Israel Uses Coronavirus Treatment as a 'Living Lab' for New Technology

JERUSALEM -- At a medical center outside of Tel Aviv, 11 Israelis remain quarantined after disembarking last week from the Diamond Princess luxury cruise ship in Japan, where hundreds of passengers became sick with coronavirus. But even after two of these quarantined Israelis have tested positive for the new virus, medical staff have hardly touched the group. Instead, they are relying on telemedicine tools to remotely monitor and communicate with the isolated patients.

"We have been able to meet all their medical needs without exposing the staff," says Eyal Zimlichman, the doctor overseeing the group's isolation and care at Chaim Sheba Medical Center, a sprawling campus on a former military barracks.

The model reflects the increasing embrace of telemedicine in general in recent years, and its potential in dealing with the new virus, officially known as COVID-19, which emerged in Wuhan, China, late last year and now affecting at least 40 countries, health officials say.

"This current environment certainly makes for an interesting proving ground (for) existing solutions," says Crystal Riley, a lecturer in health administration at New York University's Wagner Graduate School of Public Service. "It's not outside the realm of possibilities that new technologies will emerge from this epidemic."

Chaim Sheba's innovation center recently put out a call to entrepreneurs in Israel, which has a large digital health sector, and around the world for proposals for new solutions to test and treat patients with coronavirus.

"Word has gotten out that we have this group of people here and we have gotten so many emails from startups offering us their solutions," Zimlichman says. "This is like a living lab here."

Last week, when the passengers from the cruise ship arrived on a chartered flight to Israel, medical officials transported them in shuttles to Sheba. Upon arrival, doctors wearing protective gear physically examined the patients, none of whom had any symptoms of the virus.

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But since then, doctors have not had much physical contact with the patients. Rather, each day, the patients use hand-held smart devices from Israel-based startup TytoCare, which they hold over their chests, allowing doctors to listen to their heart and lungs remotely. They also use the devices to let doctors look into their ears and throats. Under their mattresses, a sensor system from the Israeli medical device company Early Sense, which never touches the patient, monitors their breathing patterns for subtle changes and potential signs of respiratory infection. The EarlySense system collects and analyzes more data than traditional methods, and is not invasive, which is key in getting people who may not even be sick to comply with precautionary medical monitoring, doctors and company officials say.

"These patients perceive themselves as healthy, so why make them suffer," says Guy Meger, chief technology officer at EarlySense.

The quarantined patients also can attend live yoga classes and other social activities using Uniper, an interactive video-communication platform marketed for homebound elderly people.

"For people who were already quarantined on the ship, and now here, this contact is really important," Zimlichman says. Hospital officials would not grant interviews with any of the patients, citing privacy concerns.

So far, even the two patients whose nose and throat swabs tested positive for the virus are not showing any symptoms, Zimlichman says. But should they, or others, start to become sick, there is a large white robot that doctors can employ to conduct more in-depth checks, including looking into their pupils and examining them with a stethoscope.

"We are really putting a lot of hope in these systems," Zimlichman says, explaining that these and many other telemedicine tools not only collect copious amounts of data from current patients, but also utilize machine-learning and artificial intelligence to analyze the data.

Health officials also hope a new directive for those in Israel who are worried about possible coronavirus symptoms or exposure to call a hotline rather than visit a medical facility will help prevent any spread of the virus. The hotline, run by the Magen David Adom emergency response service and the ministry of health, allows callers to have video conversations with doctors, nurses and medics.

"The video gives an extra dimension and it helps people to actually see the professional giving them a serious, personal answer," says Yoni Yagodovsky, director of international relations at Magen David Adom. Officials have also been dispatching nurses and medics to test people for the virus at home, rather than having them come to a medical facility.

But while Israel and other countries have been turning to more telehealth solutions, it can be a psychological adjustment for patients, who are used to physical contact with health-care providers, experts say.

"Barriers to telehealth are largely in people's lack of education on the utility of it," says Mariea Snell, professor and assistant director of the online doctor of nursing program at Maryville University in St. Louis. Another challenge is scale, Zimlichman says, especially when it comes to new products.

"We are assuming we will get more cases," Zimlichman says, explaining the current tech-enabled isolation unit at Sheba has room for 40 people. "One thing we worry about is having enough of these smart devices; if we get thousands of cases, we won't be able to do this for every patient."

Sara Toth Stub is a journalist based in Jerusalem. She spent a decade writing for The Wall Street Journal and Dow Jones Newswires, and has also written for The Atlantic, The Washington Post, BBC Travel and other publications. You can find her on Twitter here.