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The Hospital of Israel

February 17, 2016

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Israel's National Medical Center

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Born in 1948...

Born in 1948 along with the fledgling State ofIsrael to treat the wounded of Israel’s War ofIndependence.Tasked personally by Prime Minister DavidBen-Gurion, Dr. Chaim Sheba opened asmall military hospital at Tel Litwinsky (laterrenamed Tel Hashomer, meaning 'Hill of

Guardians') to heal the brave men and women injured in thepivotal battle for Jerusalem.Tel Hashomer Hospital became the Sheba Medical Centeras it grew to encompass four specialized hospitals andhundreds of medical clinics and scientific

laboratories…

Eyal Zimlichman MD, MSc Sheba Medical Center

Among Our Goals• A comprehensive hospital where the

patient is at the center• Providing the highest quality health

care to patients and their families• Synergism between medical care and

research• Development of new and leading

technologies• Education of all health professionals

with emphasis on future team leaders• Economic stability

Eyal Zimlichman MD, MSc Sheba Medical Center

Lab Complex

Sheba Medical CenterGeneral Hospital

Academic

Rehabilitation

Facts and Figures• Comprises 120 departments and

clinics, 1,482 licensed beds, 7,200 healthcare professionals, including 1,000 doctors 2,300 nurses and 1,500 paramedical personnel.

• 1.4 million patient visits a year, 185,000 emergency visits95,000 inpatients, 600,000 hospitalization days and 10,500 newborn deliveries.

• Situated on a 150-acre campus.• A built-up area of over 4,000,000 sq.

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Medical Education• MD programs with the Sackler Faculty of Medicine, Tel-Aviv University 4 years, 6 years, and American programs• MD programs with London Saint George University• Residency and Fellowship programs• Sheba School of Nursing

A four-year BA program affiliated to Tel-Aviv University

Post graduate nursing programs• Academic School of Physical therapy• Academic School of Speech Therapy• Medical Simulation CenterEyal Zimlichman MD, MSc Sheba Medical Center

Medical Research• 25% of all Israeli medical clinical research is conducted at Sheba.• The main clinical trial venue for the Weizmann Institute, Tel Aviv and Bar-Ilan universities.• A key partner with industry as testing center for Israeli medical technology and new drugs.• One of two medical centers in Israel with US Dep. of Health federal wide assurance designation.• A home to major research centers in regenerative medicine, neuroscience, cancer, heart disease and genetics

Eyal Zimlichman MD, MSc Sheba Medical Center

Tech Transfer and Commercialization Strategies

Successfully Transfer and Commercialize Technologies that Lead to Economic Development  

Technology transfer is a complex process. It operates as part of the Hospital’s internal culture and environment and as part of the external environment in the community and state.

Internally, the “culture” is one of the strongest and most pervasive influences on its technology transfer and commercialization performance. This includes incentives to inventors, rewards, and leadership from management.

Sheba Medical CenterMinistry of Health – Central LaboratoriesBarzilai Medical CenterZiv Medical CenterGalilee Medical CenterWolfson Medical CenterMental Health Center

Lateral Technology Transfer Company

The Acute Care General Hospital

Safra Pediatric HospitalHospitalization tower

Buchman Women’s Division

Lab Complex

Teaching Campus

The Rehabilitation Hospital

Rehabilitation

Geriatrics

The Rehabilitation Hospital

A Central rehabilitation hospital in Israel400 beds, 14 buildings.

Comprehensive rehabilitation including:orthopedic, neurological, respiratory, psychiatric,geriatric, trauma and MS rehabilitation.Utilize High-Tech and Low-tech technologies as well as social support to supply an integrated care to its patients

Eyal Zimlichman MD, MSc Sheba Medical Center

Quality and safetyThe Strategy

Sheba Medical Center considers quality and safety as a priority.

Achieving quality is accomplished through standardization of care, implementation

guidelines and protocols to reduce variance, continuous measurement and feedback, constant drive to improve outcomes with minimal patient

harm, and promoting staff education for high quality care.

Eyal Zimlichman MD, MSc Sheba Medical Center

MSR – The Israeli VisionNational resource for comprehensive inter-

disciplinary, multimodality medical simulation center dedicated to:

Patient safety and quality careHands-on training Readiness to clinical practicePerformance assessment

Cultural Change Vehicle

Eyal Zimlichman MD, MSc Sheba Medical Center

MSR - Virtual Medical Environment

• Broad-spectrum simulation modalities Simulated patients / Hybrids High-tech simulators Task trainers / Skills lab

• Clinical environments Home, Field, ER, OR, clinic Customized - EMR

• Debriefing capabilities One-way mirrors Digital A-V equipment Debriefing software

• Multidisciplinary staffEyal Zimlichman MD, MSc Sheba Medical Center

Simulation Modalities

Eyal Zimlichman MD, MSc Sheba Medical Center

IT in Sheba

EnterpriseData

Warehouse

Vital Signs Systems

EMR & CPOE Chameleon-Elad

groupMetavision-

iMDsoft

Laboratory - AutoLIMS

Imaging- Pacs, Carestream, C-

Pacs

Medical Admin. Logistics

HR

Finance-TMR, Gomla Ltd.

