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"To manage the crisis we will have to strengthen artificial intelligence for improving care from home." (photo: Tobias Koch).

Israel’s Formula For Combating The Pandemic: Digitalization

How has Israel hacked the pandemic with emerging technologies, and what makes the country a vibrant hub for innovative startups? We talk to Carsten Ovens, Executive Director of ELNET, the European Leadership Network (German chapter).

How has Israel benefited from the digitalization in healthcare when the COVID-19 hit the world?

To understand it, we should look at the state of digitalization prior to the COVID-19 pandemic. Already in 1995, Israel started to digitalize patient data and data in the health system in general, including public health. The mandatory health insurance fully covers 99% of the citizens, who also have electronic medical records. Moreover, the systems are interoperable what enables data collection and analysis.  

This digital backbone of the healthcare system has helped to combat the COVID-19 pandemic. For example, the data available in the system were delivered to Pfizer/BioNTech for research on COVID-19 vaccines. Different countries then used the findings to prepare vaccination and pandemic management strategies. Thus, everybody profited from digital infrastructure.

Can you name a few key technologies that have been particularly helpful?

Let me name three groups of technologies that were helpful for Israel. First, solutions related to monitoring, contact tracing and reporting. The Israeli Ministry of Health partnered with GlobeKeeper for voluntary coronavirus tracking in order to slow down the spread of the virus. The app HaMagen – Hebrew for The Shield – was one of the first tracking systems, quickly adopted and widely used.

The group of technologies for pandemic surveillance was symptom detection and diagnosis – many exciting tools in this field were developed by local startups. For example, AI-powered remote triage of COVID-19 symptoms in real-time or an app for early detection of patient deterioration through vital signs.

And, of course, telemedicine whereby patients have access to health services during the lockdown or when people were afraid to visit the doctor. We’ve seen enormous progress in these technologies. For example, TytoCare is an all-in-one remote medical examination solution that allows physicians to connect with patients at home to check their state of health using a handy device. There were also first trials of robotic technologies that are still in the early stage of development.

What innovations should be implemented in healthcare globally to manage the crisis better?

I think that all the mentioned technologies already give us a lot of possibilities in terms of pandemic surveillance. Now it’s time to scale them and improve their effectiveness. We will have to strengthen life sciences to ensure that vaccines can be manufactured, updated and distributed quickly whenever the new variant of the virus comes. We have to invest much more into research and innovation, support startups developing novel solutions for medicine. What’s also crucial is intensifying work on technologies which, while promising, are still at the early stage of development. I mean, first of all, artificial intelligence for improving care from home.

There are more than 700 digital startups in Israel, out of which 85% apply AI solutions

We have to improve the pandemic response by strengthening international cooperation, financing mechanisms, and coordination of relevant initiatives. We’ve seen that highly developed countries with better health systems could manage the pandemic better while developing countries were hit most and didn’t have the chance to fight the crisis. It also refers to the distribution of resources like masks or vaccines. There is much room for improvement.

So international cooperation might be the most significant strength against a pandemic that we didn’t exploit as well as possible.

We saw how at the beginning of the pandemic, countries tried to individually solve a problem that is global. Over time, we realized that this doesn’t make sense since pandemic response works only if it’s a global, not a national action. Now we see that multilateralism helps to tackle global challenges.

Since then, we have established new collaboration structures and are slowly learning how to work hand in hand. We shouldn’t forget that we owe vaccines to international cooperation in science. There are also many local initiatives worth mentioning. One of them that I’ve been involved in is the German Israeli Health Forum for Artificial Intelligence (GIHF-AI).

What is this initiative about?

Briefly said, it’s about knowledge and experience exchange in order to shape the positive impact of artificial intelligence and machine learning on medical care. Within the project, stakeholders representing academia, industry, research, and politics share their expertise to learn how to better prepare for the next waves of the pandemic and – in a longer perspective – how novel technologies can strengthen the healthcare system and medicine.

And how is AI already used in Israeli healthcare?

There are more than 700 digital startups in Israel, out of which 85% apply AI solutions. AI is the fastest-growing technology within the digital health sector. If we deep dive into Israeli’s digital ecosystem, we will recognize that scientists and engineers developing AI applications for diagnosis and treatment have strong support from the government, for example, the Ministry of Health. Thanks to the program launched in 2018 by the government, up to $270 mln shall be invested into startups working on AI-driven solutions.

What drives the innovation development are pharmaceutical companies cooperating with startups to develop AI systems and computational biology for drug research – to find new treatments faster and more efficiently, avoiding experiments on animals.

Israel has become a hub for digital innovations in healthcare, attracting international startups and venture capital. You’ve already mentioned the critical enablers like investments and collaborations. What other factors make Israel so attractive for innovators?

I recommend the book “Start-up Nation: The Story of Israel’s Economic Miracle” by Dan Senor and Saul Singer, which describes the country’s path – from a nation with no natural resources relying primarily on agriculture to one of the leading high-tech nations globally.

Several factors made it possible, first of all, education. As military service is mandatory, the best talents in maths or physics can develop their interests in the Israeli Defence Forces, where they receive the best training on information technologies. Afterward, many of them decide to study IT-related topics in one world’s leading universities that Israel has and continue their careers in the public or private sector.

Secondly, already years ago, Israel started to attract venture capital from all other the world. Israeli’s founders often reinvest their profits into the startup ecosystem so that it can grow further. Money and hubs attract new innovators, new investors accelerate the development of new products, and so on – it is a self-perpetuating system of innovation in healthcare and many other industries like finance or areas like cybersecurity. Besides, the Israeli’s mindset “just do it” and “dream big” matters. Such an approach contains a lot of creativity when it comes to problem-solving, progress, and making things better. The mix of these features makes Israel so innovative. We have more than 60 unicorns what demonstrates the scale of the ecosystem.

In 2018, a $266 mln national digital health project was approved, aiming to digitize the medical records of all residents living in Israel and leverage big data. But, do residents have trust in data-driven healthcare?

Overall, there is considerable trust in data and the available applications. Citizens are used to using apps or software based on data. Although the European GDPR is not adopted in Israel, the data-related regulations are similarly strict. Therefore, citizens can be sure that their personal data is well protected.

The privacy protection law introduced in 1981 regulates several vital issues. In addition, the Ministry of Health also sets some rules that guarantee high standards. For example, when data collected from the healthcare system were donated to Pfizer/Biontec for vaccination development, the scope of information didn’t include any personal details but only relevant information on immune response, antibodies, age, medical history, etc. Data must be handled fairly to gain trust.

Israel also has a “hands-on” mentality – if the application is successful, it means it is also safe, which also increases trust.

Let’s talk about the German Israeli Health Forum for Artificial Intelligence (GIHF-AI) established by the European Leadership Network (ELNET). What do you expect from the initiative?

The objective is to foster knowledge transfer on improving the healthcare system and lives of individuals by utilizing AI and modern technologies. We have identified three working groups to help us develop policy recommendations. The first one focuses on technology and security, covering topics like interoperability, available data, robust data protection, and ethical standards. The second group is tackling the challenge of regulation. In such a sensitive field as personal data, we need a regulatory framework for digital health, AI-based applications.

Last but not least, the third group focuses on communication and trust. We want to address the question: What is needed to strengthen trust in AI among different stakeholders in healthcare systems?

Over time, GIHF-AI will connect various experts from Germany and Israel – and in the long run, also from other European countries.

Whixx

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