digital health israel research paper

DIGITAL HEALTH - ISRAEL

SimoneAmar,SamMessenger,KobySokoloff,andColeWest

DeanMalter–Business,InnovationandEntrepreneurshipinIsrael

DigitalHealth-Israel 2

T a b l e o f C o n t e n t s

WhatisDigitalHealth? ........................................................................................................... 3IsraeliHealthCareSystem................................................................................................................ 4Wearables........................................................................................................................................ 5A. ReWalk: .....................................................................................................................................6B. AngelSensor .............................................................................................................................7C. OrCam ...........................................................................................................................................7

eHealth,CloudComputing,andHealthData..................................................................................... 8PersonalizedMedicine ................................................................................................................... 10Gamification .................................................................................................................................. 11Education ....................................................................................................................................... 12MobileHealth ................................................................................................................................ 12SocialTech ..................................................................................................................................... 14DigitalandMobileHealthConferences........................................................................................... 15

SWOTAnalysis...................................................................................................................... 17Strengths........................................................................................................................................ 17Weaknesses ................................................................................................................................... 18Opportunities................................................................................................................................. 22Threats........................................................................................................................................... 24

EconomicImpact .................................................................................................................. 24

FutureGlobalImpact ............................................................................................................ 25

WorksCited.......................................................................................................................... 26


What is Digital Health?

Digitalhealthistheconvergenceofhealthcare,digitaltechnology,andgenomics.Itisa

burgeoningglobalindustrythatwillgreatlyimpacttheworldinthecomingdecadesby

increasingcareaccess,loweringcosts,andgreatlyimprovingqualitybymakinghealthcaremore

personalizedandprecise(FDA).

Oneofthemainusesofdigitalhealthispersonalhealthmonitoring,whichwillflipthe

wayhealthcareisdone.Anindividualwillwearawirelesswearabledevicethatmonitorshisor

herhealthsituation.Thenacomputerwillusebigdatafromtheindividual’spersonalmedical

historyandgenomicconstructtogivepatientsanoutlookontheirhealthsituationandhelp

predictpotentialhealthissues.Thecurrenthealthmodelindevelopedcountriesrequires

patientstogotoahospitalwhentheyhaveaproblem.Usingthisnewmonitoringtechnology,

patientswillgotoahealthcareprofessionalwhenthedevicedetectsapotentialhealthissue.

Thismodelwillputfewerburdensonthehealthcareindustry,lowercostsforcustomers,and

savelives.Personalhealthmonitoringisagoodexampleofwhatdigitalhealthisbecauseit

showstheinterconnectivityofdifferenttechnologiesthatisimprovinghealthcaredelivery.

Othertypesofdigitalhealthincludemobilehealth,eHealth,healthIT,gamification,and

telehealth,socialtech(Sonnier).Thispaperwillexploreeachoftheseareasofdigitalhealthin

depth.

Theseinnovationsareoftenconfusedwithbiotech.Althoughthereisacrossover

betweenthetwofields,biotechnologyfocusesmoreonbiologicalbasedsolutionstohealth


issueswhereasdigitalhealthaddsvaluetocustomersthroughcomputing,interconnectivity,

data,anddevices.

Digitalhealthwillbecomemoreimportantasglobaldemographicschange.TheCenter

forGlobalDevelopmentwroteinareportondemographicsthatlongerlifespansinthefuture

meanthatnationswillhavedifficultydealingwiththebudgetaryburdenofelderlyhealthcare

infrastructure(Nugent,Seligman).Inaddition,becausemorenationswilldevelop,illnesseswill

shiftfrominfectiousdiseasestochronicones.Chronicdiseasesrequiremonitoringand

multifacetedregimens,whichisdifferentfrominfectiousdiseasesthatrequirevaccinesand

basicinfrastructurelikecleanwater.Digitalhealthwillimprovethelifeofthosewithchronic

illnesses.Healthcaremustmeettheneedsofthegrowingandagingworldpopulation.With

healthcareatitscurrentstatus,therewillnotbeenoughresourcesforthefuturedemand.

Digitalhealthwillbridgethegapbetweenfuturedemandandfutureresources(dhez).

IsraeliHealthCareSystem

InordertoevaluateandunderstandtheIsraelidigitalhealthindustry,itisimportantto

examinethehealthcaresysteminthecountry.Israelhasauniversalhealthcaresystem,which

offersfourdifferenthealthplansthatofferdifferentservices(NefeshB’Nefesh).Theircurrent

systemisbasedontheNationalHealthInsuranceLawpassedin1995thatsaidthatallresidents

shouldreceivehealthcoverageandthegovernmentpromisesthatallresidentshaveaccessto

healthserviceswithoutdiscrimination(MinistryofAliyahandImmigrationAbsorption).

Sincethislaw,healthinIsraelhasgreatlyimprovedtobeoneofthebestintheworld.

IsraelhastheeighthhighestlifeexpectancyintheWorldaccordingtotheWorldBank


(UniversityofPennsylvania).AccordingtoBloomberg,Israelhasthefourthmostefficienthealth

systemintheworld(Linder-Ganz,Tzach).Thisrankingwasbasedonlifeexpectancyandper

capitaspendinghealthcare.Israelspends7.5%ofitsGDPonhealthcarewhereasAmerica

spends17.9%(UniversityofPennsylvania).TheOECDsentadelegationtocommendIsraeli

healthcareprovidersfortheirefficacyindiagnosingandtreatingpeoplequicklyandpreventing

repeatedmedicalvisits(Linder-Ganz,Tzach).Further,Israelisabletoprovidegoodhealthcare

atarelativelylowandefficientcost.

