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Meet the world’s first Women’s Health Innovation Centre

The Israeli Women’s Health Innovation Centre aims to make top OB/GYN care available to everyone

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Dr Avi Tsur, OB/GYN and high-risk pregnancy expert, tells FemTech World how telemedicine could transform our traditional healthcare system.

The world’s first Women’s Health Innovation Centre, directed by Dr Avi Tsur, OB/GYN and high-risk pregnancy expert, was launched as a collaborative effort by ARC – Accelerate, Redesign, Collaborate – Centre for Digital Innovation, the Sheba Gynaecology and Maternity Centre, and Gertner Institute for Health Policy at Sheba Medical Centre in Israel.

Originally designed to promote patient and doctor safety during the pandemic, the centre combines telemedicine with in-person visits to “enhance treatment and offer patients the best care possible”.

“Sheba Medical Centre is the largest hospital in Israel and one of the leading hospitals in the world,” says Dr Avi Tsur, who serves both as director of the Women’s Health Innovation Centre and of OB/GYN BEYOND, the first virtual obstetrics and gynaecology department, as well as an attending physician at the Josef Buchmann Gynaecology and Maternity Centre at Sheba.

“The Women’s Health Innovation Centre essentially treats all aspects of innovation in women’s healthcare, AI, telemedicine, virtual reality, precision medicine and inventing medical devices and incubates new concepts in telemedicine.

“Once we develop a comprehensive clinical service it is handed over to OB/GYN BEYOND, that is capable of taking it in to the next level, both from a clinical point of view, but also in terms of marketing strategy and budgeting.”

The new hybrid clinic for women with high-risk pregnancy focuses in particular on transforming care for women with diabetes in pregnancy and offers both in-person and at-home visits that include comprehensive care, digital urine dipstick assessment, ongoing glucose monitoring, as well as foetal ultrasound and foetal monitoring.

“Following the Covid-19 outbreak, we started to use telemedicine technologies to treat women in hospital without having contact between the staff and the patients and that was a big step for us in being able to treat pregnant women remotely,” Dr Tsur tells me. “Now this hybrid approach means that multiple tests can be done at home, leveraging various technologies.”

Indeed, new analysis from McKinsey & Company has shown that telehealth utilisation has increased 38 times from pre-pandemic levels. “Telemedicine is very much like our chat right now,” explains Dr Tsur.

“Although our Zoom meeting is not as good as an in-person meeting, it allows us to do things that would not have been possible otherwise. Same goes for telemedicine services.

“When it comes to remote services, we also take into account the time it takes for a patient to get to the hospital, the time waiting for a nurse, an ultrasound and then, for a foetal monitoring assessment,” he continues. “In-person, all of these would take at least three hours, but when we switch to telemedicine visits, they take around 30 minutes.”

Even though telemedicine has certain limitations, Dr Tsur emphasises that there are many things that can be safely done at home. “I think around 90 per cent of things can be done remotely, especially within a hybrid system when we don’t miss the in-person meeting.

“Initially, many physicians and most of the patients were not aware of the possibility of doing an ultrasound or foetal monitoring assessment at home. But we arrange a first in-person visit, we take the patient to one of the rooms where we do telemedicine visits and we let them connect themselves to the foetal monitor so that they have the chance to see the monitor on the screen,” he explains.

“This way they can actually get the feeling of what we do and what we see in hospital. Once they do it, they feel more confident to do it at home next time.”

The Sheba Medical Centre, alongside the Israeli Foreign and Health Ministries, were also involved in establishing Shining Star, a dedicated field hospital in western Ukraine that served Ukrainian refugees and locals and trained local medical teams in telemedicine and field medical care.

The field hospital’s approximately 100-strong staff included doctors, nurses, medical lab workers, medical engineers, and pharmacists, as well as logistics and operational personnel. “We leveraged our technology to provide direct telemedicine services to refugees in Ukraine,” the high-risk pregnancy expert says.

“All of our physicians at Sheba, each one in his expertise, were interested in playing a role in the field hospital and with the telemedicine services, we were very eager to do everything we could to provide the best technologies care remotely.”

Dr Tsur believes that telemedicine can play an important role in humanitarian medicine. With hundreds of women at risk in Ukraine due to sexual violence, bad weather conditions and a lack of care, good pregnancy treatment is imperative.

