RE­SEARCH AT RAM­BAM MED­I­CAL CEN­TER ‘A

The Jerusalem Post - The Jerusalem Post Magazine - - REFLECTION­S - • ALAN ROSEN­BAUM

ny physi­cian who is en­gaged in re­search does not ac­cept things as they are,” says Prof. Ye­huda Chow­ers, di­rec­tor of both the Di­vi­sion of Re­search at Ram­bam Health Care Cam­pus in Haifa, and the hos­pi­tal’s Gas­troen­terol­ogy In­sti­tute. “Re­search is a very cen­tral theme in the life of an aca­demic, cut­ting-edge hos­pi­tal,”

As the largest aca­demic hos­pi­tal in the North, Ram­bam ac­tively en­cour­ages re­search col­lab­o­ra­tion at all lev­els. “First and fore­most,” ex­plains Prof. Chow­ers, “re­search is a very im­por­tant tool for ex­cel­lence in medicine. Hospi­tals are not only known for the care that they give the pa­tient, but for their abil­ity to de­velop new in­sights and path­ways into pa­tient care.”

Re­search at Ram­bam is pa­tient-ori­ented. To that end, Pro­fes­sor Chow­ers notes that all of the prin­ci­pal in­ves­ti­ga­tors in its clin­i­cal re­search in­sti­tute are physi­cians. “When you look at lead­ing re­search,” he says, “the peo­ple who de­ter­mine the re­search area are all physi­cians. The peo­ple who for­mu­late the ques­tions and lead the di­rec­tion are the med­i­cal staff.”

At Ram­bam, all the dif­fer­ent com­po­nents of the hos­pi­tal’s re­search and in­no­va­tion units in­ter­act with each other and ap­pear in the hos­pi­tal lit­er­a­ture in the shape of a hub. Ev­ery­thing is in­ter­re­lated and con­nected, from re­gen­er­a­tive stem cell ther­apy to cannabis re­search, from big data to bio-bank­ing.

Prof. Chow­ers pro­vides some real-life ex­am­ples of how prac­ti­cal re­search is per­formed at Ram­bam. “Cannabis, for ex­am­ple, is hyped in the mar­ket to­day,” he notes, “but we are much more in­ter­ested in the med­i­cal side. We de­cided to unite all the en­ti­ties in the hos­pi­tal that per­form clin­i­cal stud­ies in cannabis.”

To that end, Ram­bam cre­ated a lab­o­ra­tory that is ded­i­cated to cannabis re­search. In the lab, cannabis is frac­tion­ated, and sep­a­rated into spe­cific com­po­nents and ac­tive in­gre­di­ents in or­der to to find novel phar­ma­ceu­ti­cal com­po­si­tions based on cannabis plants to treat pa­tients with dif­fer­ent dis­eases. Cannabis is used to treat pain, can­cer and in­flam­ma­tory bowel dis­eases symp­toms, and child epilepsy. “In­stead of hav­ing each de­part­ment con­duct­ing its own re­search, we have a co­or­di­nated in­tra-hos­pi­tal body. We can of­fer a unique op­por­tu­nity to de­velop cannabis-plant and re­lated prod­ucts both from clin­i­cal side the ba­sic sci­ence sides.”

In the area of can­cer pre­ven­tion, headed by Dr. El­iz­a­beth Half, the hos­pi­tal ini­ti­ated a mul­ti­dis­ci­plinary clinic for can­cer pre­ven­tion and early de­tec­tion that to­gether with the Ram­bam Re­search In­sti­tute is en­gaged in de­vel­op­ment of new tools for early de­tec­tion of can­cer. She ex­plains, “Un­der the lead­er­ship of Prof. Irit Ben Aharon, head of the On­col­ogy Di­vi­sion, we have a spe­cial pro­gram for young peo­ple with can­cer and we are work­ing with Dr. Naama Geva Za­torsky from Haifa’s Tech­nion[-Is­rael In­sti­tute of Tech­nol­ogy] to de­ter­mine the char­ac­ter­is­tics of mi­cro­biomes to try and screen for these young on­set can­cers.”

Prof. Chow­ers adds that re­searchers from Ram­bam’s Gas­troen­terol­ogy De­part­ment and Prof. Shai Shen-Orr’s lab­o­ra­tory at the Tech­nion are us­ing clin­i­cal data on bi­o­log­i­cal drugs com­bined with bi­o­log­i­cal “big data” and ad­vanced ma­chine learn­ing to study pa­tients’ im­mune sys­tems, in or­der to per­son­al­ize pa­tient care and se­lect the right drug for the right pa­tient at the right point in time.

An­other ex­cit­ing area of re­search at Ram­bam is the In­no­va­tion Lab, which is part of Ram­bam Medtech, the tech­nol­ogy trans­fer of­fice for Ram­bam, which works as the hos­pi­tal’s in­dus­trial li­ai­son to bring med­i­cal in­no­va­tions to mar­ket. The In­no­va­tion Lab,

headed by Dr. Yair Feld, an in­ter­ven­tion car­di­ol­o­gist, de­signs de­vel­op­ment of new med­i­cal de­vices and has the lat­est equip­ment, in­clud­ing 3D print­ers to sup­port de­vel­op­ment of the next gen­er­a­tion of med­i­cal de­vices. Ram­bam is also a part­ner in MindUp, Haifa’s Dig­i­tal Health In­cu­ba­tor.

