative to traditional DOT practices. Local health departments may want to consider these new resources when contemplating whether a VDOT program might be an appropriate addition to their TB control programs.

This post was developed by Brittney Crock Bauerly, J.D., Staff Attorney for the Network for Public Health Law–Northern Region.

The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this post does not constitute legal advice or legal representation. For legal advice, readers should consult an attorney in their state.

Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not necessarily represent the views of, and should not be attributed to, RWJF.

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