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by Eyal Zimlichman, MD, Chief Transformation and Innovation Officer, Sheba Medical Center & Avi Tsur, MD, Deputy Chief Transformation Officer, Director of Sheba Women’s Health Innovation Center, Director of OBGYN at Sheba Beyond, Sheba Medical Center
Since the start of the Israel-Hamas war, the relentless demands of wartime have propelled local medical teams to adapt and integrate new technologies at an unprecedented pace.
We, leaders at Israel’s largest Medical Center, have faced a brutal three-pronged assault: a daily influx of injured civilians and soldiers, a depleted workforce due to medical personnel called to military duty, and the looming danger of relocating the entire medical center to missile-proof shelter.
Faced with more patients and fewer staff, our response was to unleash the power of AI and automation, forging a path to treat more with less.
When forced to relocate our patients to a missile-proof shelter, we leveraged our state-of-the-art technologies to pivot in-person treatment to remote care. While receiving treatment at home, patients were able to use their own shelters, while remaining together with their families during stressful times.
This period has taught us valuable lessons in crisis management and the value of strategic adoption of health technologies. Similar to COVID-19, many of the tech advancements pursued as a result of this war will now serve as valuable additions to our ongoing healthcare toolbox in the long term.
There will inevitably be further conflicts and pandemics in Israel and worldwide, with hospitals at the forefront of treating all those affected. We’d like to share some of the considerations we have navigated for integrating health technology to meet the new challenges that war thrust upon us.
We chose to focus on two examples from very different clinical disciplines – scaling rehabilitation services and providing real-time remote care for high-risk pregnant patients in the comfort and safety of their homes.
Organic & Open Innovation
To ensure our success, we first had to determine the right approach. When it comes to innovation in the hospital environment, there are two general approaches. Organic innovation includes technologies that hospitals develop in-house, based on needs that physicians recognize in their specialty. Whereas open innovation involves hospitals incorporating technologies that have been developed by external parties.
Both methodologies offer important benefits. Over the last year alone, we have seen successful organic innovation with 15 promising companies developed at our hospital to meet critical unmet needs. However, this process takes time and when managing a crisis, open innovation can often provide faster, broader and more market-ready solutions.
When evaluating open innovation opportunities, it is crucial to consider the bigger picture beyond the immediate need. Hospitals need to identify the most appropriate technologies, evaluate the product’s current working status and its future potential development, while also predicting and addressing any implementation challenges in advance.
Rehabilitation – Responding to Issues of Scale
Following the October 7th attacks, thousands of people were rushed to Israeli hospitals for emergency treatment. In the aftermath, with a military operation on the horizon, the Israeli healthcare system faced the daunting prospect of treating even more patients with severe and complex injuries, placing further strain on our limited resources and requiring out-of-the-box thinking to rise to the challenge.
Sheba Director General, Prof. Yitshak Kreiss, immediately anticipated one of the greatest missions and challenges our hospital had ever faced – scaling our rehabilitation services.
Rehabilitation is a labor-intensive field, requiring a large, multi-disciplinary team of occupational therapists, physical therapists and speech therapists often working with patients one-on-one. We turned to technology and innovation to support our rehabilitative care programs.
To ensure we got these choices right, we formed a multi-disciplinary committee, including seasoned innovation and technology leaders at the hospital and members of the rehabilitation clinical teams led by Prof. Gabriel Zeilig, Head of Innovation in Sheba’s Rehabilitation department. This committee was involved in decisions throughout the identification and selection process, evaluating, critiquing, and analyzing possible solutions, ensuring that any technologies would complement and optimize clinical team performance.
Our experience has demonstrated that integrating AI/machine learning technologies with remote care solutions significantly enhances the efficacy of patient treatment. AI-powered tools have been instrumental in guiding patients through essential, repetitive tasks—be it physical or mental exercises—that play a crucial role in their rehabilitation and recovery process. This integration aims to extend our care to a larger number of patients over longer periods without needing to expand our clinical team. Moreover, these AI tools prove invaluable in ensuring continued care even after patients are discharged, enabling them to maintain their recovery process at home. We expect that the most effective use of these tools will occur when patients begin utilizing them under our supervision at Sheba.
In addition to AI-driven solutions, we also recognize the importance of remote care technologies that do not rely on automation or AI. These technologies are crucial for two key reasons: they enhance logistical operations within the hospital through in-hospital telemedicine, and they ensure a seamless continuity of care for patients transitioning from hospital to home-based care.
Redefining Pre-Natal Treatment
Even amid the turmoil of war, the reality of expectant mothers and newborns persists. For those facing high-risk pregnancies, intensive monitoring of both mother and fetus is typically conducted in a hospital setting from diagnosis to birth.
The grim prospect of relocating many of our hospital beds to missile shelters necessitated the difficult decision to scale down our high-risk antepartum unit from 39 beds to merely 15, in anticipation of a potential patient evacuation to a bomb shelter. Additionally, as alarms sounded, schools and childcare facilities shut down, and stress levels surged, our patients overwhelmingly preferred to remain at home with their families and children.
In response, we enhanced our existing comprehensive virtual pregnancy service to meet the demand for intense comprehensive remote care, effectively substituting for in-hospital antepartum stays. We utilized technologies such as secure, HIPAA-compliant video chats for ongoing communication between pregnant patients and their doctors, alongside remote medical-grade fetal monitoring and remote ultrasound for real-time remote monitoring.
Continuous, 24/7 communication with the hospital reassured our patients, offering them a sense of security even while receiving care from a distance. This transition to remote prenatal care has not only overcome logistical hurdles but has also led to an improved patient journey, which is crucial during such challenging times.
HealthTech Innovation in Times of Crisis
The Chinese word for crisis compromises two Chinese characters meaning ‘danger’ and ‘inflection point’. The recent war has not only highlighted the vital role that innovation plays in managing crisis but also the role of crisis in driving innovation.
Medical centers worldwide are challenged by aging populations, rising costs and shrinking workforces. These issues are prevalent in calm times and worsen during crises. Our experiences show how these challenges can be overcome, in part by leveraging remote and automated technologies. However, these technologies should not be limited to wartime response and must continue to be used in normal times to become part of the standard of care.
When faced with a crisis, there is a natural tendency to cling to the routine. However, we cannot let this approach define our attitude towards innovation.
Rather than resisting change, we must embrace technology to enhance our ability to respond swiftly and effectively. Our experience shows the benefits of leveraging open innovation to drive remote and automated care and can provide a blueprint for other hospitals facing crises in the future.
Prof. Eyal Zimlichman, MD serves as Chief Transformation and Innovation Officer of the Sheba Medical Center, is the Director and Founder of ARC Innovation and Co-Founder of Future of Health (FOH).
Dr. Avi Tsur, MD serves as Deputy Chief Transformation Officer of the Sheba Medical Center, Director of OBGYN at Sheba Beyond and Director of the Sheba Women’s Health Innovation Center. Dr. Tsur is also co-founder and Chief Medical Officer of Shela, an ARC company advancing maternal-fetal precision medicine.
Published May 15, 2024, HIT CONSULTANT
