A doctor, an engineer and a businessman meet at Rambam

You've heard of start-ups, you've heard of bio-tech and Med-Tech, but Rambam Biodesign is no longer an accelerator or incubator of a medical startup.

Talia Levin

07/07/2022

Thursday, 07 July 2022, 15:53 ​​Updated: Friday, 08 July 2022, 09:29

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Dr. Yona Weissbruch (Photo: Courtesy of Rambam)

Biodesign is a program developed at Stanford University a little over twenty years ago.

"When you look at the startup world, and medical technologies and what technologies are advancing, you see that those who succeed are the ones bought by the big giants with the ability to distribute to hospitals and health systems," explains Dr. Jonah Weisbuch, director of the Biodesign program and senior ENT doctor At Rambam, who studied at Stanford and was trained in the biodesign program while there, he returned to Israel, established and manages the program in Israel.

"Over the years the experts have realized that the secret of success is start-ups that focus and start from the problem itself, and become experts in the same problem, they dress it with different technology and angles to solve the same problem and it also progresses business-wise. "Where can this technology be used if it is at all suitable, and in the end they do not always succeed."

Rambam-Biodesign uses a methodology developed at the prestigious Stanford University to crack the formula for the success of medical innovation ventures, and process the process efficiently in terms of time and decision making. Two engineers and two businessmen, with a significant emphasis on integrating women, brothers and sisters, and teams from the periphery, as well as young students alongside experienced experts, including students from Clover College of Design and Visual Communication who offered design solutions for various projects and developments.

"40 years ago, for example, no one thought about the end user, everyone thought only about technology and what it was supposed to do. The idea of ​​connecting doctors and engineers and business people from day one," says Dr. Weisbuch, "is to streamline operations and shorten time. .

We see that in the world of mid-tech and bio-tech, and medical devices sometimes take technological products more than a decade until they reach the market.

And it must be streamlined from day one. "

How is it done?

" The process is done from day one.

You have a niche that you have researched and you understand its need before you start thinking about a technological solution.

Then, into the prototype considerations you put business considerations, how I get to the market and who will use it.

Our goal at BioDesign is not only to produce a patent that I can sell but also to get it to the end, to the patient, and to do that you have to take into account who will pay for it, and who will use it and all these things are done from scratch, unlike what happens in startups where you Take an engineer or doctor with an invention and connect an engineer to it, and go into a kind of accelerator that sees that there is a chance to advance, form a company and then bring in a CEO only at the end. The engineers in Israel run towards the solution It's for the market. "

As mentioned, Dr. Weisbuch, with the support of Stanford and the cooperation of Rambam Hospital, founded the Israeli Biodesign, which is running for the second year.

"It is very suitable for Israelis, because unlike other places in the world, we do not have to teach a culture of risk-taking. But it is important to understand the global markets as well."

Recall that this is a national program that has the cooperation of the Technology Division of the Ministry of Health, with 8 teams completing the second cycle this year, which was very successful not only in cooperation with the Health hub of the Technology Division of the Ministry of Health, but also in the interest of medical institutions. Academia and industry.

Among the groups working on groundbreaking developments: a group that develops a special mask that will increase patients' responsiveness to the use of a home device to prevent sleep apnea, a group that finds a technological solution for early detection of delirium, the same state of confusion that many patients encounter and causes complications, morbidity and mortality and more.

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Tamir Israeli (center, without tag) and the "Back Pain" group (Photo: courtesy of Rambam)

The results are visible in the field

Lower back pain, for example, is a serious problem that affects about 600 million Americans each year, most of whom have no known source of pain.

"There are various treatments, most of which do not really work. Many use painkillers, sometimes to the point of addiction, and in severe cases offer a pacemaker implant solution to reduce pain. We are developing wearable technology that will disrupt the electrical signals of the central nervous system and prevent invasive surgery," says Tamir Israeli, a high-tech entrepreneur, 31 years old from Palmachim.

"I was looking for a solution to a personal medical problem and that's how I heard about Rambam Biodesign.

I applied and was accepted, "explains Israeli." Today there is a partial solution, a pacemaker that is inserted into the spine during surgery and aims to transmit electrical pulses, which disrupt the signal of pain.

We have developed a wearable prototype that will be attached to the back at the bottom and will operate on the electromagnetic fields, but from the outside. "

"If the investment is found for further development, we are several months away from cracking models for changing electrical signals and testing clinical feasibility. We are currently focusing on pain, but when we know how to produce the models for changing electrical signals, the technology can be adapted to a very wide range of health conditions. Electrical systems of the central nervous system, such as situations of sleep apnea, "notes Israeli, emphasizing that" the market size of pain treatments is estimated at about $ 79 billion as of 2021, and the potential for penetration even if it is 1% is huge because it is possible from the beginning. To reach a turnover of $ 400 million. "

Karin Brisker (second from the left, in black) and the "Joint Replacement" group (Photo: courtesy of Rambam)

Another group that is of interest is the group that deals with the prevention of reoperations for joint replacement.

"We are aiming for joint replacement in general, but we are starting with knee replacement surgery. Every year, about 600,000 knee replacement surgeries are performed in the United States.

In 10% of cases patients will develop severe infections that require reoperation.

Patients do not feel that an infection is developing until it is too late, and this is a difficult and common problem that currently has no solution, "says Karin Brisker, 29, from Herzliya, a data researcher (data scientist) from Microsoft and a member of Rambam-Biodesign.