Nonetheless,Israelneedstoimproveitshealthcareinfrastructure.Averageoccupancy

rateis98%andduringtheinfluenzaseasonitis115%,forcingpatientsneedtosleepinthe

hallways.Theratioofmedicalprofessionalstothepopulationisdecreasing,whichwillleadto

longerwaits(UniversityofPennsylvania).Therefore,Israelwillhaveanevengreaterstrainon

theirhealthcareinfrastructure.Israelcouldspendmoreonhealthcarespendingbuttaxesare

alreadyhighandthebudgetistight.Inaddition,raisingtaxesandhealthcarespendingwould

bepoliticallyunfavorableanddifficult.Israelneedsmoredigitalhealthtoreducehealthcare

spendingandtoovercometheinfrastructuregap.Tothatend,growingdigitalhealthisvitalfor

Israel’seconomicprosperityanditshealthcaresustainability.

Wearables

Wearabletechnologyisrapidlychangingtheworldwelivein.Thesegadgetsaretracking

dataandinformingusersabouttheirhealth,fitnessandlifestyle.Byusingsensors,theInternet,

andBluetooth,thesedevicescanconnectwirelesslytoyourSmartphoneorlaptop.

Additionally,moreadvancedandhi-techdeviceswereinventedtodotheunthinkable.Products


suchasReWalk,anexoskeletalwearableenablingparaplegicstowalkagainandOrCam,asmall

attachablecamerathataidsthevisuallyimpairedto“see”againarealsoamazingIsraeli

inventions.Theincreaseduseofwearableswillsoonchangethewaymedicalcareisprovided

shiftingitsfocustopreventativecare;andIsraelwillbeattheforefrontofthisrevolution.

A. ReWalk:

ReWalk,isatechnologythatwasinventedbyDr.AmitGofferwhocreatedabionic

walkingassistancesystemtohelpparaplegicsstandup,walk,andclimbstairsagain.The

technologyusesalegandhipexoskeletonbrace,whichgiveshandicappedindividualsthe

abilitytousetheirupperbodytosupportthemselvesandmotiontothedevicetowalk

(ArsTechnica,2012).Thedeviceisabletosensetheslightestalterationinone’scenterofgravity

toholdthemuprightandevenwalkbyregulatingthefunctionalspeedoftheexoskeleton.

(ArsTechnica,2012)

Dr.Goffer’sideawasbasedonhisownpersonalexperience,beingaquadriplegic

himselfandstrugglingtofindanyproductthatcouldhelptheparalyzedbecomereintegrated

intosociety(NoCamels,2014).Thisdevicehashelpedthesepeopleimprovetheirdailylivesand

mentalwellbeingjustbybeingabletostandupandspeakwithpeopleeye-to-eyeagain.

Goffer’sproducthasinspiredandgivenhopetomillionsofdisabledindividualsaroundthe

worldwhopreviouslybelievedtheywouldneverbeabletowalkagain.Ithasgivenpeopleso

muchhopethat,ClaireLomas,evendecidetocompletetheLondonMarathonusingthedevice.

Ittookher16days(LifeScience,2012).ARGOMedicalTechnologies,Dr.Goffer’s$300-million-

dollarcompany,hasbeengrowingtremendouslyintheinternationalmarketaswell.TheFDA


forcommunalandeverydayuseintheU.S.approvedReWalkandPresidentObamaapplauded

Dr.Goffer’sdeviceataconferencein2013(ReWalk,2013).

B. AngelSensor

AngelsensorisanotherIsraeliwearable,whichmonitorstheuser’svitalsandgivesthem

real-time data to improve their daily life. Thewristband calculates body temperature, pulse,

bloodpressureandoxygen levelsand is linked toanappbyBluetooth thusallowing it tobe

accessedthroughaSmartphone,computer,orevenafitnessmachine(Indigogo).Thisdeviceis

a part of the future of healthcare that relies on instant and personalized preventative care.

Thesetechnologieswillmakepeoplemoreawareoftheirpersonalhealthandencouragethem

tolivehealthierlives.OnethingthatdifferentiatesAngelSensorfromothersimilarproductsin

themarket is that Angel Sensor opens “communication protocols, API/SDK and sensor data

streams”, which gives users more app options, rather than a single, exclusive app (Angel

Sensor).Additionally,AngelSensorhasplentyofuniquefeaturessuchasaworkouttracker,a

heartratemonitor,avibratingalarmclock,fertilityandsleepmonitorsandmuchmore(Angel

Sensor).

C. OrCam

OrCamisanotherincredibleproducttocomeoutofIsrael.Itwasdesignedtohelpthe

visuallyimpaired“see”again.Orcamisasmallwearablecamerathatunderstandswhatisin

frontofitanddeliversthatinformationverballytothewearer(Orcam).Theblindandvisually

impairedarenowawareofwhatisaroundthemthroughcommandsprovidedbytheOrCam.

Thevisuallyimpairedcandoeverydaytasksjustlikeeveryoneelse.Orcamcaneven


remembersfaces,objectsandplaces(VisionAware,2013).Eveninthe21stcentury,thereis

stillagreatneedforthistypeoftechnologytoassistthevisuallydisabled.

eHealth,CloudComputing,andHealthData

eHealthistheuseofinformationandcommunicationtechnologiesforhealth.Itisa

rapidlygrowingfieldwithusesexpandingtopatienttreatment,healthcareworkforce

education,andpublichealthmonitoring.Israel’srevenueinthismarketwas$19.3millionin

2016andisexpectedtoshowanannualgrowthrateofover15%through2020(Statista,2016).

Thisgrowthcanbelinkedtoafewfactors.