The Israeli expert adds that: “Western medicine is very risk averse, which is not a bad thing, but I think we have to understand that humanitarian medicine creates different challenges, and being able to take some risks is needed if we seek to make a change.

“What we’ve been doing in Ukraine provided a great jump in expert-to-expert services, leveraging new technologies that allow experts in the field to consult even bigger experts in the hospital. It also taught us that we can’t reach the same ‘perfection’ often expected in the normal life scenarios.”

The Israeli humanitarian delegation to Ukraine

While the field hospital was limited to a certain amount of time, the use of telemedicine in various aspects of women’s health, during humanitarian crises, will continue.

“In many ways, our field hospital was limited in time because of the challenges we faced,” Dr Tsur points out. “Telemedicine, however, allows us to provide ongoing help to patients in remote places and it provides us with opportunities for learning more about humanitarian medicine. In my opinion, there’s a very good symbiosis between innovative inventive technologies and humanitarian medicine.”

The medical expert does not rule out other future projects and says that the team behind the Sheba Medical Centre is happy to collaborate and share their knowledge with other centres interested in doing similar things in various scenarios in countries taking refugees.

“My hope is that in five years from now, maternal foetal telemedicine will be maternal foetal medicine,” Dr Tsur adds. “I hope that pregnant women will receive the treatment that they need at home or at work or wherever they are. I also hope that we, at Sheba, will play an important role in developing the clinical paradigm and technologies serving this revolution, both in telemedicine and AI solutions.”

Would this mean less telemedicine hesitation? “I hope so. It’s our role to show people that telemedicine is safe. 10 years ago, people were hesitant to use mobile banking services, but we are in a totally different place today. I hope the same will happen with pregnancy services.”

For more info, visit eng.sheba.co.il.

 

 

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The start-up on a mission to transform metastatic breast cancer management

More than two million women globally were diagnosed with breast cancer in 2022 alone

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One in eight women in the US will be diagnosed with breast cancer in their lifetime and one in 39 will die from it. Could this start-up have the solution?

Nine years ago, Hollywood actress Angelina Jolie announced in a New York Times op-ed that she’d decided to go public about her elective double mastectomy to “encourage every woman” to think about their own risk of breast cancer.

The article went viral and increased breast cancer awareness around the globe, leading to the so-called “Jolie effect”.

But while campaigns like this have changed the way we talk about breast cancer, they haven’t translated into better patient outcomes.

The World Health Organisation revealed that in 2022 the “burden of breast cancer” caused 670,000 deaths globally.

In the UK, one woman is diagnosed with breast cancer every 10 minutes, leading to nearly 1,000 deaths each month.

Survival rates have indeed improved in many parts of the world and diagnostic methods have come a long way in identifying a tumour’s molecular profile. However, questions remain when it comes to choosing the most effective treatment combination for a particular tumour or patient.

“Oncologists consider multiple factors to determine the treatment strategy: the patient profile, the clinical tumour stage, the pathological tumour grade, the molecular tumour profile, treatment guidelines and study results, and patient-specific contra- indications,” Wolfgang Hackl, translational oncology scientist and founder and CEO of OncoGenomX, tells Femtech World.

“But there is nothing to assess whether a certain treatment works in a specific tumour. Oncologists can only be certain about that after the entire treatment journey, which can take months, sometimes years.”

Without a tool to support clinical decision-making, doctors turn to risk-adapted approaches, extending moderate therapies for low-risk cancers and intensive therapies for high-risk cancers. But this doesn’t solve the problem, says Hackl.

“Many patients are still over-treated for fear of being under-treated,” the founder explains.

“In breast cancer, about 60 per cent of women receiving treatment are over-treated. These patients end up having side effects which means they have to stop treatment. When they stop treatment, they are at risk of recurrence.

“This applies to under-treatment too. Under-treating and over-treating patients can both lead to sub-optimal treatment.”

The solution, however, could be closer that we might expect. PredictionStar, a decision support technology developed by Hackl and his team at OncoGenomX, could potentially transform breast cancer drug development, diagnosis and outcomes, facilitating individualised therapeutic decisions at any stage of the disease trajectory.

Wolfgang Hackl, founder and CEO of OncoGenomX

The tool, which uses AI and machine learning algorithms, identifies whether a certain therapy works in a particular tumour and finds the treatments proven to be the most effective for each patient and their specific tumour.

