Enhancing management of tuberculosis treatment with video directly observed therapy in New York City.

Directly observed therapy (DOT), the standard of care for monitoring patients on treatment for tuberculosis (TB), requires substantial health department resources, and can be inconvenient and disruptive for patients.To determine whether video technology for remote observation of patients on anti-tuberculosis treatment (VDOT) is as effective as in-person DOT.Eligible TB patients in New York City were prospectively enrolled in VDOT from September 2013 to September 2014. We compared treatment outcomes and worker output for VDOT and in-person DOT.Among 390 patients on DOT for the treatment of TB, 61 (16%) were on VDOT and 329 (84%) on in-person DOT. Adherence to scheduled VDOT sessions was 95% (3292/3455) compared to 91% (32 204/35 442) with in-person DOT (>P < 0.01). VDOT enabled a DOT worker to observe a maximum of 25 patients per day, similar to DOT workers who observed patients in clinic (n = 25), but twice that of DOT workers who observed patients in the community (n = 12). Treatment completion with VDOT was similar to that with in-person DOT (96% vs. 97%, P = 0.63). The primary problems encountered during VDOT sessions were interruption of video and audio connectivity.Implementation of VDOT resulted in successful anti-tuberculosis treatment outcomes while maximizing health department resources.