Supply Systems

Information exchange-dbMotion

Eyal Zimlichman MD, MSc Sheba Medical Center

Sheba’s EMR

Inpatient

Critical Care

Outpatient

Emergency Rooms

One ComprehensiveSystem

14 Years of EMR Experience

Eyal Zimlichman MD, MSc Sheba Medical Center

Eyal Zimlichman MD, MSc Sheba Medical Center

Computerized Departments

Inpatient Departments Surgery, Internal, Critical Care, Gynecology, Neonatal, Maternity, Psychiatry,Geriatrics, Rehabilitation Diagnostic ImagingRadiology, Cardiology, Nuclear MedicineLaboratoriesPathology, Microbiology, Chemistry, Hematology, Genetics, Reproduction ……… OncologyOutpatients, Chemo, RadiotherapyEmergency Rooms

Outpatient Departments

Eyal Zimlichman MD, MSc Sheba Medical Center

SmartDoc

Smartphone Applications for Physicians

Eyal Zimlichman MD, MSc Sheba Medical Center

Patient Portal: Sheba Yashir

Patient Internet Environment Private Area Communicator Tool Personal Documents

Lab ResultsImaging ResultsDischarge PapersOutpatient Visit Papers

Ask the Doc Conferences and Special Events Medical Articles Patient Empowerment

Eyal Zimlichman MD, MSc Sheba Medical Center

A Computer for Every Patient

Empowerment Opinions and Surveys Personal Medical Documents

(Sheba Yashir) Entertainment

InternetIPTVVOD

Communication ToolFamilyFriendsStaff

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IT solution to address hand hygiene compliance through

patient empowerment

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CLINICAL STANDARDIZATION

Clinical care

pathways

Guidelines

Checklists

Risk assessment

Decision support

Clinical Standardization Through Information Technology

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Preventing Adverse Drug Events

David W. Bates

Eyal Zimlichman MD, MSc Sheba Medical Center

Medication Decision Support

CurrentlyDrug-Drug InteractionsDrug-Allergy Alerts Drug Dosage AlertsDrug- Blood Tests (renal function) Duplicate Therapy

In developmentRight Drug in the Right DepartmentContinuous monitoringAdaptable algorithms

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- Big data- NLP- Machine

learning

Our BI System:CHESS (Clinical Health Economy and Satisfaction Simulator)

EMR

Lab

ADT

PACS

CPOE

IRB

HR

Financial

Academic

Safety/RM

Infec. Dis. Training

DATA WAREHOUSEData analytics

Case-mix adjustment

CHESS measures

SQL data

Dashboard presented on an

organizational web portal (Microsoft

office SharePoint)

Overall – 86 quality indicators:

43 – clinical perspective18 – financial perspective11 – patient perspective9 – Crew resource and

academic perspective5 – Case-mix measures

Dashboard

Balanced Score Card Approach

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CHESSBI Dashboard

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CHESS

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Patient Reported Outcomes Program at Sheba Medical Center

a. Developing and implementing a patient reported outcomes system that would collect, analyze and report patient reports concerning health status.

b. Personal and aggregate reports are fed back to both the electronic medical record as well as to the patient portal.

c. This project is being conducted together with Clalit Health Services, Israel's largest HMO.

Eyal Zimlichman MD, MSc Sheba Medical Center

Patient Reported Outcomes Program: Tablet Patient Interface

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Patient Reported Outcomes Program: Smartphone Patient Interface

Patient Reported Outcomes Program: Patient Report

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PROs CollaborationsPatient Reported Outcomes Measures Collaborative• Cleveland Clinic

(Cleveland, OH)• Partners Healthcare

System (Boston, MA)• Allina Health

(Minneapolis, MN)• Sheba Medical Center

(Israel)• Dartmouth-Hitchcock

Medical Center• St. Antonius, NL• Radboud Medical

Center, NL

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Thank you

Eyal Zimlichman MD, MScEyal.zimlichman@sheba.health.g

ov.ilDeputy General Director

Chief Quality OfficerSheba Medical Center