“It harnesses four patent-pending core technologies,” says Hackl.

“The first technology is an innovative tumour profiling test, the second one is an individualised prediction model, the third one is a digitalisation tool for information sharing without migrating patient data and the fourth one is a reinforcement technology, which helps the algorithm learn from treatment decisions.”

As far as tumour gene tests are concerned, PredictionStar works with standard, unsupervised, or commercial target gene panels, not only expanding their scope but also raising the applicability of test results from an average 65 per cent to more than 80 per cent.

For the first time, Hackl says, oncologists will be able to understand which treatment combination will work the best for a patient and their tumour.

“PredictionStar takes away the uncertainty around breast cancer treatment decisions and increases the likelihood of opting for the most effective treatment combination without delay and without exposing the patient to the side effects of an ineffective treatment.

“The whole technology is designed as an instrument agnostic which can work with any other existing technologies to allow for seamless interactions, irrespective of the systems that already exist in hospitals.”

The fascinating part is that the tool has a feedback loop which means the technology improves, the more information it gets, refining its therapy guidance.

“This is dramatic if you think about it,” says Hackl. “The US, UK and European countries spend hundreds of billions on cancer treatment every year.

“However, data shows that in cancer R&D, the clinical failure rate is about 30 per cent, which means that one out of three phase three clinical studies fails.

“This is a problem because this is the part of the development which generates 70 per cent of the development cost. Based on the data we have, we believe PredictionStar could reduce treatment expenses by at least 20 per cent.”

At a time when healthcare budgets are being squeezed, this reduction would be significant.

“We tend to believe that healthcare costs are a problem of the poor economies, but richer countries struggle with high healthcare costs too,” Hackl points out.

“This is something that has become very clear in recent years. The way healthcare costs are incrementally increasing over time is not sustainable and needs to be addressed.”

With such impressive capabilities, it seems to be only a matter of time before the availability of robust patient data sets extends the scope of PredictionStar to other cancer types. Hackl doesn’t rule this out.

“Currently, we are focusing on breast cancer, but we are intending to roll this out in other cancer entities,” he says.

If everything goes according to plan, PredictionStar could be ready for use in clinical and translational studies in the next 15-18 months, the founder adds.

“OncoGenomX’s data on file suggest that PredictionStar is leading the game and we have good reasons to believe that it has significant potential to improve clinical and economic outcomes beyond today’s achievements.”

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Could an adhesive device be the answer to perineal tears? This start-up thinks so

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Ditte Marie Fog Ibsen, co-founder and CEO of oasicare

A new device promises to provide midwives with a “third hand”, substantially reducing perineal tears, but could it really work?

“Simply surviving pregnancy and childbirth can never be the marker of successful maternal healthcare”, the World Health Organisation concluded after a damning report revealed that 287 000 women died in 2020 during and following pregnancy.

While maternal mortality rates are down sharply from where they were 20 years ago, research by United Nations shows that progress toward reaching the UN’s sustainable development goal of reducing maternal mortality has stalled.

According to the United Nations Population Fund (UNFPA), every two minutes a woman dies because of complications due to child birth or pregnancy.

But maternal mortality is not the only problem – for every woman who dies, there are about 20 to 30 women who experience injury, infection, or other birth or pregnancy related complication.

“Maternal mortality is only the tip of the iceberg when it comes to maternal health,” says Ditte Marie Fog Ibsen, co-founder and CEO of oasicare, a medical device start-up based in Copenhagen.

“Maternal morbidity is the hidden base, predominantly featured by perineal ruptures.”

Perineal ruptures are extremely common and expected complications of vaginal birth. In the UK, about 85 per cent of women sustain some degree of perineal trauma during childbirth.

Multiple studies have found that some women who experience severe perineal lacerations suffer long term psychological trauma and social isolation. However, the stigma around the topic means that many feel too embarrassed to seek help.

“Postnatal care is mainly focused on women with higher grades of perineal ruptures, downplaying the impact of lower grade ruptures on woman’s quality of life,” says Fog Ibsen.

“Short, medium and long-term complications are fairly common but rarely acknowledged or prioritised in the global health landscape.”

‘Women’s tears are not properly assessed’

Fog Ibsen and her friend, Julia Sand, were working as industrial designers creating solutions for midwifes when they realised the scale of the problem.

“We were trying to help midwifes manage their work-related musculoskeletal symptoms when we came across a even bigger problem: perineal ruptures.

