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Israel: An Impossible to become Possible

Israel: An Impossible to become Possible

By: Arunas Karlonas, Commercial attache of Lithuania to Israel

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Undoubtedly, the Israelis are the most successful innovation creators in the world. Where does the secret of a state with a large part of its territory covered by desert and with rather unfriendly neighbors lie? Why the country of 9 million people boasts more than 6.500 startups, 7.6 percent of its workforce is engaged in Hi-Tech and it generates 13 % of GDP with 38 % of export volumes? Why is Israel not a market but rather a gateway to global markets with more than 370 multinational companies operating there? What is the secret of Israeli innovation success?

The answers to those questions were provided during the Mission: Innovation 2020. This intensive session for European diplomats was organized by the European Institute of Innovation and Technology (EIT) Hub in Tel Aviv together with Innovation Without Borders (IWB). At the mission, we had a chance to meet the key stakeholders, including government experts, tech entrepreneurs, representatives from multinational companies, VCs, etc. We had a unique possibility to learn the ways the Israelis create and develop innovative products and services, establish connections in the ecosystem, jointly develop technologies and projects.

Representatives from Cyprus, Germany, Greece, the Czech Republic, the Netherlands, Belgium, Austria, Lithuania, Sweden, and the EU Delegation had the opportunity to participate in this Mission.

Israel‘s innovative thinking is an extremely complex recipe but following the discussions with Start-Up National Central, 8200 Alumni, Israeli Innovation Authority, Israeli Export Institute, Technion, and business representatives from Quedma Innovation, Deloitte, Road2, SAP, Enel, Volkswagen group, and others, we found out what the secret ingredient is. It is their courage to take risks, to fail, and to start again. This is in their blood.

In this regard, I would like to point out the key elements of why the Israelis are very innovative and respond to challenges so successfully:

Desire to be safe and independent

Many Israelis seek to work independently and be self-supporting. They set up businesses alone or in groups and if they fail with what they do they keep starting from scratch again. They understand that failure is no punishment but rather an opportunity to learn from the mistakes made and so they keep moving again. I suppose that the ‘everything will be fine’ formula is deeply rooted in their minds. Israel is unique in its cultural environment, in fact, it is the cradle of cultures where Jews and Arabs coming from Europe, America, the former Soviet Union, and elsewhere complement each other and make a stimulus to create something new.

Israel ambassador Dani Dayan very well reflected on the Israelis’ ability to achieve this most remarkable success in entrepreneurship and innovation “I think that Israeli men and women really dream of being the next Bill Gates or to found the next Google or Microsoft“

Another important aspect is that the very specific geographical and geopolitical situation determines the wish of every resident of Israel to be safe, strong, and independent. Israel is situated in a region with very few friendly states so the people of this country must always be vigilant and watchful for alerts.  Protecting the country means protecting yourself. This tense geopolitical situation provides a powerful stimulus for the development of new border and air protection, urban surveillance systems, air, water, and food security technologies. The feeling of personal insecurity is the best driver for being ahead and creating something new and innovative.

Israeli Defence Forces: the school of innovation

At the meetings with Israeli entrepreneurs and founders of technology companies, we found out that lots of them have ‘graduated’ from the IDF school, mostly from the elite Unit 8200, the biggest and most sophisticated unit in the Army.

As representatives from the 8200 Alumni organization mentioned, for the Israelis, the army is the school where they learn to be an interpreter, engineer, programmer, constructor. This valuable education enables them to use their precious knowledge and skills gained for designing and developing new inventions. A good example that illustrates how the Army promotes innovation is presented at the Peres Center for Peace and Innovation. The story is about a military man, who worked with precise missiles and used his knowledge to invent a capsule to be used in endoscopy; so it is the miniature camera in a pill designed to take photos while traveling through the gastrointestinal tracts.

So in Israel, military service is a substantial step in every civilian’s life.

Attention to R&D

The Government of Israel pays huge attention and provided considerable fundings to R&D. Israeli scientists and researchers are among the best ones in a world. Israel is ranked #1 in private R&D expenditure as a percentage of GDP was about 4.3 % (as of 2016), of which 84 % comes from the private sector, which is the highest indicator among the OECD countries reflecting the prospering innovation ecosystem of the private sector. Israel is also ranked #2 at the Innovation Index of the Global Financial Forum (Global Competitiveness Report, 2016-2017) that includes parameters such as scientific research institutions, R&D expenditures of the business sector, cooperation between the academia and industry, the pool of scientists and engineers and the number of patents in ratio to the size of the population.

The Israel Innovation Authority promoting international cooperation in R&D of significant technological innovation supports bilateral R&D programs based on government-to-government international agreements and implementation agreements between government agencies and regional authorities. These programs allow the sharing of risk inherent in project funding as well as offer assistance in finding technology and business partners. Israel is the first in the world for business investment in R&D as a percentage from GDP. This provides the answer to why Israel is home to more than 350 R&D centers of some of the world’s largest multinational corporations, such as Microsoft, Apple, and Google.

