“Israel is a world leader in everything related to digital medical data because it’s the first country in the world whose national healthcare system has been undergoing a process of digitization for close to 25 years. Various units in the healthcare system have been uploading medical information to computer databases for nearly three decades. So, regardless of us providing data to Pfizer for its research on its Covid-19 vaccines, what we’re talking about is data that exists in Israel and is very broad - we have the full medical file of every person who’s infected - and also very deep because it goes back many years back,” said Orli Tori a partner at the VC fund Triventures Foundation, who leads seed investments in digital health through the Triventures ARC fund.
Q&A - How is technology and data helping Israel become the first country to vanquish Covid-19?
Israel can use medical data to defeat the virus without violating people’s privacy
“The digital gathering of medical information started 25 years ago, but it didn’t happen overnight nor across all sectors. In the beginning, it was only certain laboratory test results, some medical files, and various documents that instead of being written by hand in the doctor’s notepad, were added to the computerized database. Over time it accumulated. Nowadays, there are some areas where the data has significant depth, while there are others that have only recently undergone digitization, like the imaging sector. In addition, all military medical systems have undergone the digitalization process, and it’s likely that any data concerning soldiers and reservists is organized in databases now too,” Tori said.
According to Tori, the main reason why the Israeli healthcare system’s data is so important for Pfizer is because of the structure of its healthcare market, especially since the government passed a law to socialize the entire healthcare system, requiring every citizen to purchase healthcare from one of a small number of closely regulated HMOs. This unique structure ensures that despite the fact that these organizations are public bodies, they have an incentive to keep their customers healthy, and not wait to engage with them after they are already sick. The Israeli system differs from the U.S. one, which rewards all the factors in the chain for consuming services; the sicker you are, and the more you need health services, the more hospitals earn revenue, the more doctors and pharmacies make.
“In Israel, in comparison, HMOs have an interest in lowering expenses, streamlining the service, and encouraging better quality service. Therefore, for years the Israeli healthcare system has been geared toward preventative healthcare,” Tori said. “Over the past few years, the world has realized that if people adopt healthy habits, get vaccinated, and get a physical once a year - they will reach old age healthier with fewer expenses. If we look at aging world population, this factor is definitely crucial. The global pandemic emphasized the differences between various national healthcare systems, both in the way they approach traumatic events such as a pandemic, and how they cope with them.”
The advantages of the Israeli healthcare system over other national healthcare systems stem from a few basic factors and the special combination between them: centralization, how 100% of the population’s medical data is digitized, healthcare systems that aim toward preventative treatment, and rare logistical capabilities.
The importance of centralization is expressed by the ability to reach decisions quickly, and carry out statewide operations, like the Covid-19 vaccine campaign.
100% of the Israeli population is insured and every citizen has their medical file digitized. Those capabilities include two-way sharing between HMOs and hospitals. A vaccine recipient’s information is immediately available to any relevant body in the treatment chain.
The percentage of those vaccinated in Israel is very high and is a well-known and well-established fact. Even Pfizer is familiar with the figures, from its activity in vaccinating children, as well as the high vaccination rates, and Israel’s ability to use sophisticated transportation and smart-engineered distribution and to deep-freeze and store vaccines.
“Israel’s agenda is all about promoting health. Other countries can only dream about communicating with patients via text message or through an application, or having see their most recent lab test results on an app or website,” Tori said.
Referring to the type of medical information that Pfizer is interested in, Tori estimates that “since data of all types of has been collected, they’re probably most interested in different types of intersecting sample data. For example, finding out the serological results of a representitive sample of those who’ve received the vaccine, to help companies and doctors understand how a person can develop antibodies based on a large number of people, and not just the relatively small samples that they tested in clinical trials. The question of how long it takes a person to develop antibodies - whether it’s two to three weeks, a month, or two months, has a bearing on a company’s ability to streamline the vaccine supply to the entire world population.”
As for the question of whether she thinks that Israeli healthcare system compromised their clients’ privacy in return for the promise of more of Pfizer’s vaccines, Tori claims that since 2018, the Israeli healthcare system has based all its activities on draft regulations on the use of secondary medical information, which allows HMOs to conduct data research resulting from the monitoring of patients. “Although these regulations still haven't been formally approved, the preparatory work has already been done, they have undergone several changes and are constantly being fine tuned so that the HMOs are de facto in compliance with regulations. The result is that there is a working framework that providers have adopted and are following. The leading approach of the entire system is to balance the benefits of sharing patient information for promoting public health while ensuring that patient information remains private and secure.”
Tori believes that it is likely that cybercriminals will try to hack into such systems and use the information. “Even if everyone ensures and is convinced that their information is hermetically sealed and anonymous - with enough effort, it can still be extracted and deciphered. The idea is to create a system of checks and balances for the public. Israel has stepped up not only for the good of its citizens, but for the good of the entire world population, and this is something that we will forever be credited for. I have no doubt that the data that is accumulated here is of high value since we have a diverse population, genetically and also in terms of age and ethnicities, which really allows companies to gain a lot of knowledge about public health which can afterward be used on a global scale. All this can be done without harming the safety and privacy of those who are vaccinated,” she said.