“At the time, we didn’t know much about it, but we knew we had to do something about it.”

The duo began researching the issue and came up with a single-use medical device designed to protect the perineum and reduce uterine ruptures.

The product, which is currently being tested in several hospitals in Denmark, is adhesive and acts like a protective layer that prevents ruptures during childbirth.

“We are essentially trying to replicate the skin so we can prevent ruptures, which tend to happen when the vagina and perineum stretch during birth,” explains Fog Ibsen.

“We’ve made it very simple so that it can be easily applied and easily taken off.”

The interesting part, she says, is that women don’t actually notice it.

“That’s a quite good thing because there’s a lot of attention on the birth. The midwifes were a bit worried initially about the adhesive and whether it could last and stick to different types of skin, but so far it’s been great.”

The midwifes have played a crucial role in the product development process, helping the oasicare team identify issues early on and improve the device.

“We relied on their knowledge to get the balance right so that in the future we can give the product  to people who don’t have the same level of experience, but can still use it to prevent ruptures.

“The product is very easy to cut in, for example, so that midwives can adjust it easily.”

Currently, the team is not allowed to disclose any details about the efficacy of the product but a study, which is expected to conclude later this year, will establish how much the device could reduce ruptures.

“If all the studies go well and we get good data from the hospitals we work with we could see the product on the market in 2025,” says Fog Ibsen.

Her goal, however, is to launch the device outside Denmark where, she says, women desperately need it.

“In Denmark, I think, the midwives are doing a great job, but in other parts of the world the situation is very different. Women’s tears are not properly assessed, which means that despite having suffered serious tears they are being told that everything’s just fine.

“Our goal is to make the product available in countries like India, where a lot of women would benefit from it. It’s a simple device, but it can have such a big impact.”

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Could this app change the way we live and work?

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Imagine a tool that could help women align their daily schedules around their menstrual cycle – it exists thanks to two passionate tech entrepreneurs and start-up co-founders.

Elina Vale, chief executive officer and Rustam Galiev, chief product officer, are on a mission to dismantle society’s 24/7 work culture and replace it with an “evidence-based” approach where women can thrive – regardless of the menstrual phase they are in.

The concept, also known as cycle syncing, is a way by which women adapt their health and lifestyle habits to fit the four phases of their menstrual cycle, namely menstruation, the follicular phase, ovulation and the luteal phase. During these phases, it is thought, women experience changes in key hormone levels that can affect their mood, energy and productivity.

The idea isn’t new. In fact, the practice was introduced by nutritionist Alisa Vitti in her book WomanCode in 2014.

What is new, however, is the way Vale and Galiev adjusted the method to suit women’s needs in the workplace. The founders developed an employee benefits platform that claims to combine science, coaching and artificial intelligence to help female employees improve their productivity and performance by working with their menstrual cycle. 

The app, they say, combines a to-do list, habit tracker, period tracker and mindfulness app in one tool.

“The way women’s menstrual cycle works is very different from the common nine to five routine that we, as a society, tend to prioritise. That’s what we are challenging at Essence,” says Vale.

“We aim to provide women with a tool that allows them to think [of what they could do] based on the phases of their cycle and not just in the traditional work routine.

“We are looking at things such as the type of activity that you do, the intensity, your workload and what your needs are to balance your performance and wellbeing.”

While there aren’t many scientific studies to support cycle syncing, evidence does show that hormone fluctuations affect energy, mood, appetite and sleep.

Vale says there is some research on how each phase of the menstrual cycle affects the types of activities women do. “We know, for example, that in the follicular phase it’s better to start new projects and in the luteal phase it’s better to wrap them up.”

She also says there is evidence to suggest that cultivating an inclusive workplace and actively supporting employees could improve their wellbeing and unlock their full potential.

“An inclusive workplace has been shown to improve motivation and engagement. The problem is that currently, everything in the workplace is structured in a ‘gender neutral way’, which is, by default, very male-focused. From our research, we know that most women don’t know much about their menstrual cycle, so they don’t look at the month through the four phases of the cycle.

“However, we are trying to change this perception and help women think differently.”

The end goal, the founder says, is to make employers prioritise menstrual health in the workplace and take women’s needs seriously.

“Most companies have mental health and wellbeing programmes in place – we think menstrual wellbeing should be a part of that too.”

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