Ram­bam of­fers a full com­ple­ment of in­ter­nal re­search pro­grams de­signed to en­cour­age res­i­dents, young physi­cians, nurses and other med­i­cal staff to be­come in­volved in re­search and in­no­va­tion, in­clud­ing the Lead­ers (Atidim, ba­sic sci­ence) and Malkam (clin­i­cal tri­als) pro­gram for promis­ing med­i­cal res­i­dents; the Hori­zons (Ofakim) pro­gram for young, yet more se­nior clin­i­cians; the Op­ti­mum (Me­tav) pro­gram for clin­i­cal lab­o­ra­tory re­searchers; the Guardian (Maof) nurs­ing pro­gram to en­cour­age ex­cel­lence in clin­i­cal care; the Ofek pro­gram for paramed­i­cal staff in­no­va­tion; and the Spark (Ni­totz) pro­gram to nur­ture promis­ing in­no­va­tions into suc­cess­ful prod­ucts.

“In­no­va­tion is com­ing in all ar­eas of med­i­cal de­vel­op­ment,” says Prof. Chow­ers, “from trans­port­ing pa­tients to wash­ing pa­tients, to set­ting up IV lines.” Ram­bam’s cus­tom-de­signed med­i­cal record sys­tem is also geared to­wards re­search and is spe­cially de­signed to record med­i­cal ac­tiv­i­ties of pa­tients from nu­mer­ous per­spec­tives. Wear­ing his hat as head of the Gas­troen­terol­ogy De­part­ment, he ex­plains that for ex­am­ple, three dif­fer­ent vari­ants of med­i­cal records ex­ist for gas­troen­terol­ogy pa­tients, en­abling bet­ter clin­i­cal track­ing and treat­ment. The hos­pi­tal heads can check the sta­tus of ev­ery pa­tient and track costs ac­cu­rately. “This de­vel­op­ment, which is very unique to Ram­bam, al­lows us to have very high-qual­ity data from hos­pi­tal­ized pa­tients. The data is very deep and very de­tailed.”

Ram­bam is also mak­ing ex­ten­sive use of ‘big data’ in in­te­grat­ing in­for­ma­tion from imag­ing data, vi­su­al­ized data and other pa­tient in­for­ma­tion. “We have ex­ten­sive col­lab­o­ra­tion with com­pu­ta­tional sci­en­tists at the Tech­nion and the Univer­sity of Haifa,” says Prof. Chow­ers, “as well as with those in the hos­pi­tal.”

One of the most sin­gu­lar ar­eas of re­search and de­vel­op­ment in the hos­pi­tal is the Helmsley Health Dis­cov­ery Tower, a 20-story build­ing, which will in­te­grate medicine, academia and in­dus­try. Es­tab­lished through a ma­jor do­na­tion from the Helmsley Foun­da­tion, and part­nered with the Univer­sity of Haifa and the Tech­nion, the Dis­cov­ery Tower will be a hub to fos­ter novel ideas for the trans­for­ma­tion of health care at the lo­cal, na­tional and global lev­els. “We have a deep work­ing re­la­tion­ship with the Tech­nion and the Univer­sity of Haifa,” says Prof. Chow­ers, “and the Helmsley Tower will in­clude all three in­sti­tu­tions. We see them as very im­por­tant col­lab­o­ra­tors with the hos­pi­tal.”

As one of Is­rael’s top med­i­cal cen­ters, Ram­bam works with other in­sti­tu­tions around the world in med­i­cal re­search. “We have col­lab­o­ra­tions with Memo­rial Sloan Ket­ter­ing Can­cer Cen­ter and work in close col­lab­o­ra­tion with Stan­ford Univer­sity School of Medicine in Palo Alto, Cal­i­for­nia,” notes Prof. Chow­ers. Stan­ford’s dean has vis­ited Ram­bam sev­eral times, and Ram­bam staff have vis­ited the Stan­ford cam­pus as well. “We are es­tab­lish­ing dif­fer­ent types of col­lab­o­ra­tion with them,” he says. “In­sti­tu­tions like Stan­ford and Har­vard, which are fa­mous for their re­search, are mod­els for what is go­ing on at Ram­bam.”

The list of re­search in­no­va­tions at Ram­bam ex­tends into nu­mer­ous ar­eas, in­clud­ing stem cell re­search in car­di­ol­ogy, bone re­gen­er­a­tion, wound heal­ing and many other dis­ci­plines. “Re­search teaches you that there is al­ways some­thing un­der the sur­face,” says Prof. Chow­ers. At Ram­bam, doc­tors and re­searchers will con­tinue to look for that ‘some­thing,’ to en­sure bet­ter pa­tient care.

(Mochly El­dar Ar­chi­tects)

THE HELMSLEY Health Dis­cover Tower.

(Miki Koren, Gal Ko­ran)

RE­SEARCH AT Ram­bam Health Care Cam­pus.

(Pioter Fliter)

PROF. YE­HUDA CHOW­ERS, di­rec­tor of the Di­vi­sion of Re­search at Ram­bam Health Care Cam­pus.

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