OneistheestablishmentoftheVCfirmeHealthVentures.eHealthVenturesisa

consortiumofelitehealthcareorganizationsandinvestorswhoaresearchingfortechnologies

thatwillalterthehealthcareindustry.TheconsortiumincludesMaccabiHealthcareServices,

theClevelandClinicInnovations,andeHVUSAaspartners.WiththecreationofamajorVCthat

focusesoneHealthandrelatedfields,Israelistartupswillreceivethefundingtheyneedtoget

offtheground.

AnotherfactorcanbelinkedtothedecisionbytheIsraeligovernmenttodigitizeallof

theircitizens’healthrecordsovertwodecades.ThishasputtheIsraelimedicalcaresystemfar

aheadofitstimeandhasledtotwoimportantresults.First,ithasallowedhealthservices

providerssuchasMaccabiandClalittobesomeofthefirsttoleveragethepoweroftechnology

toimprovethequality,efficiency,accessibility,andfinancialaspectsofhealthcare.For

example,thecentralmedicalrecord(CMR)givespatientsinteractiverecommendations,allows

themtofillprescriptionsontheirown,sendsmedicationreminders,andmore.These

capabilitieshaveincreasedusercomplianceby63%andmedicationadherencebyover80%.


Secondly,theCMRhasbeenessentialtoIsraelieHealthstartupsastheaccessto24yearsof

healthdatahashelpedthemdevelopandtesttheirsolutions(Israel’sBigImpact,2016).

ThelastmajorfactorcanbetiedtotheincreasedformationofeHealthincubators.Over

thepastfewmonthsmultiplelargecorporationshavesetupincubatorsthroughoutIsrael.

MedtronicandIBMsetupadigitalmedicineincubatorinHaifa,Johnson&Johnsonpartnered

withORbiMedandTakedatoformFutuRx,TevaandPhilipsalsocreatedone,andSanara

Venturesisexpectedtolaunchonesoon.Alargedrivingforcebehindtheseincubatorshas

beentheIsraeligovernment.Theyarecontributing85%ofthe$500,000to$800,000budget

giventotheincubators,andtheytakenoequity,receivingonly3-5%royaltiesuntilthestartup

repaysthem.TheseincubatorswillhelpensuretheseIsraelstartupsbecomecompetitiveinthe

U.S.market(eHealthVentureswithClevelandClinic,2016).

CloudcomputingandhealthdataaredirectlyrelatedtothefieldofeHealth.TheCMR

storeshealthdataonthecloud,whichallowsforstorageoflargeandrapidlyincreasing

amountsofdata.Additionally,cloudcomputinghelpshealthdatabeeasilysharableamong

healthprofessionals,insuranceproviders,andpatients.Asstatedearlier,Israelwasoneofthe

firsttoleveragethistechnologyinthefieldofmedicinewhenitcreatedtheCMRovertwo

decadesago.

Alloftheseareasconnecttooneanother.Forexample,justlastyearTeva

PharmaceuticalspartneredwithIBM’sWatsonHealthCloudtoprovidepatientsandhealthcare

provider’sbenefitsfromhealthdataandthecloudtechnology.Thispartnershipwas

groundbreakingasithastheopportunitytochangethewaypeopleusemedicine.Inthis

projectaresearchteamswillformdiseasemodelsandadvancedtherapeuticsolutionsthrough


theuseofbigdataandmachinelearning(TevaPharmaceuticals,2015).Thishasthepotential

tochangehealthcareintomorepreventativecareinadditiontosavingmillionsofdollarsand

improvingthequalityoflifeformany.IftheWatsonHealthCloudisabletodiagnosediseases

andsicknessbeforethehumandoctorcanfindthem,thistechnologywillbeahuge

breakthrough.Itwillallowpatientstotreatandbeattheirconditionslongbeforetheyfeelthe

symptoms.SomeofTeva’sfirstgoalswillbetodrawconclusionsonhowtobestreducedrug

misuseandincreaseprescribedmedicationadherence(TevaPharmaceuticals,2015).

PersonalizedMedicine

Personalizedmedicineismedicalcaretailoredspecificallytothepatient.Personalized

medicineisperformedtodaybutnotwithasmuchaccuracyastherecouldbewhenusingbig

dataandalgorithms.Whenadoctorperformsayearlycheckup,heorshewillaskyouyourage,

familyhistory,dietaryandexercisehabits,andotherfactors.Thedoctorwillthenpredictfuture

medicalissuesforthepatient.Ifthepatientalreadyhasanillness,amedicalprofessionalwill

prescribebasedonthosefactors.

Whendigitalhealthisimplementedintopersonalizedmedicine,itwillmoreaccurately

provideprognosesandtreatmentfromthehealthmonitoringdevicesandbigdata.These

devicesandtechnologieswillbeabletoconnectone’ssymptomstotheirgeneticcode

(Sawyer).Personalizedhealthdeviceswillalsobeabletoprovidepharmaceuticalcompanies

datatoassesstheirproductsinordertoimprovethem(Ward).

Personalizedmedicineisaflourishingsub-industryinIsrael.Dr.ShaiMelcer,Executive

DirectorofBioJerusalem,abiologicalsciencesdevelopmentgroup,assertedthatpartnerships


inpersonalizedmedicinewouldbeatrendin2016forIsrael.“It’sgoingtobeayearwherebig

pharmaandhealthcaresystemswillbecombiningdifferenttypesofsolutionstogivebetter

healthcare”(Leichman).DrugcompanieswillteamupwithIsraelipersonalizeddatadiagnostics

startupstoimprovetheirdrugs.

