GistMD's flagship project, the partnership Tel Aviv Sourasky Medical Center (Ichilov) to design the first patient-centered digital hospital, was featured in this year's Israel Health Magazine, published annually by TheMarker. Below is a full translation of the article. The full magazine can be read here.
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“The Patient Centered Revolution Starts in Israel: A New Language for Doctor-Patient Communication”
First model of a patient-centered digital hospital developed at the Tel Aviv Sourasky Medical Center (Ichilov) will empower patients in Israel and across the world
Orna Yitzhak Birbach
TheMarker | Israel Health Magazine | April 30 2021
Improving patient engagement through the treatment and recovery process is a central and critical challenge facing healthcare systems in Israel and the world. The leadership team of the Tel Aviv Sourasky Medical Center (Ichilov) made a strategic decision to meet this challenge by transforming Ichilov into the first patient-centered digital hospital, which will become a model for hospitals in Israel and the world in the implementation of digital solutions for patient engagement and health literacy for the patient journey from admission to discharge into the community. In the same way Israel led the world in COVID-19 vaccinations, it will now be a worldwide leader in the patient-centered revolution.
A body of international research indicates that patient and family engagement improves chances of recovery and reduces the risk of complications. An engaged patient’s hospital stay is shorter by more than 50% compared to an unengaged patient, and the chance of readmission is significantly lower. Unengaged patients considerably increase the burden on caregiving staff and the cost of their care is much higher. A British study from 2018 found that patients with low levels of engagement cost the healthcare system 33% more.
Prof. Ronni Gamzu, Ichilov’s CEO, search for digital solutions improving patient engagement led to a unique partnership between the hospital and an Israeli digital health firm, GistMD. Over the last two years, medical staff from across the hospital worked with a multidisciplinary team from the company composed of product managers, psychologists, anthropologists, animators, UI specialists, translators, AI experts, and software developers. Part of the work was funded by grants from the Israel Innovation Authority and The National Digital Program of the Government of Israel supporting the development of a series of animation-based personalized digital patient education kits. Using these modular kits, patients can access information on their condition and treatment throughout their journey, in a clear and friendly format. This is achieved using animated educational videos speaking the patient’s language and personalized according to their demographic and medical profiles.
“In order to be involved in decisions regarding his health, the patient needs to understand a plethora of medical terms, many of them outside the scope of his or her knowledge”, says Prof. Gamzu. “Combined with variables such as language and cultural gaps, and the patient’s mental and emotional state, the challenge becomes even more complex. Every medical practitioner has experienced the frustration of hearing from patients that they don’t know what to expect, even after their clinician has done everything possible to educate them on their condition and treatment.”
Preparation for Surgery
Prof. Idit Matot, Director of the Division of Surgery and Chair of the Department of Anesthesiology, Intensive Care and Pain, led development and implementation of the first educational kit, preanesthesia education for children. Before implementation of the educational videos every child scheduled for surgery had to visit the hospital at least one day ahead of the procedure to meet an anesthesiologist. Today, with the system deployed, the situation has changed dramatically. After the procedure is scheduled, parents receive a text message linking to a preoperative questionnaire and a video personalized for their child. If the parents entered negative responses to all questions, and viewed the video, no further evaluation is required, and the patient arrives at the hospital on the day of the surgery, meeting the anesthesiologist at the operating room. In this way, the hospital reduced preanesthesia evaluations for children by some 70%. The economic implications -- thousands of anesthesiologist hours saved and more efficient utilization of operating rooms -- are enormous. In addition, patient feedback points to significant improvement of preoperative education and patient experience, through reduced time demands on the patient and family.
From the Heart
In parallel, Prof. Shmuel Banai, Director of the Cardiology Division, headed development of educational videos for heart failure patients. Heart failure is a complex chronic disease, and 25% of patients hospitalized for its treatment are readmitted at least once. Prof. Banai recruited a team led by Dr. Ofer Havakuk, Director of Cardiologic Hospitalization, and Sigalit Dayan, Director of Cardiologic Nursing. The team developed an array of personalized videos for relevant clinical scenarios, including a variety of associated diseases such as diabetes and hypertension. The video accompanies the patient and family throughout the journey and changes dynamically with his condition. Today, several weeks after deployment, the change in patient experience is already tangible. Patients begin meetings with doctors better prepared with an understanding of their condition and the treatment required.
Ichilov’s Nursing Division led development of an app for hospitalization wards, educating patients on common procedures, such as colonoscopy, gastroscopy, coronary catheterization, pleural tap, urinary catheterization, and nasogastric intubation. A pilot deployment of the app was recently launched in two of the hospital’s internal medicine wards. In addition to improving patient education and engagement, the app enables the hospital to meet accreditation standards.
Catching the Eye
Development of educational kits for intravitreal injections (injections into the eye), led by Prof. Anat Loewenstein, Director of the Ophthalmology Division, is in its final stages. The first kit to be deployed will be for patients suffering from age-related macular degeneration (AMD). The division pioneered use of intravitreal injections for treatment of this disease, and the kit is expected to improve the experience and outcomes of hundreds of thousands of patients worldwide.
In parallel, development of an educational kit for obstetric preanesthesia is approaching its final stages. The work is headed by Prof. Carolyn Weiniger, Director of the Obstetric Anesthesia Unit at the Lis Maternity and Women’s Hospital, in close cooperation with the hospital's midwives and Dr. Sharon Orbach-Zinger of the Rabin Medical Center (Beilinson), Chair of the Israel Association of Obstetric Anesthesia.
News of the successful implementation at Ichilov has reverberated across Israel and the world. The system is currently under review at other hospitals in Israel, as well at the Mount Sinai Health System in New York and Charité – Universitätsmedizin in Berlin. GistMD estimates that more than 100,000 institutions worldwide are potential clients, and that the system will define an international standard of care integral to the next decade’s patient experience.
“We couldn’t have achieved success without Ichilov’s medical excellence and the vision we share with all our interlocutors at the hospital -- executives, doctors and nurses”, says Dan Rolls, GistMD’s founder and CEO.
It Happened Because of Mom
The idea of developing personalized patient education kits was born three years ago, when the mother of Dan Rolls, GistMD’s founder and CEO was hospitalized for heart failure. Her heart wasn’t getting enough oxygen and high concentrations of carbon dioxide were building up in her body. She needed to be intubated, but refused to cooperate. After several days of unsuccessful attempts, one of the nurses tried using a familiar metaphor: “You know that feeling when you’re eating hummus and it seems like it’s stuck in your stomach? Well, this is a similar situation. You’ve got a lump of CO2 stuck in your body. We need to get it out so that you can get better.” This ostensibly “simple” explanation was tangible and accessible to Rolls’ mother. She signalled with her hand to bring the instrument over, and began to cooperate.
Rolls describes the event as magic unfolding before his eyes. When he heard the nurse speak, he was reminded of the classic educational animations broadcast on Israeli Educational TV. He understood, however, that solution lay in personalized videos, because one video would not be appropriate for all patients. Thus was born GistMD, a company dedicated to leveraging Israel’s position as a hub of innovation and medical excellence into development of personalized education solutions improving patient experience and engagement.
Rolls was joined by Prof. Ori Rogowski, Director Internal Medicine C at Ichilov, Dr. Amir Beker, an expert in medical technology and AI, and Dr. Orit Neudorfer, a pediatrician with rich experience in medical research. With help of Nir Kalkstein, one of Israel’s most successful entrepreneurs and an impact investor, the patent attorney Dr. Ilan Cohn, venture capitalist Peter Kadas, and other investors, the company was launched.