Q&A: Sheba Medical Center's Eyal Zimlichman Discusses Healthcare Innovation on a Global Scale

The chief innovation and transformation officer at Israel's largest hospital talks about the ARC innovation model and efforts to forge international partnerships.

One of the world's most innovative healthcare organizations is Sheba Medical Center, located near Tel Aviv in Israel. In 2019, the hospital launched the ARC innovation model, and set its sights on guiding the evolution of healthcare across the globe. Earlier this year Sheba signed an agreement with Deloitte Consulting to facilitate adoption of the ARC model in other countries.

To explore the global implications of the ARC model, HealthLeaders sat down, virtually, with Eyal Zimlichman, MD, MSc (MHCM), chief transformation officer and chief innovation officer at Sheba Medical Center. Prior to joining Sheba, he was lead researcher at Boston-based Partners Healthcare, now part of Mass General Brigham, and conducted research for Brigham and Women's Hospital and the Harvard-affiliated Center for Patient Safety Research and Practice on using technology to improve quality and patient safety.

Q. What is the ARC innovation model and how does it benefit healthcare organizations?

Zimlichman: ARC is short for accelerate, redesign, and collaborate. The ARC innovation model allows healthcare institutions to accelerate transformation efforts to answer the many challenges that healthcare systems currently face while also turning healthcare innovation into an engine of economic growth.

Based on our experience at Sheba Medical Center, we were able to build a model that can really move the needle on both aspects simultaneously. The model was built in a way that is very structured, enabling it to be implemented successfully anywhere in the world not just specifically at Sheba. To our knowledge, it is the only model of its kind in the world.

Q. Several large health systems in the US have created their own innovation centers and programs. How does the ARC model differ from those programs?

Zimlichman: ARC is not really an innovation center; it's much broader because it has a global aim. ARC aims to transform healthcare around the world, and to do so by the year 2030. This goal requires a very specific strategy that will enable us to reach the global standard we've set for ourselves.

To achieve this goal, ARC has built a global ecosystem that now includes more than 140 members in almost 30 countries. These members are all working together to lead transformation efforts for themselves, but also drive this as a global effort. This is unique because other hospitals typically focus internally to create solutions to be deployed only in their institutions.

Our partners include leading medical centers such as Mayo Clinic, Mass General, and Cedars Sinai, in addition to many international industry partners, governments, academia, startups, and more.

Q. What are the challenges or barriers to healthcare innovation that ARC addresses?

Zimlichman: ARC is looking to address the most critical challenges facing healthcare.

One of these challenges, for example, is quality and patient safety. There are huge gaps in quality and patient safety around the world which we've not been able to address over the last 30 years.

Another challenge we're facing is the workforce shortage and burnout, which is a critical problem right now, especially post-pandemic. ARC is focused on finding solutions to address this by taking the load off clinical teams and creating solutions that can replace some tasks that today are carried out by humans.

A third challenge is the rising cost of healthcare. Healthcare costs are on the rise in every developed country around the world and they are reaching unsustainable levels. It requires innovation to be able to provide a high level of care at a lower cost.

Finally, how do we build a system that will be more focused on the patient's needs and expectations and have the patient play a critical role within the system? This is another barrier that current healthcare systems have not been able to bridge. ARC is working on solutions to try and solve that.

Q. How are new or emerging technologies integrated into the ARC model?

Zimlichman: To really see the vision for the future of health come alive and make these transformations a reality, technology needs to play a central role in disrupting how we're delivering healthcare today.

We need to focus on two avenues to create these technological solutions. One is organic innovation, and the other is open innovation.

Organic innovation is technologies we develop in-house, based on the needs that we realize in the market. We then find the right teams to create solutions that we can implement and take to market, to have large-scale implementations across multiple institutions.

However, organic innovation is never enough to create meaningful transformation. For that, you also need to have open innovation, which is the ability to look outside of your own walls. We find the best technology outside and bring it in, so that we can create impact for our patients.

This is a central component of ARC as well. We've built an open innovation platform that constantly allows us to find the right technology, prove that it works, and take it to large-scale implementation.