TheBi-nationalIndustrialResearchandDevelopment(BIRD)Foundation,aUnitedStates

andIsraeltechcoalition,recognizesIsrael’sstrengthindigitalhealthandpersonalizedhealth

specifically.LastyearBIRDsentadelegationof12IsraelidigitalhealthstartupstoAmerica

(Weinreb).Fourofthetwelvearedirectlyunderthecategoryofpersonalizeddigitalhealthand

someothersarecrossoversbetweenpersonalizedmedicineandothers.Thefourwere,

Healarium,anappthatofferspersonalizedcareplansbasedonpersonaldata,Healthwatch,a

garmentthatmonitorsvitals,Medivsor,constantresearchaboutyourillnesstailoredtoyour

specificcondition,andSweetch,adiabetesdailyregimenguidebasedonpersonaldata.

PersonalizeddigitalhealthinIsraelissostrongthatitissharingitssuccesswithAmerica.

Gamification

Gamificationinthedigitalhealthindustryistheuseofgamesandcompetitionto

motivateandassistpeopleinimprovingtheirownhealth.Oneexampleoftheapplicationof

gamificationintheIsraelidigitalhealthindustryisSweetch.Thecompany’smissionisto

“developtechnologytopreventpeoplewhoareatriskfordiabetesfromdevelopingthe

disease”(Israel21c,2016).Thecompanybelieves“thatincorporatingtechniquesfromgaming

appscanhelpwithusers’health”(Israel21c,2016).Theplatformanalyzesdatatodeterminea

person’sriskfordiabetes.Itthenhelpstheindividualsetgoalstoreduceriskbystayingactive


throughincreasedtimewalkingandothercardio-intensiveeverydayactivitiesandorbyeating

healthier.Thesmallstepsthatareseamlesslyintegratedintoaone’severydaylifebythe

platformalongwiththegamificationaspectofgoalsettingmakeitmucheasierforonetomake

necessarylifestylechanges.Thecompany’sfounder,DanaChanan,says“Sweetch’sbehavioral

analyticsenginecanbeappliedtoothersignificantchronicdiseases,suchashypertensionand

obesity”(Israel21c,2016).Thisshowsthepowerofthedigitalhealthindustryasatechnology

builtforonepurposecaneasilybeappliedtocareforotherhealthrelatedproblems.

Education

Thelastkeysubsectionofthedigitalhealthindustryiseducation.Ayoungcompany

withinthissectorisMovinGame,whichisa“mobileappbasedonvirtualcharacterswhich

encourageschildrentoperformrecurringactivitiesinreallife”(MovinGame).Theappusesa

combinationofaugmentedrealityandvirtualrealitytechnologytohelpchildrenbuildhealthy

habits.ThecompanywasstartedinDecemberof2015,andisstilldevelopingthetechnology.

Consideringthat1in3Americanchildrenandadolescentsareobese,anapplicationthatmakes

healthyhabitsandhealtheducationmorefunfillsahugeneedandhasgreatpotentialto

improvetheoverallwell-beingofmanypeople(MovinGame).

MobileHealth

MobileHealthtodayisgrowingextremelyrapidlywithhundredsofthousandsofhealth

appsonAndroidandiOSandaprojectedmarketvalueof$26billion.Outoftheworld’s

estimated7billionpeople,6.8billionhaveaccesstoamobiledevice(TIME,2013).WithIsrael

specificallybeingoneoftheworld’stopSmartphoneusers,itisnosurprisethatpeoplewantto


domore,andaccessmoreinformationontheirdevices(TIME,2013).Todate,61%of

SmartphoneusershavedownloadedamHealthappontheirdevicetoimprovetheirlivesin

someway,andIsraelhastakentheleadinthesemobilehealthtechnologies(OurCrowd,2015)

Israelientrepreneursconstantlycreatenewdigitalhealthappsmanyofwhichare

showcasedattheyearlymHealthinTelAviv.Theirfocusistointegratemobiletechnologywith

healthcareservices,envisioningpharmacies,forexample,beingreplacedbyamobileappor

platform(mHealth,2016).Additionally,Israeli-mademobileappslikeHealarium“letscardiac

rehabpatientsrecordbloodpressure,weight,blood-sugarlevels,minutesofphysicalactivity

anddietaryhabitsoverathree-monthperiod,andsuggestseducationalactivitiesgearedto

changinglifestylebehaviors.”(Israel21c,2014)Peoplewilllearnmoreaboutwhatishappening

withintheirbodies,andwillbelesslikelytotakerandommedicationsorvisitdoctorssooften.

OtherappslikeMakeMyPlateactasapersonalizednutritionexpert,totellonewhatexactlyis

thehealthiestlifestyle;orTotallyPregnant,anappthatinformspregnantmothersonthestages

ofthebaby’sdevelopmentandherownhealth,withoutgoingtoanobstetrician(Israel21c,

2014).Thesetechnologiesaresoaccessibleandeasytousethattheyarereallychangingthe

wayhealthcareworks.

LeviShapirofoundedthemHealthconferencementionedearlier.Hecurrentlyteaches

DigitalMediaEntrepreneurshipattheIDCinHerzliya,andheisanexpertinthefieldofmobile

healthdevelopment,whichheseesasafactorthatwilldrasticallychangethefutureof

healthcare(JerusalemPost,2015)ShapiroisdedicatedtosupportingIsraelidigitalhealthstart-

ups.Shapirogivesmoneyto12differenthealthfocusedVC’s,whichinvestinmanyIsraeli

digitalhealthstartups.(JewishBusinessNews,2015)


Althoughthehealthcareindustryseemstobeopposedtodrasticchanges,mHealthis

goingtobecomeincreasinglypopularinprovidinguserswithimportantdataandtrackingthings

likeasthmaordiabetes,whichwilllowertheexpensivecostsofmosthealthcaretoday.

