The secret to fostering innovation in hospitals is to harness clinical and research curiosity and their ambition to better clinical yields.
Earlier this week, I led an inspirational talk exploring innovation in conservative healthcare ecosystems with three Israeli experts — Shiri Carmielli, Ravit Warsha Dor and Dr Yona Vaisbuch. The idea was to share knowledge and experience with health ecosystems in the emerging Europe region, where innovation is still more moderate.
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Over the last 15 years, my three guests have worked to first understand and then address the concerns of those lagging when it comes to health innovation.
Ravit has worn quite a few hats — she is a health tech expert, investor, and venture builder with experience in digital health, medtech, health policy, business development, start-up mentoring and coaching.
Shiri is a senior strategic business and management consultant and serial digital healthcare entrepreneur. She also spent seven years in the US working with real-time cardiac monitoring medical devices, at a time when digital health was still in its infancy.
Yuna meanwhile is an ear and skull base surgeon in Rambam’s Department of Otolaryngology-Head and Neck Surgery, and the founding director of Biodesign Israel.
Three challenges
All three have experience working in conservative healthcare systems. In 2006, Shiri was working in the US, at the beginning of the digital health era, where it was common for physicians to promote a lack of collaboration with other innovation actors.
“When we were looking at the market, we learned that we needed to separate the physicians and the senior management in our approach and work with them. The [physicians] had no openness and willingness to listen. When we approached a hospital and went to the senior management and said ‘this is the future of technology’ and the physicians are not interested in it, the management would not even try it,” Shiri says.
Meanwhile, Ravit at the time was an entrepreneur developing a proof of concept and wanted to try it with one of the health maintenance organisations (HMOs) in Israel.
“My challenge was to find a person who would even listen to me, who would know how to take the technology and find the right people and work with me. When I joined the Ministry of Health in 2017, it was my job to connect the new innovative technologies of Israeli start-ups and also large organisations with the Israeli healthcare system,” Ravit said.
“When you enter the medical school, and you are exposed to the clinical circumstances, you are still on the customer side, and you can already see the conservative approach to the workflow and to the habits that currently the medical staff has,” Yona added.
Referring to Shiri’s experiences, he added that over the last two decades not much has changed – health tech is not an easy area to work with and this results in a more conservative approach because of the risk involved.
“So, before trying to innovate, first do not harm. Of course, you’d like innovation but you’d like it to be tried by somebody else,” Yona added. “Now that we understand where this conservative approach comes from, we need to build bridges and common languages between tech people, medical people and businesspeople, so they will understand each other’s points of view.”
Several tips
And the mindset has had to change at all fronts, little by little, step by step.
Shiri concluded that the enabling factors to foster innovation implementation in hospitals is to harness the clinical and research curiosity and their ambition to better clinical yields. They also knew they could not try and change the physicians’ and clinicians’ habits, at least at the beginning.
Yona had a piece of advice for start-ups: “Don’t just say, I am innovating, I am improving something, why don’t you take it. You’d better ask the physician, how much I need to improve the current state of things for you to be willing to use it. We need to understand usability, the time limit, the fatigue, those hurdles that are actually opportunities because technology can solve some of those problems but not like in the past when digital health tried to solve niche problems instead of looking holistically at the problem.”
There is also the question of all the stakeholders being involved in the process of building innovation: the industry, academia, medical centres, NGO’s, and the government.
“It is not a natural thing to bring the government and the industry to work together. There are ethical issues, and somebody has to invest their energy to solve the legal problems so they can meet together.”
And then platforms that bring all the components and stakeholders together.
“Biodesign in Israel is one of those platforms and we say tell everyone to ignore our own jargon and use the Biodesign language so that everyone can understand each other, say which step or milestone of the project we are at, we are working together for the same goals,” he said.
Ravit emphasised the importance of so-called early adopters, who need to be found in all organisations: start-ups, medical organisations, academia, NGO’s and the government.
“You really need to have these people who are willing to collaborate and these collaborations are the key, because you cannot go on your own. You need to have the whole ecosystem behind you.”
Ravit was one of the organisers of the MHealth Israel community almost two decades ago.
“We started by phoning people and telling them that we were organising a conference about digital health and perhaps you’d like to join. And we called people who were not even into digital health. We simply interested these people in combining the tech industry and the health industry and tried to build something together.
“The specifics of the Israeli market is that it is small, and most technologies developed in the country are not used there and the founders are not bothered to work with the Israeli organisations due to bureaucracy and other gaps. Ravit also emphasised the fact that both physicians and start-ups faced the lack of funding challenge and that is where the government stepped in.
“We created, together with the Innovation Authority, a programme that allows start-ups to test their technologies with health organisations even if they are at a very early commercial stage and the product is not ready yet,” he added.
The funding would go to the start-up and would be shared with the health organisations. These events helped close the communication gap between agile start-ups and the less energetic health organisations, which eventually helped the entire industry understand the healthcare innovation landscape.
Data is key
And there is the entire area of data collection, which is a strength Israel is known for.
“Israel started to collect health data digitally almost 30 years ago. We have been smart enough to utilise this strength while we are building the digital health ecosystem here,” Ravit said.
Yona added that in the era of data, Israel is a pioneer in not only collecting but also anonymise it.
“Several companies from Israel understood the need for collaboration to first anonymise data in one way but then create and invest in infrastructure that will enable the ecosystem to approach the data.”
“I would definitely show the connection between data-driven clinical yields and cost-savings. That would also help close the gap between the physicians and the medical staff and the senior management,” Shiri said.
“And the availability of data is not enough. I can see a lot of physicians and senior managers looking at data and not knowing what to do with it. So, it is important to show them how to connect it with business models and cost-saving,” she added.
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