Obviously, it would be difficult to copy and reproduce all this in other countries. Because each country is unique in its own way; yet, we can definitely learn from Israel’s courage to create and to be not afraid of making mistakes.

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Access to Healthcare

The Health not The Death is a fundamental human right. A healthy population is not to be seen as human and social capital, an input, or by-product, towards economic growth. Alongside a healthy and sustainable environment, a solidarity, a healthy population must be the ultimate goal especially nowadays in helping Ukrainian migrants with cancer and their families.

Solidarity in health is a cornerstone of EU health policy. There are wide disparities in many health outcomes across the region and those outcomes. The access rules dramatically affect healthcare systems which are at the forefront of the migrant way, the people who are searching for help and the way how we could enhance and support their healthier and wellbeing status.

In order to ensure their access to care and continued cure in need, the probability of receiving a timely diagnosis and of surviving differs greatly from country to country where they are now. There is lack of information, help and inequalities in access. People need help in navigating cancer knowledge, diagnostics, secondary monitoring and prevention, way of treatments, and care.

Shifting our mindset, supporting healthcare connectivity, removing inequalities overall across Europe is our mission and even more now in a time of crisis, helping the Ukrainian people dealing with cancer is a good place to begin this transformative revolution.

1) Whether we have a chance to foster more holistic and integrated approaches to receive information and care, by supporting coordination and maximising an enabling and health-enhancing effect of care across services from different countries?

2) Whether actions should address the social determinants of health, the countries where they are now, the health need which they have, the social and language barriers are the conditions which have to be taken into consideration in a coordinated manner?

How might we improve patients and /or people who seek healthcare support, access to healthcare services at an EU & the Member States Healthcare systems level? Especially in a time of crisis in Europe.

How might we support refugees fleeing from their countries by navigating them to medical centres to receive best available care?  

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Predictive Treatment

Precision medicine aims to personalise care for every individual. Nongenomic and genomic determinants, combined with information from patient symptoms, clinical history, and lifestyle (nutrition, physical activity, stress etc.), can facilitate personalised diagnosis and prognostics. Yet this goal requires access to massive amounts of data which may come from different structured and unstructured sources; these can be our medical records, laboratory testing, a range of medical devices as well as from the patient himself. AI & ML can combine input from these multiple sources, analyse them and identify biomarkers that can support health professionals make more informed decisions. The convergence of precision medicine with the advanced AI capabilities will improve the ability to personalise care – improve diagnosis, risk prediction as well as therapy planning.  

HCPs want to better predict treatment response, given uncertainty around which treatment to prescribe to which patient and when to prescribe. How do we risk assess the patients, match them with the right treatment (personalised). How can we transform the wealth of data and link it to the predictive nature of how the patient will respond?

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Patient Journey Navigation

Being diagnosed with cancer is overwhelming and comes as a blow. Patients may feel on a roller coaster of emotions—they are scared, lost & confused not knowing what to expect, who to refer to, what to do and how to tell their loved ones.  They directly refer to “Dr. Google” to look for information about their disease, possible treatments, QoL strategies with the aim to have better understanding of their disease and learn how to better cope with their disease & treatment, yet information is not always valid, accessible, nor personalised or tailored to the patient’s status and needs therefore left with huge amounts of non-relevant information. Coming to the doctor, the physician’s time is limited and mostly focusing on the physical aspects of the disease & treatment, not leaving much time to ask questions nor discuss more holistic aspects of the disease such as emotional, psychological, social aspects. The patient (& caregiver in many cases) leaves the room with unanswered questions, doesn’t remember much of what has been said, and feels he is not heard, nor seen as a whole.

The need for navigating this journey along the emotional psychological stress is overwhelming & patients and their caregivers look for support (case manager/companion/partner) to help manage their disease holistically – starting from having clarity around their disease and treatment by having access to reliable and personalised information during their journey as well as having an integrated holistic care system , supporting them and their loved ones to navigate through the different aspects of their disease – medical, emotional, logistical, psychological, social, rights.

How can we support patients to navigate through the complexity of their disease and treatment ensuring they have validated holistic information about their disease journey & treatment and be empowered to  effectively manage their care 

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Peer-to-Peer Medical Exchange

As medical events pivoted from conference centres and meeting rooms to the virtual settings, learning opportunities continue. Lectures and presentations are translated to the new digital world, yet the ability to connect and network is relatively lost. Peer interaction is essential not only for information exchange but to share practical insights, allows consultation & in-person experience cross country and across borders leading to better disease management.

This peer-based learning/ consultation is highly valued amongst practising clinicians and was generally achieved when HCPs and KOLs met their peers in national & Intl conferences, group debates, advisory boards and even during quick corridor conversations. Attempting to replicate these in-person experiences into the digital space creates challenges and are not effective nor impactful as face-to-face engagements. 

How might we improve HCP medical exchange enabling physicians to easily communicate, consult, exchange opinions leveraging individual experts & centres of excellence knowledge, experiences, and practices?

How can we leverage the technological expertise to allow HCPs to connect with leading experts across countries to get advice / counselling for their cases?

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