SocialTech

Socialtechisapplyingtechnologyforthepurposeofimprovedcommunicationbetween

people,andcanbeseenasasubsetofdigitalhealth.Onegreatexampleofacompanyinthis

spaceisTalkItt.TalkIttisavoicerecognitiontechnologythathelpspeoplewithspeech

disabilitiesspeakusingtheirownvoice.Thisisabrandnewtechnologythatseekstoimprove

thelivesofthe1.5%ofpeopleworldwidewhosufferfromsomesortofspeechdisability.By

usingmachinelearningtechniques,thisapp,VoiceItt,willlearntheuniquespeechdisabilityof

theuserandwilltranslatetheirwordsthroughaphoneortabletsopeoplecanunderstand

them.Further,VoiceIttwillcreateaspeech-recordingdatabasethatwillgreatlyimprovethe

depthofresearchconductedondifferentspeechdisabilities.Theproductisnotyetavailableas

itiscurrentlyundergoingbetatesting,however,thefirstversionshouldbereadybythe

beginningof2017(DevoraMason,PersonalCommunication,July10,2016).

TalkIttalsohasclosetieswiththeUnitedStates.Itplacedsecondinthe43North

businesscompetitionandnowhasanofficelocatedinBuffalo,NY.Atthisofficetheyconducta

lotofthebetatestingreceivingfeedbackfrommedicalprofessionalsandtheydeveloptheir

marketingstrategy(DevoraMason,PersonalCommunication,July10,2016).

ThatbeingsaidtheU.S.,outsideofSiliconValleyandafewothercities,iswaybehindIsraelin

termsofhavingestablishedecosystemsforthedevelopmentofnewtechnologystartups.This

isoneofthereasonsoneoftheconditionsofreceivingsupportfrom43Northwastoopenan


officeinBuffaloastheyareseekingtodeveloptheirownclusteroftechnologystartups(Devora

Mason,PersonalCommunication,July10,2016).

ThesocialtechlandscapeisuniqueinIsrael.FirstofftheJewishideaofTikkunOlam,

makingtheworldabetterplace,playsstronglyintothedevelopmentofthesesocialventures.

Israelisareeagertocreate,invest,andhelpinanywaytomakeventuresthatchangethe

world.VoiceIttisagreatexampleasithasreceivedwidesupportfrominvestorsand

acceleratorsacrossIsrael,allowingVoiceItttoinvestlargeamountsoftimeandmoneyintothe

R&Dbehinditsproduct(DevoraMason,PersonalCommunication,July10,2016).Withoutsuch

devoutsupport,thesetypesofventureswouldneversucceedasoftentheyareforniche

marketsthattakealongtimetoprofitfrom.Additionally,duetothetensepoliticalsituationin

IsraelandthegrowingBDSmovementIsraelisfindsocialtechtobetheperfectspaceforthem

toshatterthetypicalnegativenotionsurroundingIsrael.IfIsraelcanbuildproductsthatwill

helppeopleandtheirfamiliesacrosstheworld,thentheymightbeabletoflipthescript.

PeoplewillnotwanttoboycottIsraelbecausetheywillrealizesomeonetheyknowdesperately

needstheseIsraelinnovationstoleadbetterlives.

DigitalandMobileHealthConferences

Everyyear,forthepasttwoyearsIsraelhashostedamHealthConferenceinFebruary

andaDigitalHealthConferenceinDecember.Thisshowshowsuccessfulthesetwoareasarein

Israelforthemtoattractthebestandbrightestinthesefieldseachyear.

ThemHealthConferenceisorganizedbymHealthIsrael,anon-profitorganizationfor

entrepreneursaddressinghealthcareinnovation.OutsideofthisconferencemHealthIsrael

holdsfrequentMeetups,Roadshows,LinkedInGroups,andmaintainsamobilehealth


database.Atthispastyear’sconferencetopicssuchas“Aging2.0vAsiaRoundtable”,Medical

VR,3D,HumanAugmentation,&BrainComputerInterface”and“InsuranceataCrossroads”

werediscussed(mHealthIsrael,2016).TheconferenceisheldatTelAvivUniversityandis

attendedbysomeofthetopprofessionalsinthefield.Attheconferencethereisalsoastartup

contestwiththewinnerreceivingafreetriptoHouston,TXwheretheydemonstratetheir

productatthehealthtechconferencethere(mHealthIsrael,2016).Thedaysleadinguptothe

conferenceislabeledmHealthWeekandthereareeventseverydayacrossthecountry

includinginJerusalem,Haifa,BeerSheba,andTelAviv.Thisweekbuildsupexcitementforthe

culminatingconferenceattheendoftheweek,andhelpsspreadthereachoftheconference

tootherareasbesideTelAviv.

EYIsrael,Start-UpNationCentral,VeritasandIATIhosttheannualDigitalHealth

Conference.Lastyear’sthemewas“TheInternetofMe”whereitdocumentedtheshiftof

powerandcontrolfromproviderstopatients(DigitalHealth.il,2015).Over500localandglobal

participantswereinattendancetoexploreIsrael’samazinginnovationinthefieldwherethey

haveover300activestartups.Theyearlyconferenceseekstoinformpeopleinthehealthcare

industryoftherapidandunprecedentedchangesthatarecomingtothesectorfromtheability

tousebigdata,cloudcomputing,andwearablestoprovideimprovedoutcomesforpatients

andcareproviders(DigitalHealth.il,2015).Atthisconferencethereisalsoastartupcontest

wherethewinnerreceivesexposuretoinvestors,businesspartners,andpotentialclients.Apart

fromtheconferencesatwo-dayhackathonisheld,whereteamstrytocreatesolutionsfor

digitalhealthanddevicesforpeoplewithneurologicaldisorders(DigitalHealth.il,2015).


Thesetwoconferencesandtheprogramsassociatedwiththemareyetanotherexample

ofwhyIsraelhastheperfectecosystemforstartupsindigitalhealth.Theyhavenumerous

opportunitiestolearn,network,andpresenttothebestandbrightestinthefield.Asthese

conferencescontinuetogrow,Israel’sdigitalhealthindustryshouldcontinuetodevelopwithit.

