How exactly is this done? The patient is hospitalized at home and the staff treats him with a unique 24-hour app. • Patient: "It's better than face-to-face treatment."

• This is how online psychiatric treatment works

  Photo: 

  Yossi Seliger

Exposure: In the psychiatric ward of the Sheba Government Hospital in Tel Hashomer, an online and innovative psychiatric outpatient service began. 

As part of the care, 35 patients and patients, who need urgent and vital psychiatric hospitalization, remain at home and are accompanied for months in 24-hour follow-up and online care by the department's medical and nursing staff. This is the first time in Israel that an online medical escort service is being used, replacing psychiatric hospitalization, and according to department heads at Tel Hashomer, it is also an unprecedented global innovation.

The service at Sheba, first revealed here, began as early as November 2019 and is intended for Maccabi and United Health Fund members. To date, around 35 patients have been admitted to the home, while now, following the sharp rise in the use of online medicine during the Corona epidemic, increased use of the innovative service is expected. In addition, the experience gained in the Sheba psychiatric ward with patients' online support has also contributed to the patient's medical surveillance in the Corona Special Psychiatry Department, which deals with all 20 corona mental patients in Israel.

The new service was approved by the Ministry of Health, and is intended for Maccabi and United medical examiners who are in urgent need of psychiatric hospitalization in an open ward, after significantly worsening their mental state (the service is not intended for hospitalized patients with fear of injuring themselves or others). In these cases, patients go online to their homes after being found to have family members who can accompany them throughout the hospital stay.

Each patient receives a special kit for home admissions, which includes a tablet with a unique application that allows continuous communication with the caregiver, written messages and video calls with the doctors, nurses, psychologists, dieticians and social workers, occupational therapists and other staff who regularly accompany patients.

In addition, the patient receives a smart watch by which the team receives information, among other things, on the patient's physical activity, sleep and medication, and blood pressure, heart rate and blood pressure monitoring. These metrics are passed in the app to the medical team. The app sends alerts in case of special problems for patients, according to the metrics that are regularly and continuously checked in their homes.

Less hospital load

Dr. Asaf Caspi, director of Psychiatry A and Deputy Director of the Sheba Psychiatric Division, told Israel Today: "We have worked for two years on developing the service and building a model that will provide care for psychiatric patients at home, using advanced telemedicine technologies.

Through the use of technology, the patient is in daily and continuous contact with the multidisciplinary staff who accompany him, and in the acute phase of home hospitalization the patient arrives at the hospital for a follow-up appointment once a week. Then, as his condition stabilizes, the patient continues to receive medical follow-up with the same therapist who accompanied him from the beginning of the process to creating trust, therapeutic continuity, collaboration and significantly improving treatment outcomes. "

Prof. Mark Weiser, director of the Sheba Psychiatric Division, told Israel Today that "The great advantage of psychiatric inpatient care is the integration and faster return of the patient to the routine, and the service may also lead to a reduction in the burden in psychiatric hospitals, by allowing some patients to receive Online treatment of their homes and community. " 

Prof. Amity Ziv, director of the Sheba Rehabilitation Hospital, where the psychiatric ward operates, said: "The service expresses the understanding that it is desirable and desirable to produce alternatives for patients instead of psychiatric hospitalization, and the program also significantly increases the potential for healing and rehabilitation of patients." While Dr. Galia Barkai, director of pediatric infectious diseases and director of telephony at Sheba, emphasized that "we are already experiencing international interest in the service, which expresses the understanding that the field of telemedicine is going to occupy a wider part of the medical world." 

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Forgotten in the closed wards

One of the patients hospitalized at the Sheba team’s online escort is Jordan (Jordi) Har Even, 26, from Rosh HaAyin. Jordan suffered a mental crisis after she was diagnosed with a chronic illness that necessitated a series of difficult and lengthy treatments and surgeries, and was hospitalized in her home in November 2019 with close support from the Sheba team.

She said, "If there was no possibility of hospitalization, I probably would have to voluntarily be admitted to a psychiatric ward and maybe not even stay alive," she says, adding: "Even before the Corona era, I thought I could talk to a psychiatrist over the computer, And help, but I found that you could have a really good and successful therapy conversation through the computer, and those conversations were much better than the mental health care I received face to face.

"The therapeutic response is very comprehensive and the feeling is that you are not alone every moment you need. My mental and emotional state has greatly improved as a result of the online hospitalization. I felt that all the staff reached out to me and so they were able to rescue me from the dark pit and save my life, and I want to thank them."