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Expanding Remote Access to Care for Parkinson's Patients During the Covid-19 Crisis

To Whom It May Concern:

I am approaching your trust during this extremely unfortunate period from the Israel Parkinson's Association (IPA).

Founded in 1993, IPA supports people affected by Parkinson's disease and their caregivers. The Association operates 17 branches nationwide that provide information, education and support programs, health and wellness activities, and events to facilitate a better quality of life for Parkinson's patients and their caregivers. Patients also benefit from access to IPA's Hotline, legal counseling, and a web-based resource center, which includes a wealth of information on rights and eligibility, forms, and appeal procedures.

IPA is the only organization that provides outstanding services for Parkinson's patients in Israel. 

Following the outbreak of COVID-19 in Israel, IPA's branches have been closed for in-person services, and patients have been following rigorous shielding measures and home confinement. As the disease continues to spread, it is expected that patients will maintain strict social distancing for at least another year due to their clinical vulnerability. Confinement has left many without access to therapies and rehabilitation programs that help them manage the symptoms of their chronic and progressive disease. Moreover, their family members - a crucial support system - are also restricted from visiting them.

In 2019 IPA piloted a telehealth video-conferencing service integrating symptom management and patient and family education. The service was designed to support outpatient rehabilitation and offer a partial replacement for face to face care. Initially, it was launched to enable remote access to multi-disciplinary care and convenience for patients living in peripheral and underserved areas and patients with progressive stages of the disease, who are unable to travel. The service was built on an existing platform developed by the Sheba Medical Center Rehabilitation Unit (ReAbility Online) and modifications were made to address motor and non-motor symptoms, and psychosocial aspects of Parkinson's disease. Parkinson's disease particularly lends itself to telemedicine because many aspects of the diagnosis and treatment of the disease are "visual", meaning that the interaction with the specialist primarily consists of listening to the patient and observing them perform certain tasks. Through Sheba's Reliability Online platform, patients receive various treatment services ranging from motor-cognitive and movement therapy to psychological counseling.

Due to the program's success, at the beginning of 2020, we began a collaboration with the Sourasky (Ichilov) Medical Center through which additional patients receive treatment through synchronous videoconferencing. Patients receive treatment packages which include speech and swallowing therapy sessions. Patients report high satisfaction both from Sheba and Ichilov's treatments. Finally, patients who are bound to their homes can receive treatment which prevents their deterioration and improves their quality of life.

Following the temporary closing of our branches and patients' home confinement due to the Coronavirus, we decided to further expand our online services to ensure more patients, who are now bound to their homes, receive needed treatments. We therefore recently launchedParkinet- offering additional treatments and activities online via synchronous videoconferencing including Feldenkrais, Physiotherapy, Music Therapy, Thai Chi, Physio-Box, Dance and Movement, and even Salsa Dance. The therapies and activities will be administered by practitioners from the community with expertise in Parkinson's disease and will be complemented by support groups and educational lectures for patients and caregivers. The patient and his/her family will be able to access services (in private or small groups) as recommended by their healthcare team. This is a dynamic model that responds to the patients' needs which evolve over time due to disease progression. The services offered are subsidized to reduce healthcare expenditures and attract more patients to our association.

Our entire online services, including Sheba's ReAbility Online platform, Ichilov's treatment packages and Parkinet programming, are managed together and coordinated to ensure all patients receive needed services. While the Coronavirus pandemic is expected to stay with us for an indefinite period of time, our Remote Access to Care Program has become vital for all Parkinson's patients in Israel. It transforms care for patients, enabling them to continue to access treatments as part of routine management. Bringing these treatments into patients' homes facilitates an enhanced form of holistic and patient-centered care and helps to alleviate social isolation and loneliness.

The IPA is the only association worldwide that provides this type of service, and in this scope, to Parkinson's patients.

We hope you will consider helping us fund this effort on behalf of the Parkinson's Patients that we serve.

In the meantime, thank you for your time and consideration and be well during these trying times.

Zion Azrad          
Director of Resource Development           

Tel: + 972-54-5629482