The United States sees itself as leading the world in healthcare innovation, and U.S. researchers have undoubtedly achieved amazing things. But according to a recent FREOPP ranking, America isn’t at the very top of the heap — in fact, it trails five much smaller nations, including my own home country of Israel.
How do places like Israel punch above their weight? It’s because they are light-years ahead of the U.S. in one key area: clinical data sharing. It takes huge volumes of clinical data to develop AI diagnostics, transformative new treatments, and other computer-enabled medical technologies. In America, however, clinical data remains siloed away — shared within individual healthcare systems, but not accessible at a national or even regional scale.
That means that while the U.S. remains a powerful force, it isn’t reaching its full potential. With better data-sharing practices, American researchers could unlock new medical breakthroughs that would bring enormous benefits to patients in the U.S. and around the world. Here are 3 key lessons that providers and policymakers can learn from Israel’s data-sharing practices:
- Private capital is key, but requires guidance
The top countries on FREOPP’s index all have universal health coverage — but it’s private capital, not centralized control, that drives effective data sharing. Israel’s vibrant health tech sector now comprises over 700 startups, and its digital health sector drew $1 billion in new investments in H1 2021. With Israeli tech leaders raising capital and selling products worldwide, the startup ecosystem also provides global connections that help make Israel a world leader.
Of course, the U.S. also has incredible strength in this area. U.S. digital health startups raised over $29 billion last year, and the Small Business Innovation Research (SBIR) program has helped to unleash scores of new drugs and hundreds of medical devices. But despite immense financial power, U.S. startups lack a stable 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 such as the Cures Act to try and open up the market.
That’s where government leadership can play a vital role. In Israel, the government has worked since the 1990s to accelerate the push toward healthcare data digitization. It’s not just the government’s recent efforts to digitize personal health records, or the Israel Innovation Authority’s far-reaching data-sharing program — it’s also a well-developed public-private partnership model that provides public funding to match capital that data-sharing and digital-health startups raise from VCs and angel investors.
That’s Israel’s secret sauce: a powerful tech ecosystem combined with practical government support. Israel’s leaders don’t tell entrepreneurs what to do — but they do provide clarity around the challenges that the healthcare sector is facing, and help gently steer innovation in the right direction.
- Innovation demands clinical data, not claims data
Many Americans assume their healthcare data is already being shared effectively. After all, if you log into your patient portal, you can view test results or records from various providers, all in one place. But that kind of sharing really only happens within a single healthcare system, though: start looking across systems, and you’ll see that what’s really being shared is claims data, not clinical data.
What’s the difference? Claims data is information like diagnostic codes and quantifiable test results. It’s easy to standardize and share, but not all that useful: few breakthroughs spring 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 scrawls on a test result, or the time-series data of your EKG and imaging generated by medical devices. That can yield genuinely new insights — but because it’s messy and hard to make interoperable, it seldom gets shared beyond the hospital within which it’s generated.
Israeli providers haven’t fully solved this problem but, because our hospitals are typically bigger than the average U.S. hospitals, we’re able to compete with (and outcompete) the U.S. when it comes to leveraging clinical data at scale. By partnering with HMOs and outpatient clinics, Israeli providers can also capture longitudinal data, obtaining a 360-degree view of the patient that’s unavailable to most American providers.
This is an area where the sheer scale of U.S. healthcare is an incredible untapped asset. If America were to incentivize and sanction safe, secure pooling of clinical data across networks, it could unlock vast troves of new clinical data — and drive innovation at a rate that few other countries could match.
- Military-grade security is a must-have
Israel is ahead of the pack when it comes to security, drawing 31% of global cybersecurity investments, and that impacts digital health innovators, too. When I launched my own health data startup, I had to work with Israel’s cybersecurity committee, the National Cyber Directorate, to validate our tech solution — and as a result, my company’s solutions were more secure and futureproof by design.
The U.S. lacks equivalent leadership on this issue, and as a result its healthcare sector lags behind on security issues. Hospitals work to harden networks and fend off ransomware attacks, but give little thought to how to share data securely. Understandably — especially given HIPAA obligations that make them liable for patient data — many U.S. providers simply hunker down, refusing to share data even in the name of supporting innovation.
That’s a problem because refusing to engage doesn’t make patient data safer. We already live in a world in which anonymized data can become identifiable: facial features can be extrapolated from brain scans, for instance, while genomics researchers routinely use data that’s inherently traceable to specific individuals. And because data can be used in aggregate to identify subjects, a privacy lapse impacting one dataset can easily lead to other anonymized datasets becoming linkable to specific individuals.
All this makes the failure to pay attention to data security and privacy a critical point of failure for U.S. health innovation. The key is to realize that opting out of data sharing isn’t a viable option: instead, providers need to proactively build systems to enable secure data sharing. One solution: enable developers to work on data in-situ, rather than handing over ownership of data to third parties whose security and privacy measures may not be adequate.
A challenge and an opportunity
Effective data sharing starts with recognizing the value inherent in clinical data. On this front, Israel is ahead of the curve. The country’s Pfizer deal — effectively trading data for Covid-19 vaccines — reflected a clear understanding of both the value of clinical data, and the importance of developing robust 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 scrambling.
What we’re seeing in Israel is a snowball effect: the more you prioritize and invest in data sharing, the greater the ROI you realize, and the more investors and innovators flock to your healthcare sector. It isn’t too late for America to ride that wave, too — but doing so will require real leadership, a new focus on clinical data, and a new commitment to security and privacy.
Given the size of America’s healthcare system, the volumes of data that flow through it, and the amount of capital flowing into research and development in the U.S., the potential opportunity is enormous. The world already looks to the U.S. 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: Evgeny Gromov, Getty Images