Telemedicine for Inpatient Psychiatric Care: Remote Care in a COVID-19 Mental Health Unit

The study examines the implementation of a new model of remote care by telemedicine technologies at a COVID-19 acute psychiatric unit. Remote care by telemedicine technologies accelerated during the COVID-19 crisis, not only for outpatient care but also for hospital inpatient care. To enhance the safety of the staff in the COVID-19 units, conserve PPE, and provide a method for communication with experts and families, hospitals developed a new model of in-patient telemedicine. The model was implemented in an acute psychiatric unit for COVID-19 patients in Israel with a control room and audio-video system to remotely supervise, communicate, and treat the patients in the contaminated unit. The study is based on semi-structured interviews of medical staff, architects and digital technology directors, and observations in the COVID-19 unit in June - December 2020. The study illustrates the impact of the built environment on the implementation of telemedicine technologies for inpatient care. It demonstrates limitations caused by the location of the audio-video system to avoid vandalism and the complexity of the system due to the dynamic movement of patients in the unit. The results indicate the system's dependency on the collaboration of patients and the need for coordination between caregivers. While inpatient telemedicine holds potential to enhance the quality of care and safety of patients and staff in COVID-19 units, its implementation in acute psychiatric units requires further development in the integration of digital technologies with the design of the built environment to address unique challenges of mental health.