Research: 'A very important tool for excellence in medicine'

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.

By ALAN ROSENBAUM
The Helmsley Health Discover Tower (photo credit: MOCHLY ELDAR ARCHITECTS)
The Helmsley Health Discover Tower
(photo credit: MOCHLY ELDAR ARCHITECTS)
‘Any 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 Mind-Up, 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.
This article was written in cooperation with Rambam Health Care Campus.