SWOT Analysis

Strengths

TheIsraelidigitalhealthindustryisoneofthefastest-growingandmostexciting

industriesintheworldtoday.Ithasthepotentialtodrasticallychangethehealthcarelandscape

inthenearfuture.Itisanindustrythatleveragestheuseoftechnologyandtherapidly

developingInternetofThingstoprovidenewandimprovedhealthcaresolutions.Thingssuchas

self-diagnosis,AIprovidedsicknessprevention,andmoreareallbecomingpossiblewithdigital

healthtechnology.

Israelinparticularissuchanamazinghotbedforinnovationinthisindustryfora

numberofreasons.Firstly,allIsraelis’healthrecordshavebeendigitalforovertwodecades.

Thisgivescompaniesaccesstolotsofdataandmedicalinformationtousewhendeveloping

digitalhealthstartups(eHealthVentureswithClevelandClinic,2016).Moreover,Israelhasthe

perfectstartupecosystem.Itisoneofthepremiertechhubsoftheworld,wheretoptalentand

ideasaredevelopedandshared.Startingaventureisthepopularthingtodoandthereforethe

bestandbrightestalltrytheirhandatentrepreneurship.TheChiefDataScientistandthe

numerousacceleratorprogramsalsosupportthisecosystem.Thesepeoplegivestartups


resourceslikemoney,toworkspace,totherightnetworkofpeople.Everythingthatdigital

healthstartupsneedtothriveisrighthereinIsrael.

Weaknesses

OneofthemajorweaknessesinthedigitalhealthindustryinboththeUnitedStatesand

inIsraelisthelegalrestrictionsplacedoncompaniesinthehealthcarefield.ThisaffectsIsraelin

particularbecauseoftentheirtargetmarketistheU.S.andthereforeIsraelhastoconcern

themselveswithtwosetsofverystrictregulationswhenbuildingtheirproducts.TheFoodand

DrugAdministration(FDA)enforcethemostextremeregulationsonappsthatcould“posea

risktopatientsafetyiftheydonotfunctionasintended”(Waxman,2016).Theseapplications

arecontrolamedicaldeviceordealwithdiagnosisandtreatmentrecommendations.Theapps

thatallowtheconsumertomanagetheirownhealtharestilloverseenbytheFDA,butthe

agencyonlymaintains“enforcementdiscretion,”whichisaliabilityfordigitalhealthinvestors

andstartupsinIsraelandtheUnitedStates(Waxman,2016).TheFDA’sdiscretionmeansthat

investorsneedtodoincreasedduediligencetomakesurethatstartupsthattheyinvestinare

compliantwithcurrentlaws.IthasbecomemorecommonplacethatAmericaninvestors

requireacquisitionagreementstostate“thattherearenocurrentorthreatenedenforcement

actionsbytheFDAoranyotheragency,thatnolicensesissuedbytheFDAhavebeen

suspended,andthatanyclinicaltrialisbeingconductedinaccordancewiththelaw”(Waxman,

2016).ThefactthatAmericaninvestorsrequirethesetermsaffectsIsraelistartupsbecause

IsraelidigitalhealthstartupsoftenseekthesameAmericaninvestorsthatAmericandigital

healthstartupsdo.


AnotherregulationobstaclefordigitalhealthcompaniesfromIsraelandAmericais

patientprivacy.HealthInsurancePortabilityandAccountabilityAct(HIPAA)hasa‘“Privacyrule’

thatgovernspermissibleusesanddisclosuresofprotectedhealthinformation(PHI),anda

‘SecurityRule’thatgovernselectronicstorageandtransferofPHIbycertaincoveredentities,

includinghealthplans,healthcareprovidersandanybusinessassociatedwiththeseentities”

(Waxman,2016).Adheringtotheseadditionalregulationscreatesmanytechnicalandfinancial

burdensfordigitalhealthstartupsthatdealwithimportantpatienthealthinformation.These

burdensareinplacetohelp,butalsocreatemanybarrierstoentryinthedigitalhealth

industriesofIsraelandtheUnitedStates.Thismakestheprocessfordevelopingnewhealth-

relatedtechnologyevenmoredifficultandlessdesirableforentrepreneursandinvestors.

AnotherweaknesssharedbyboththeAmericanandIsraelidigitalhealthindustriesis

thedisconnectbetweenthosewhoneedthetechnologythemostandthosewhoreceivethe

solutions.Oneofthebiggestadvantagestothedigitalhealthindustryisthefactthatitenables

peopletomonitortheirownhealthdigitally,andhopefullytoaidinearlydetectionofailments

aswellasthepreventionofthem.Thisearlyprotectionandpreventioncansaveaperson

hundredsifnotthousandsofdollars.Thepeoplewhoneedthesesavingsandthenew

healthcaresolutionsthemostarethoseoflowersocioeconomicstatus“becausethey’remore

likelytohavechronicillnesses,likediabetes,thatareexpensivetotreat”(Ostrov,2016).

However,peopleoflowersocioeconomicstatusarelimitedbythemoneyandtechnologythat

theyhaveaccessto,socompaniesinthedigitalhealthspacemustgetcreativetoreachthem.

