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Doron Netzer

Clalit Health Services, Israel

Presentation Title:

CPi - Clalit proactive and preventative intervention. Artificial intelligence & decision support system at the point of care

Abstract

Clalit is the largest HMO in Israel that insures more than 4.7 million people and the second HMO worldwide after Kisser in USA. CPi - Clalit Proactive and Preventative Intervention, is the flag project innovation of clalit community division, in collaboration with clalit research institute and clalit digital division. This innovation combines big data, medical databases, artificial intelligence and a complex computer algorithm, which guides the doctor during the visit, to provide evidence-based personalized knowledge.

We used the current guidelines from the American Diabetes Association and converted those guidelines to the Israeli basket aiming to give the right medication to the right patient considering the patient morbidity as; Atherosclerotic disease, Heart Failure, and Chronic Kidney Disease. Expert committees create an ideal "clinical pathway" for each clinical condition and so, patients “travel” through these pathways every single day and gather their personalized recommendations. CPI can advise to add another diabetic medication for the patient, while taking into account his cardiac, kidney and liver functions. Detailed Explanation is available for each recommendation from Dynamed (wwwdynamed.com) This is already happening nowadays, more than 1500 physicians, half of the primary care physician at Clalit use this platform.

No more, surrogate outcomes but rather pure major events outcome. The vision - Patients will receive a proactive and preventive care suitable to their current condition based on the most updated clinical guidelines in an attempt to reduce the gaps in good clinical practice and combined them together to a pure handy knowledge for the primary care physician. The former name of the project was POEMS -Patient oriented evidence that matters meaning we treat our patients in order to improve their morbidity and to reduce their mortality. For example, Diabetes is a major issue at the primary care clinic. When I started to practice medicine there were 3-treatment option: Sulphonyls urea Metformin and Insulin. Unfortunately, nowadays there are more than 60 drugs on the shelf, each one of them with pros and cons, and as the one responsible for the evidence-based care, it is hard and almost impossible to remember the names, the inclusion criteria and the adverse effect of each drug concerning the patient history.

In 7 years the WHO is aiming to declare the world as free from hepatitis C. In March 2023 we added, hepatitis C as a major issue at CPi. We developed strict algorithm by Artificial Intelligence according to patient's risk factors. The patients are sent to Antibody Blood test (AB for Hepatitis C). People with positive AB will automatically pass PCR test, those that are positive will be presented to the physician at the CPI screen, guiding him to prescribe one out of the two anti-viral treatment for hepatitis C while checking beyond the screen the cross reaction between the patient chronic medications and the new viral medication against Hepatitis C .

By June 2024 we are going to launch our last version of Obesity treatment according to the latest evidence as the same manner as diabetes. Couple of months later we will launch the CPI model for primary CVD treatment according to the evidence based guidelines supported by remote monitoring at the patient own and comfort environment using blood pressure gauge and glucose sensors that can broadcast the output directly to the patient record and CPi. CPi is a breakthrough platform for Clinicians. Our routine quote for the busy physician is that three clicks for an answer are two clicks too much.

Biography

Doron Netzer Specialist in family medicine, in his current position head of the community medical services division at Clalit. Trust for cross-organizational medical policy based on evidence-based medicine. Chairman of the Medical services basket Committee at Clalit and the founders of the hospital at home for general inpatient care. Formerly deputy director of Meir Hospital at Kfar Saba Israel. Developer and chief researcher of the flagship project of Clalit health services: CPi-clalit proactive and preventetive intervention, a project that combines personalized medicine, medical databases, artificial intelligence and a complex computer algorithm, which guides the doctor during a visit, to provide evidence-based appropriate treatment. Chief researcher, in groundbreaking articles about the corona virus, which were published in leading journals worldwide; Nejm, Lancet Id, Nature Medicine, Nature Communication & Rheumatology and led global decisions in the treatment of the corona epidemic.