Q. Would you say that's like a venture arm within ARC? Is that a good way to describe it?

Zimlichman: There is also a venture arm within ARC. The funds work to recognize the right technology, give it the support needed to grow, and get to a point where it can impact many patients.

In 2019, we identified the need for capital within ARC and established our first fund, Triventures. This was followed by two more funds, including Shoni Health Ventures. They are critical as well to ensure we get great ideas and great technologies to scale up.

Q. How do you measure success in the program?

Zimlichman: There are several metrics that we use. Some specifically look at the impact on our patients. For example, clinical outcomes or cost reduction. For technology solutions, we generally measure how much we're able to improve efficiency as well as effectiveness. That's one angle.

The other angle, of course, is financial. Are we able to really drive the economy and make this a successful and sustainable commercial model? We measure how many companies are born out of ARC. How much money have they raised? What are their accumulated valuations? How much are they selling on the market? These are all metrics that we've been following since the launch of ARC three and a half years ago.

Q. Could you point to a specific pain point in the healthcare industry that the ARC model has already helped to address?

Zimlichman: One example is our focus on technologies specifically related to artificial intelligence, which allows us to help clinicians improve decision-making and efficiency. A company called AI Doc that started at Sheba and is now deployed in 1,200 hospitals around the world, and is transformative in the way that it helps radiologists in the emergency department read the scans in a much more efficient manner. That has led to an improvement in patient outcomes--reducing mortality rates, for example, but also creating a reduction in cost for the hospitals due to the increased efficiency of radiologists. This is an example of where we could help in terms of being more sustainable, both in terms of trying to reduce our dependency on the human factor and improving quality and patient safety.

Q. What are the biggest challenges that healthcare organizations face in adopting the ARC model?

Zimlichman: One significant aspect is the culture. It requires a culture of innovation, a culture of being open to change. That is not always existent from the get-go, but part of the ARC model is about improving the culture.

We firmly believe that culture can be transformed and become a culture that's more open to innovation and change. This is part of the model of implementing ARC. Of course, it's always a challenge, especially when you start, and there's a lot of reluctance to change from your own staff. That's challenge number one.

Challenge number two is funding. Innovation is costly in many ways, especially if you want to build something robust and big enough to have a long-lasting impact. There are many opportunities for funding, such as government support, competitive grant funding, or even philanthropy, that will allow academic medical centers to build this much-needed infrastructure. But it is a challenge. Finding the source of funding, as we all know, is a challenge.

Q. How will the Deloitte partnership help this program?

Zimlichman: After spending three years building the ARC model, we started implementing it in different sites around the world. We very quickly understood that this was not our business; we're not consultants, we're a hospital. In addition, we don't have the capacity to do this for more than three or four institutions a year.  

As the demand for ARC increased around the world and we realized that we don't have the capacity to teach organizations how to build ARC, it was evident we needed to find a partner in the consulting space to help us scale up the ARC model. As a result of an RFP that was put out, with five consulting firms applying, Deloitte emerged as the winner. Now we're at a stage where we're putting together a joint product that Deloitte will take the lead in implementing around the world, with ARC's help to make sure it accurately encompasses what ARC is about.

We believe Deloitte is a critical partner to deliver a more professional product and enables us to scale up. Instead of doing just three or four implementations each year, we will be able to do 40 a year, which is our ultimate aim, to be able to scale up significantly.

Q. How do you see this program evolving?

Zimlichman: We see the ARC ecosystem growing, becoming stronger, and building better ways to collaborate. It's always a journey that we're on. ARC will have a substantial impact on what healthcare around the world will look like, accelerating transformation efforts through creating new solutions that will be able to answer the many challenges that we are facing.

Eventually we see ARC as a global force that will lead to two key outcomes that we're focused on. The first is improving the health of populations around the world through transformation. The second is driving the economy, within the local ecosystems, through investments, job creation, growth in businesses and so on.

Regarding our partnership with Deloitte, I personally am very excited about the possibilities. We found a great partner in Deloitte, with a very similar way of thinking.

We're confident that the Deloitte-ARC joint product will be the leading model around the world to drive transformations and growth in the healthcare sector and the economy.  I would like to relay the dedication and excitement of the entire team on this new journey we're taking together with our partners.