"I really liked the methodology because we did not want to go straight to the solution. First we studied the problem, then we tested whether the technology we would need to develop would not require additional expenditure on existing surgery costs. We found a sensor with an internal sensor that will be implanted inside the implant and warn of the onset of infection at an early stage, where antibiotics can still be treated and in a way that will prevent re-implantation and much suffering from the surgeons.

"When an inflammatory development is detected, the sensor will send warning signals to an application that will be available to the doctor and patient, so that the patient can be quickly summoned for treatment before deterioration."

"We already have a primary prototype for a sensor to be mounted on the implant. We are already clinically testing the sensor's ability to detect the development of inflammatory processes and have already developed an application infrastructure that can pick up transmitters from the implant," said Shmuel Whitman, a sixth-year medical student at the Technion.

"Assuming you find the investment, we estimate that large-scale development could be used within a few years. Since the market size of US knee joint surgery alone is estimated at $ 6.5 billion, and due to population aging it is expected to grow by another 4.1% per year.

Of these our penetration potential is relatively high because there is full insurance coverage and the sensor should be inserted in the same procedure, without this significantly increasing the expense.

Even if at first there will be an intrusion of only 20% it is a turnover of $ 1.3 billion.

And that's even without calculating the joint replacement market in the US and around the world.

The solution to heat waves

Development of technologies in the field of gynecology FemTech is a hot field, but focuses mainly on the field of pregnancy and childbirth.

Menopause is neglected and lacks much knowledge in the field.

"We found that one of the problems not known to the general public is that the first signs of menopause begin about a decade before menopause. In the late 1930s and early 1940s. There is no public awareness, neither among women nor among doctors," says Inbar Gerbler, an entrepreneur in the field of innovation. Medical and group membership.

"Sometimes the consequences are severe. Early symptoms can be treated easily and effectively. But menopause is undiagnosed and therefore doctors interpret the symptoms as separate diseases and women receive medication for years without justification. "For sleep disorders, for depression sometimes for years."

According to her, menopause is not a point in time but a process that with the increase in life expectancy may continue for several decades.

"Today 700 million women are in menopause and by 2030 there will be more than a billion, 52% of them over the age of 40. Today the whole process of diagnosing menopause is completely subjective because there are no clear criteria for diagnosis. During learning the subject told us a patient her family doctor gave her estrogen For a year and a half without having any deficiency in this hormone, and because of the surplus she began to develop diseases. "

"The solution?" And the second development is a home test, "says Gerbler, adding that" nowadays there is a comprehensive hormonal test but it is done in a lab and it is a relatively expensive test and too few women are tested. We develop a relatively simple home test, such as saliva and urine Estimate the changes and volatility. "

Regarding the process of sprouting the venture, Gerbler says that "the shell of researchers, doctors and mentors from the industry who are full of knowledge in international markets and regulation of all kinds have greatly shortened and focused the thinking process. Technological solutions are suitable for the Israeli market, which does not necessarily fit the structure of the market in the United States, and it is discovered after years of development that no one will pay for it.

The second problem is that technologies in the medical world come from other worlds from the field of security and military.

We are trying to solve a problem that is not a problem and that no one is interested in solving. "

Gerbler notes that at Rambam-Biodesign for half a year they only learned about the problem from all its aspects, “We started developing the technology in a second phase.

There is no test today that replacements are something new, so our economic calculation was based on $ 120 per woman per year, on

42 million women aged 35-55.

Dr. Weissbach, one of the program's executives, notes that "everyone says medicine should be at home and that's the future, but in the end the world's biodiesen program participants are only brought to hospitals. We changed that, in Israel we are the only ones in the world. "In the community and at home. That's why the members of the groups come from all these worlds."

, Has joined another prominent group that has noticed an ambitious goal to develop a home test for early detection of lung cancer.

"Every year, 2 million cases of lung cancer are diagnosed worldwide, and this is the first cause of death. In Israel, about 2,500 new cases are diagnosed each year. Lung cancer lasts in Israel and around the world for an average of 3-6 months. "

It should be noted that for the first time in Israel, Rambam Hospital managed to shorten the diagnostic process to two weeks from the moment of the presence of a suspicious lung lesion until the start of treatment.

"Rapid diagnosis has significant implications for the patient's health, as a tumor that can be operated on is as close as possible to the initial symptoms, continues to grow during the months leading up to diagnosis, continues to spread and may make the surgical procedure irrelevant," says Dr. Yaniv Dotan, director The Rambam Lung Institute and mentor in the program, notes that Rambam seeks to be at the forefront of early diagnosis, rapid diagnosis and multidisciplinary treatment of lung cancer.

The group's goal was to find a solution for early diagnosis. " We have decided to develop a cheap, available, simple and effective home test that will be based on a saliva test.

Studies have found that there are biomarkers (markers) for the development of saliva cancer, but these are many thousands of markers.

We believe that it will be possible to reduce and pinpoint the biological markers that indicate the development of lung cancer, "says Dr. Ron Golan, a physician at Ziv Hospital in Safed and a specialist in biomedical engineering, and a member of the Rambam-Biodesign group, adding that" with a suitable investment within 3 In 4 years, it will be possible to develop a home test with an insurance indemnity along a route similar to other tests available on the market today.

There are 14 million Americans each year who are at risk for developing lung cancer, and the disease diagnosis market rolls in $ 850 million.

We believe in the first year we will sell home diagnostic kits for 1% and within 5 years for 20% of the 14 million in the risk group.

We believe we can enter a thirsty and desperate market for a solution that will save millions every year, and the group members intend to establish a company and continue to develop. "

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