Patient-Centered Telehealth Solution for Observed Urine Collections in Substance Use Disorder Care Delivery During COVID-19 and Beyond

Abstract

Patients with substance use disorder (SUD) rely upon urine drug testing to support treatment adherence and to mitigate relapse. Before the onset of coronavirus 2019 (COVID-19), the logistical challenges of randomized observed collections for urine drug testing for the patient were significant. During COVID-19, these barriers were often insurmountable. Since SUD patients represent a population at a higher risk for complications from COVID-19, an alternative strategy to support COVID-19 testing was urgently needed. We designed and deployed a telehealth-based solution in which patients could use mobile devices to connect with trained collection professionals to perform observed urine collections, often referred to a UA (urinalysis). The solution was designed with patient-centered best practices for telehealth, stigma prevention, trauma-informed, empathy and compassion, and to remove barriers to access to care. This approach demonstrated high patient satisfaction scores thereby proving that it is possible to provide urine collection services in the patient’s home via a telehealth technology, while still upholding SUD testing integrity best practices. This study lays the path for a more patient-centered way to support this population.

Patient Experience from an eHealth Perspective: A Scoping Review of Approaches and Recent Trends

“…Usability, user-centered design, and participatory development of eHealth with patients: The articles on PX include studies with patient-centered design [44,38,47], usability evaluation [48], and research on users' experiences on acceptability of an intervention [37]. Study findings indicate that solutions designed with a patient-centered approach improved UX [38] and demonstrated high patient satisfaction scores [47]. Further, two articles [30,49] describe a framework to inform the patient-oriented design technology solutions for improving PX.…”

“…(incl. qualitative and/or quantitative questions) [19,20,[22][23][24][25]28,29,34,40,43,46,[52][53][54][56][57][58]60] Interview [30,32,35,37,42,45,59] Focus group [36,41] Service analysis [31,51] Design methods [44] Reviews [26,39,49] Implementation study [18,21,50,61] Cross-sectional study [27,33] eHealth pilot or trial [38,43,47,48,55] The most frequently used method (i.e., surveys) was applied in 18 papers (see Figure 2). As patient satisfaction was one of the most mentioned aspects affecting PX, patient satisfaction surveys were the most broadly applied.…”

“…These were grouped under "implementation study" [18,21,50,61], and they often included another research method, such as questionnaires [50]. Similarly, the five papers that reported different pilots or trials [38,43,47,48,55] also included other methods, such as surveys or usability studies, to further evaluate the success of the trial. More rarely, used methods included and cross-sectional studies [27,33].…”