Fornow,experimentstargetinglow-incomepeopleare“atinypartofthedigitalhealth

industry”because“entrepreneursarestilltryingtofigureouthowthey’regoingtomake


moneybyservingthispopulation,andgovernmenthealthprogramslikeMedicaidand

Medicarearetakingawhiletofigureouthowthey’regoingtocompensateprovidersfor

approachesthatdon’tinvolveadoctors’visit”(Ostrov,2016).Oneoftheexperimentstargeting

low-incomepeoplewastheinitiativebyZerotoThree,anAmericannonprofit,called

Text4Baby.Text4Babyisa“freemessagingserviceforpregnantwomenandnewmomsoffering

informationinEnglishandSpanishaboutprenatalcare,laboranddelivery,breastfeeding,

developmentalmilestones,andimmunizations”(Ostrov,2016).Thecompanyusedtext

messagingasopposedtoappsbecauseappsconsumealotofcellphonedata,whichis

expensiveforlow-incomecustomers(Ostrov,2016).Anotherwaythatcompanieshavetriedto

altertheirofferingstobetterservelow-incomecommunitiesistooffer“loanerdigitaldevices

topatientsafterahospitalstaytohelpthemavoidcomplicationsthatcouldlandthembackin

thehospital,”butthisofferwasnotwellreceivedbecausepatientswereworriedabouttheftof

thedevices(Ostrov,2016).

Thelimitationsoflow-incomecustomersarecertainlydifficulttoovercome,butthereis

alsoaverylargeupsidetothismarket:volume.Thereisnoshortageoflow-incomepeoplein

needofdigitalhealthtechnology,andifinexpensiveandaccessibledigitalhealthsolutionscan

befoundthendigitalhealthcompaniesinIsraelandAmericacandoverywell”(Ostrov,2016).

AlthoughtheIsraeliandAmericandigitalhealthindustriesshareatargetmarket,allof

theirweaknessesarenotthesame.Oneofthemostsignificantdifferencesisindiversityofthe

laborforce.BothAmericaandIsraelhavesignificantlydisproportionatenumbersofwomen

startupfoundersandCEOs.InIsrael,accordingtoIsrael’sCentralBureauofStatistics,“women

makeupabout35%ofthenation’shigh-techworkforcewithlessthan10%asfoundersoftech


startupsandonlyahandfulareventurebacked”(Women2.0,2013).The35%ofthehigh-tech

workforcealsoincludeslow-levelandnontechnicalpositions.EvelynRubin,aformersenior

associateatIsraeliventurecapitalfirmJerusalemVenturePartners,andcurrentlyaVPat

OurCrowd,saidthat“shecouldprobablycountononehandthetotalnumberofwomenwho

havepassedthroughtheJVPoffices(Women2.0,2013).IntheUnitedStates,from2009to

2014,15.5%ofstartupsthatreceivedfundinghadatleastonefemalefounder(Teare,2015).

DozensofventurefirmsinSiliconValleydonotevenhaveasinglefemalepartner(Farr,2015).

Clearly,thegreaterstartupcommunityinbothIsraelandAmericaislackingfemale

leadership,butthestoriesarenotthesamewhenitcomestohealthtechnologyindustries.In

theAmericandigitalhealthindustry,“6%offundeddigitalhealthcompaniesarewomen”and

only21%ofboardmembersatFortune500healthcarecompanies”arewomen(Wang).This

lackofdiversityisdetrimentaltocompaniesintheindustrybecause“80%ofhealthcare

decisionsforthefamilyaremadebywomen”(Wang).Inaddition,accordingtoRockHealth,

firmswithwomenontheirboardofdirectorshavehigherreturns(Wang).

IntheIsraelihealthtechindustryhowevertheyhaveamuchbetterrepresentationof

women.“Femalescomprise[of]about65%ofIsrael’sbiotechnologyworkforce,andabout13

percentoftopmanagementpositionsincompanieslistedontheTelAvivBiomedindex”

(Leichman,2012).AccordingtotheheadofIsrael’sNationalCouncilforthePromotionof

WomeninScienceandTechnology,“womenaremoreattractedtoeverythingthathastodo

withpeople:socialsciencesorlifesciences”(Leichman,2012).Anotherreasonthatmore

womencanbefoundinIsraelihealthtechnologyandnothigh-techisthat“high-techstartups

areoftenfoundedbymalearmybuddiesafterfinishingcollege,”buthealthcaretechnology


development“requiresadvanceddegrees,andmanywomenfinditeasiertostartafamily

whileinschoolbeforelaunchingacareer”(Leichman,2012).Although13%isnotproportional

totheIsraelifemalepopulation,itiscertainlyastart.ThenextstepisforIsraeliandAmerican

healthtechnologycompaniestoimprovetheirdiversity,andaccordingtostatistics,increase

theirreturnsasaresult.Toaccomplishthisthereneedstobeanincreasedpushinprogramsto

getyounggirlsinvolvedinscienceandtechnologyaswellasincreasednumbersofmentorship

andsupportprogramsforyoungwomeninterestedinscienceandtechnologypaths(Farr,

2015).

Opportunities

ThedigitalhealthindustryinIsraelhasagreatopportunitytogrowastheyarestilla

relativelyyoungindustry(MedTechengine,2016).Manyhospitals,doctors,andhealthcare

providersarealreadystartingtoincorporatethesenewtechnologiesintotheirwork.For

instance,theMinistryofHealthusesanappthatletspatientsknowtheadmissionandwaiting

timeatthehospital,whichhelpspatientsavoidsittinginthewaitingroomforhours.

(MedTechengine,2016)Also,hospitalsareusingsmartphonestoaccesspatients’files,instead

ofsearchingthroughpaperrecords.Althoughitisbeingadoptedinsomeplaces,healthcare

providersoverallarestillhavingtroubleestablishingastrongdigitalhealthcaresysteminIsrael

becausesomedoctorsarewarytechnologyreplacingmanyoftheirpreviousjobs;however,it

soonwillbecomemorecommonplace.(DigitalHealthIL,2015)

Anotherhugeopportunitycomesaboutfromthefactthattherearealargenumberof

incubatorsandacceleratorsspecificallyfocusedondigitalhealth.Majorcompaniessuchas


TevaPharmaceuticalsandPhilipsHealthcarehaveopenedupsuchincubatorprograms(Feirce

Biotech,2015)TheseincubatorsandlargeVC’swhoarewillingtoinvestmillionsofdollarsinto

digitalhealthtechnologiesandareopeningmajoropportunitiesforthisindustrytosucceed.

