The United States is considered a world leader in health care innovation, and American researchers have undoubtedly achieved amazing things. But according to a recent FREOPP rankingsAmerica is not at the very top of the heap – in fact, it lags behind five much smaller nations, including my home country of Israel.
How do places like Israel punch above their weight? That’s because they are light years ahead of the US in one key area: clinical data sharing. Vast volumes of clinical data are needed to develop AI diagnostics, transformative new treatments and other computer-enabled medical technologies. In America, however, clinical data remains hidden—shared within individual health systems but not available on a national or even regional scale.
This means that while the US remains a powerful force, it is not reaching its full potential. With better data-sharing practices, US researchers could unlock new medical breakthroughs that would bring enormous benefits to patients in the US and around the world. Here are 3 key lessons providers and policymakers can learn from Israel’s data sharing practices:
- Private equity is key but requires guidance
All leading countries in the FREOPP index have universal health coverage – but it is private capital, not centralized control, that drives effective data sharing. Israel’s vibrant health tech sector now includes over 700 startups, and the digital health sector has attracted $1 billion in new investment in the first half of 2021. With Israeli technology leaders raising capital and selling products worldwide, the startup ecosystem also provides global connections that help Israel become a global leader.
Of course, the US also has incredible power in this area. US digital health startups have soared over $29 billion last year, and the Small Business Innovation Research (SBIR) program helped unleash it dozens of new drugs and hundreds of medical devices. But despite their massive financial power, US startups lack a robust framework to help them work with healthcare providers at scale and securely access the data they need to drive innovation. Until recently, the situation was so bad that it prompted legislation like the Cures Act to try to open up the market.
This is where government leadership can play a vital role. In Israel, the government has been working since the 1990s to accelerate the push to digitize healthcare data. It’s not just the government’s latest effort to digitize personal health records or the Israel Innovation Authority’s sweeping data-sharing program — it’s also a well-developed public-private partnership model that provides public funding to match the capital that data sharing and digital – healthcare startups raise funds from VCs and angel investors.
This is Israel’s secret sauce: a powerful technology ecosystem combined with practical state support. Israel’s leaders aren’t telling entrepreneurs what to do, but they’re providing clarity on the challenges facing the healthcare sector and helping to gently steer innovation in the right direction.
- Innovation requires clinical data, not claims data
Many Americans assume that their health data is already being shared effectively. After all, if you log into your patient portal, you can see test results or records from different providers, all in one place. But this kind of sharing only really happens within a health system: start looking across systems and you’ll see that what’s really being shared is claims data, no clinical data.
What is the difference? Claims data is information such as diagnostic codes and quantifiable test results. It’s easy to standardize and share, but not so useful: few discoveries stem from columns of neatly tabulated numbers. Clinical data is far richer: it’s the sentence a nurse writes on your chart, the question mark a consultant scribbles on a test result, or the time-series data of your ECG and images generated by medical devices. This can lead to truly new insights – but because it’s messy and difficult to make interoperable, it’s rarely shared outside the hospital where it’s generated.
Israeli providers have not completely solved this problem, but because our hospitals are generally larger than the average US hospital, we are able to compete with (and compete with) the US when it comes to using clinical data in scale. By partnering with HMOs and outpatient clinics, Israeli providers can also capture longitudinal data, gaining a 360-degree view of the patient not available to most American providers.
This is an area where the sheer scale of US healthcare is an incredible untapped asset. If America were to incentivize and sanction safe, secure pooling of clinical data across networks, it could unlock a vast amount of new clinical data—and spur innovation at a rate few other countries could match.
- Military grade protection is a must
Israel is ahead of the rest when it comes to security, drawing 31% of global investments in cybersecurity, and this also affects digital health innovators. When I started my own health data startup, I had to work with Israel’s cybersecurity committee, the National Cyber Directorate, to validate our technology solution—and as a result, my company’s solutions were more secure and future-proof by design.
The US lacks equivalent leadership on this issue, and as a result, its healthcare sector lags behind on security issues. Hospitals are working to harden networks and fend off ransomware attacks, but they’re not paying much attention to how to share data securely. Understandable – especially considering HIPAA Obligations that make them responsible for patient data—many providers in the U.S. simply cower, refusing to share data even in the name of supporting innovation.
This is a problem because opting out does not make patient data safer. We already live in a world where anonymized data can become identifiable: facial features can be extrapolated from brain scansfor example, while genomics researchers routine data usage it is inherent traceable to specific individuals. And because data can be used in the aggregate to identify subjects, a privacy breach affecting one set of data can easily lead to something else anonymized data sets become associated with specific individuals.
All of this makes the failure to address data security and privacy a critical point of failure for US health innovation. The key is to realize that opting out of data sharing is not a viable option: instead, providers must proactively build systems to enable secure data sharing. One solution: Enable developers to work on data in-house instead of handing data ownership over to third parties whose security and privacy measures may not be adequate.
Challenge and opportunity
Effective data sharing begins with recognizing the inherent value of clinical data. On this front, Israel is ahead of the curve. The country’s deal with Pfizer — effective trading of Covid-19 data vaccines — reflects a clear understanding of both the value of clinical data and the importance of developing reliable data sharing systems. The result: Israel became the most vaccinated nation in the world and was first in line to receive additional doses while other nations were still struggling.
What we are seeing in Israel is a snowball effect: the more you prioritize and invest in data sharing, the more ROI you realize and the more investors and innovators flock to your healthcare sector. It’s not too late for America to ride this wave, but it will require real leadership, a new focus on clinical data, and a new commitment to security and privacy.
Given the size of the US healthcare system, the volumes of data flowing through it, and the amount of capital flowing into US research and development, the potential opportunity is huge. The world now looks to the US for leadership in healthcare innovation. It’s time for industry leaders and policymakers to lean in and unlock the full potential of America’s vast clinical data resources.
Photo: Yevgeny Gromov, Getty Images