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Powering Israel’s pandemic response with a nationwide interoperability platform

Editor’s note: This blog was written in collaboration with Gabi Joffe, Israel Site Leader, dbMotion. She and the team of leaders in Israel are committed to bringing the best out of all the software engineers, solution managers, and services and support teams developing and maintaining interoperability solutions for Allscripts clients.

The COVID-19 pandemic has felt a lot like building an airplane while flying it. The biomedical community began learning about the novel coronavirus, its effects on the body and treatment options while it simultaneously spread across communities, regions and eventually the world. It quickly became clear that getting through the turbulence would require collaboration among providers, public health experts, researchers, technologists and governments.

In Israel, the first case of COVID-19 was recorded in February 2020. With one of the highest population densities in the world, the country needed to act quickly to slow the spread among its population. Accessible data—and lots of it—would be key to inform the response. Existing health IT infrastructure, powered by the dbMotion™ Solution, offered an answer.

A connected country, ahead of its time

Two decades before the pandemic, dbMotion began working with Clalit Health Services (Clalit), the largest of Israel’s four health maintenance organizations (HMOs). With 14 hospitals and more than 1,300 community clinics dispersed throughout Israel, Clalit approached dbMotion to make patient data electronically shareable and retrievable among all of its clinical sites to improve patient care and reduce unnecessary tests and procedures. After a successful pilot phase at one of Clalit’s hospitals, other Clalit facilities joined what would become the Ofek health information exchange (HIE). This began back in 2000, when the digital age was in its infancy.

But dbMotion did not stop at connecting all Clalit facilities. By 2005, Sheba Medical Center, named among the world’s top ten hospitals by Newsweek, and Rambam Medical Center, one of the five major hospitals in Israel, both joined the Ofek HIE. And in 2012, the Israeli Ministry of Health (MOH) decided to connect all medical facilities to Ofek to create a nationwide HIE. As a result, Ofek now includes the four Israeli HMOs, 50 hospitals and the Israeli Prison Service—servicing the entire Israeli population of nine million people.

Still, Israel’s HIE evolution is not over. In 2016, the MOH kicked off the Eitan Project and signed a new agreement with the company. As part of the project, dbMotion is replacing the Ofek legacy system with new technology that will enable advanced data analysis and semantic-level interoperability, as users will be able to exchange information using common clinical terminologies.

Critical insights brought to the front lines

When the pandemic first hit, Israeli healthcare professionals faced challenges those in other developed countries also experienced. Clinical sites struggled with managing the influx of patients, quickly identifying and triaging patients with COVID-19 and bringing accurate, relevant information to providers at points of care.

In a matter of days, the dbMotion team rolled out a new COVID-19 dashboard based on the vast volume of data in its clinical data repository (CDR) to aid clients. This gave providers a list of patients in their facility and their clinical information related to COVID-19 as well as the following insights:

 

  • Total patients tested
  • Total confirmed cases
  • Total new daily cases
  • Total patients converted negative
  • Total currently hospitalized patients
  • Total and percent confirmed from high-risk populations
  • Gender and age distribution
  • ZIP code grid
  • Incidence of related clinical presentations, such as cough, wheezing and fever
  • Incidence of reasons for high risk for severe illness, such as asthma and being older than 65

The dbMotion team also added a COVID-19 indicator (“positive,” “recovered” or “negative”) to the top of existing applications used at the point of care, giving providers quick visibility into the COVID-19 status of each patient.

Big data makes a big difference

Israeli public health and infectious disease experts had their own initial challenges as well, namely the small amount of information available on the new coronavirus. To overcome this issue, the MOH once again tapped dbMotion to collaborate.

In the earliest stages of the pandemic, dbMotion developed a solution, approved by MOH legal counsel, with access limited to district physicians within the regional bureaus of the MOH. The solution provided access to clinical information within the Ofek HIE and enabled the MOH to perform epidemiological investigations.

As the pandemic persisted, dbMotion continued to respond to new client needs. In December 2020, when vaccination efforts began in Israel, the MOH and dbMotion partnered yet again. Together they built off the existing dbMotion COVID-19 indicator to add patients’ vaccination statuses. Additionally, immunization data was added into the national HIE so providers could access this information regardless of where a patient received care.

Bringing together business and government to benefit all

The longstanding relationship between the MOH and dbMotion showed its value time and again through the course of the pandemic. To recognize these efforts, dbMotion was visited in February 2021 by Reuven Rivlin, then-president of Israel, and Ruvik Danilovich, mayor of Beer Sheva, the city dbMotion is based in.

President Rivlin’s words at this visit encapsulate what COVID-19 has shown us all: “The coronavirus challenge is a big numbers challenge—a complicated challenge of estimates, forecasts, models and calculations. Cooperation and sharing of information are essential.”

The work of dbMotion in Israel, before and during the pandemic, is a powerful example of the Allscripts mission to build open, connected communities of health. No matter the circumstances, Allscripts will continue collaborating closely with our partners in healthcare to build and support vital connections around the world.

Comments 1

  1. Karen Keating 10/28/2021

    Well done Eli and dbMotion Team! It’s amazing to see the value of our product around the world.

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