Additionally,theexpensivecostsofhospitalandhealthcareserviceshavemadepeoplesearch

forcheaperalternatives.Thedigitalhealthgadgetsandproductsthisindustryofferscanbea

solutiontomanypeople’sproblemsconcerningexpensesbecausemostpeoplehavea

Smartphonetoaccessthesehealthcareapps.Theseapplicationsareabletotracktheirhealth

andalertthemthebest,cheapest,andquickestwaytotreathealthproblemsbeforethey

becomeserious(PWC,2014).Onethingtonoteisthatmanyofthesehi-techwearabledevices

canbeextremelycostly,butasmoreoftheseproductsareproducedandasthepriceof

microchipskeepingfallingthesedeviceswillbecomemoreaccessibletoall.Inonestudyat

PWC,surveysindicatethat68%ofpeoplewouldbeverywillingtouseawearableeverydayif

theiremployerorinsuranceprovidedit.Thiscouldbeagreatopportunitytoexpanddigital

healthcaretoalargermarket(PWC,2014)

Therearealsomanyopportunitieswheretheconsumercancontributetotheindustry’s

growth.Studiesshowthatconsumershavenotfullyembracedhealthrelatedwearable

technologies.Wearablesandappplatformsmustbeflexibleenoughtoengagealltypesof

potentialusers.Everyonecanbenefitfrommoreaccessiblehealthinformation,especiallythe

elderlywhoneedtobealertedoftheirmedicalconditionassoonaspossible.However,to

betterreachthismarketthetechnologyneedstobeextremelyeasytounderstandandsimple

tousebecausethisgenerationisnotastechsavvy.


Threats

Twomajorthreatstothedigitalhealthindustryarecyber-attacksandprivacylaws.Digital

healthrequiresalotofpersonalinformationfromtheusertobeaccessibleviatheinternetand

astheInternetofThingscontinuetodevelopitwillonlybecomeeasierforhackerstofindways

toaccessthissensitiveinformation(MedicalFuturist,2016)Thismayleadtomanypeoplenot

buyingthesedevicesbecausetheyfeeluncomfortablewithtrustingotherswiththeir

information.Additionally,everytechnologycreatedtobeusedforhealthcareissubjectto

increasedriskofbeinghackedandbeingusedtoharmtheuser.Thisthreatloomslargeandisa

bigthreattotheindustrybecausethesecompaniesmustcomplywithstrictregulationand

mustdevelopastrongcyber-securityteamtoprotectfromtheseattacks(PCWorld,2015)

IntermsofregulationbothIsraelandAmericahavetightregulationswhenitcomesto

healthcare.TheseregulationshavethepossibilityofslowingthedevelopmentprocessofIsraeli

startupsinthisindustryandmakingithardforthemtogainwidespreaduse.Forexample,the

FDAfinallyapprovedtheReWalkalittleoverayearagoafterithadalreadycreatedmultiple

versions.Andithasstillyettoapprovethestair-climbingmode.Theseregulationsmakeit

increasinglydifficultforthesebusinesstobecomefinanciallysuccessful,whichputsaneven

greaterimportanceoncontinuouslyraisingcapital.

Economic Impact

TheeconomicimpactofdigitalhealthinIsraelwillbesignificant,buthasyettobe

significantbecauseitisayoungindustry.Thereare300startupsinthatfieldinthecountry,

20%ofthelifesciencesindustry(Mitzner).Halfofthesecompanieswerecreatedinthepast


fiveyearsand66%ofthemhavelessthan10employees,sotheyhavenotscaledupyet.

(Israel’sLifeSciencesIndustry).Between2013and2014,therewasa41%increaseinthe

amountofdigitalheathstartupsinIsrael(Israel’sLifeSciencesIndustry).Thisgrowthisbecause

ofglobaldigitalhealthinvestment,whichincreased128%between2013and2014from1.8bn

to4.3bn(Israel’sLifeSciencesIndustry).Ithasalotofsupportfrominvestment,istooyoungto

haveanymajorexits.Inthecomingyearsthedigitalhealthmarketwillhavealargeimpacton

theeconomybecausethesurplusofyoungstartupswillmature,hiremorepeople,andexit.

Future Global Impact

Digitalhealthwillbeoneofthemorelifechangingtechnologiesofthefuture.Driverless

carsareofteninthemediabecausetheyrepresentthefuture.Itmeanslessaccidentsandless

timespentondriving.Digitalhealthwillbeevenmoreimpactfulbecauseitwillchangetheway

healthcareworks,anditwilllengthenandimprovelives.Firstofall,digitalhealthwilldecrease

consumer’scosts.Itwillhelppeoplelivehealthierlifestylesdecreasingtheirdoctorvisits.Itwill

alertpeopletogotoaspecialisttopreventanissueratherthanspendingtimeatageneral

practitionerfirst.Itwillhelppeoplebetternotifytheirnutritionalstatusandhowtoimproveit

thusincreasingtheirlifespan.Digitalhealthwillhelppeoplecommunicatewiththeirdoctors

fromafar,savingdoctorslotsoftimeandgrantingpeoplemoreconvenience.Thelargest

impactdigitalhealthwillhaveontheworldistheinterconnectivityofthedatacollected.This

willallowscientistsanddoctorstobetterunderstanddiseasesandgenetics.Bigdatawill

provideresearchersawealthofinformationthatcanhelpthemlengthenandimprovelives.


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