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.