How Israel Does Healthcare Innovation; An Insider's Look for Americans

An Israeli innovation expert peels back the curtain for a look inside one of the world's leading health system innovation centers.

In the realm of innovation, Israel is one of the world's acknowledged leaders, a phenomenon documented in the 2011 book Start-up Nation: The Story of Israel's Economic Miracle. Sheba Medical Center at Tel HaShomer, Israel, is the epicenter of healthcare innovation in the country, producing myriad success stories over the years, including the valve used in transcatheter aortic valve replacement (TAVR) procedures.

Eyal Zimlichman MD, MSc, serves as deputy director, chief medical officer, and chief innovation officer at Sheba, and is the mastermind behind the organization's ARC Innovation Center, that will open its first phase this year. He shares a look into key elements of Sheba's approach to innovation, providing a model and ideas which could serve as inspiration for U.S. healthcare systems that are investing in similar endeavors.

See related story: 5 Innovation Strategies You Should Consider Now From a Global Perspective.

The Guiding Strategy
 

Zimlichman joined Sheba in 2012 and stepped into his present role in 2016. This prompted him to devise a strategy called ARC, which stands for accelerate, redesign, and collaborate, and is based on four principles: invest in digital health, welcome startups, focus on collaboration, and build a facility to stimulate further innovation. This philosophy guides the organization's approach to innovation.

In the next decade, Zimlichman says he thinks digital technology has the greatest potential to transform healthcare, and Sheba already operates on the leading edge of this trend, he says. The health system has been paperless since 2004, and staff members have long been accustomed to working with digital solutions, including clinical decision support tools and electronic medical records. "It made sense that we would invest in digital health innovation," he says.

A Process Rooted in Research
 

Sheba has a long tradition of research with budgets that are "by far the biggest, compared to other Israeli hospitals," says Zimlichman. About a quarter to a third of all clinical research in Israel is conducted at Sheba, he estimates.

"That research culture also sprouted an innovation culture," he says. "Innovation and research are along the same continuum; it's not easy to differentiate where research stops, and innovation begins."

A Financial Incentive
 

About 20 years ago, Sheba opened an office to commercialize its research. The initiative has been successful, generating substantial income for the government-run hospital, Zimlichman says. Part of this effort includes a financial incentive for those who develop ideas. When physician's innovations are commercialized, for example, they receive 35% of the income that Sheba earns. Many have become millionaires, says Zimlichman, creating a strong incentive to innovate.

Welcoming the Startup Culture
 

While most health systems focus their energy on developing ideas generated from within the organization, Sheba places equal emphasis on welcoming external startups into the fold. The health system is often approached by entrepreneurs with "great ideas," says Zimlichman. They not only need clinical advice and direction to launch their innovation, they often need data and a place to test their concept, he says.

"We are in the position to provide them with that and match the startup companies with academic medical centers," he says. Because the Israeli companies usually have solutions targeted to the U.S. market, Sheba has forged collaboration contracts with many U.S. academic medical centers. Sheba is committed to providing these external companies everything required to accelerate their development processes, says Zimlichman.

Bringing Stakeholders Together
 

Bringing people together is essential to innovation, says Zimlichman. As a result, Sheba is building a 250,000-square-foot facility, the ARC Innovation Center, which will house five buildings on the medical center's campus in Ramat Gan, a suburb of Tel Aviv, upon completion in 2025.

"We think it will be a unique ecosystem, bringing together many players," he says. Startups not only can rent space, they have access to Sheba's data, clinicians, and clinical sites, including opportunities to run pilots.

Beyond the opportunity for developers to work "shoulder-to-shoulder" with clinicians, Sheba is inviting its strategic partners—large corporations—into the space. "They'll set up shop within our innovation complex, work with us, and provide us with innovation grants that will produce more intellectual property from our own idea lab at Sheba. It's a unique ecosystem that would further contribute to the acceleration of innovation," Zimlichman says.

Even before the facility was built, this approach already resulted multiple successful endeavors, including  in the launch of Aidoc, which automatically reads CT scans and has attained FDA approval for CT scans of the brain.