On October 8, 2023, just a day after Hamas invaded Israel’s south on a killing and kidnapping spree that left thousands dead and injured, it was already apparent to staff at Tel Aviv’s Sheba Medical Center that the country urgently needed new medical innovations to handle the crisis.

Most of the injured coming in to hospitals across Israel had suffered limb injuries or psychological trauma, most were young, and there just weren’t enough experts in either field to deal with the overwhelming numbers of people hurt in this sudden emergency.

That knowledge set off a chain of events that has led in the last year and a half to an eruption of new health technologies in Israel designed to deal with anything from emergency blood transfusions in the field, to apps for physical rehab, to AI for trauma diagnosis.

“This crisis created a drive for innovation. It pushed us to work harder and faster. It’s a tiny silver lining in what is a very difficult and painful situation,” says Avner Halperin, CEO of Sheba Impact, the commercialization and entrepreneurship arm of Sheba, who will be moderating a session on “War-Time Innovation, Peace-Time Solutions” at the upcoming Biomed Israel conference on May 20-22 in Tel Aviv.

Since that early understanding, the need for this type of innovation has only grown dramatically. In March this year, the Israel Defense Ministry announced that over 16,000 soldiers had been wounded in the war. That doesn’t include civilian injuries.

Sheba alone has treated around 2,116 soldiers and civilians. Shortly after the start of the war it more than doubled the size of its rehab capacity with a new rehab center for war casualties.

October 7 catalyzed entrepreneurs

October 7 was a profound blow to Israel as a nation, from every perspective. 

But in what is now recognized as a typically Israeli startup response, failure and crisis have also been the catalyst for growth, not just in military defense technologies, which certainly saw massive development during the war, but also in medical technologies.

“On October 8, it was already clear to us that the biggest challenge we’re going to be facing is around physical and mental rehabilitation,” says Halperin. “So many of the people coming in to the hospital had significant injuries like mutilated or missing limbs. 

“We didn’t have enough caregivers in the field. And many of the injuries were in young people who were very motivated in their rehab needs. They told us they were not happy with one or two hours a day, but wanted to work all day long on their rehabilitation.” 

Within about a week, Sheba had already issued a call for collaboration with startups that could come up with technological solutions or adapt existing ones that could accelerate or create more effective rehab. 

Eighty-five startups responded, and Sheba began work immediately supporting the most promising of these.

“It was very deliberate and it was a focused and structured process that began right from the start of the war, something that hasn’t happened before in Israel or elsewhere around the world,” says Halperin, who began his career as CEO of medical devices company EarlySense and joined Sheba three years ago. 

By December that year, Sheba had partnered to help found the Sderot Resilience Incubator, near the Gaza border, to develop further rehab technologies. 

A quick pivot

Halperin believes that what gives Israeli companies an advantage worldwide is how quickly they can pivot. After October 7, many companies did just that. 

“Israel is very efficient in its innovation response, and has the ability to turn on a dime,” he explains. “It got even better and faster after the attack.”

One example is Kemtai. The startup was founded to offer users a personal trainer at home, but in the wake of October 7,  made a quick pivot to create an app for physical rehab. 

The original app analyzed a user’s moves and gave feedback. The rehab solution now does an AI analysis of your movement and tells you what you need to improve. “It’s pretty neat software,” says Halperin. 

In another case, two jogging partners– a clinician at Sheba and a professor at Tel Aviv University –were already collaborating on a technology to restore touch sensation in patients, but when the war broke out, they accelerated their work. 

Their company, Tengable, has developed a self-powered triboelectric nano generator (Teng) which is implanted under the skin and connects to the nearest healthy sensory nerve to stimulate it to restore touch sensation in the patient.

“This is the bioconvergence of the future, putting a sensor into the body and connecting it to the neurons so that people can regain their sense of touch,” says Halperin.

The technology is still early stage, admits Halperin, but adds that results are promising. 

Unexpected partnerships

At the same time, the crisis sparked unusual collaborations and partnerships. Software company Microsoft and the AI R&D team of accounting giant KPMG, teamed with Sheba clinicians to create Mentaily, an AI diagnostics system that uses natural language to diagnose psychiatric or psychological issues. 

“This is helping us overcome the number one challenge in post trauma, which is identifying out of the close to one million people in Israel now at risk of post-trauma, the 10% who require professional intervention,” says Halperin.

“Ninety percent of people exposed to traumatic events will overcome the trauma on their own or with the support of friends and family, but 10% require professional intervention. The challenge is to find them quickly.”

Usually, says Halperin, the intake process by a mental-health professional can take several hours. Using AI significantly reduces that time, which is critically important when you have a shortage. “The same number of clinicians can give care to more people and identify the ones who need it the most.” 

The solution is now in advanced testing with the Israel Ministry of Defense and other organizations in Israel.

“Working with Microsoft as a strong external partner accelerated the process 10 times. What would have taken us five years, we managed in a year,” says Halperin.

Needs in the field

Sometimes new technologies are a direct result of acute medical needs on the battlefield. 

While serving as army physicians early in the Gaza war, two doctors from Sheba and Tel Aviv Sourasky Medical Center identified a need to significantly improve the effectiveness of blood transfusions in the field. Their innovation, which is still in early stages, is called Core-Blood. Sheba is now forming a startup to support the new technology.

Or there’s Rescue Heat, founded by a senior physician at Rambam Health Care Campus in Haifa, and two reservists, who understood that the biggest threat with wounds on the battlefield is hypothermia, and existing treatments are just not good enough.

The company is developing a thermal patch that can keep a wounded person warm for four hours at a steady 42 degrees Celsius. Before the war, the patch was just an idea. The war was the push to turn it into a product.

The patent-pending patch is awaiting US Food and Drug Administration approval, but has already been used in combat zones in Gaza and Lebanon. 

Among the many other companies developing new products post October 7: MyMove, which treats phantom pains after limb loss; NexoBrid, which has developed a burn treatment from pineapples; Cognishine, which supports therapists in providing effective care for cognitive, emotional, speech and language disorders; and MindTension, which focuses on measuring responses to various stress situations. 

Covid was a trigger

Halperin believes that Israel’s unique innovation response to the current war comes partly because of the groundwork laid already during the 2020-2022 Covid pandemic.  

“That’s where we first saw this kind of structured approach to medical innovation,” he explains. “The key crisis then was ventilators, sensors and diagnostic solutions, and Israeli startups were quick to adapt existing technologies to fill the gaps.  The war is a very different healthcare crisis, but the concept is the same.”

It was also because of Covid, he believes, that there was such a drastic shortfall in mental-health professionals when war broke out. “Like many nations around the world, Israel still has not managed to overcome the burden on professional mental care created during Covid,” he admits.

Innovations will help the world

As with many innovations developed in response to conflict, the end result is that the civilian market also benefits. “Every technology that we talk about is not just valuable for war injuries, but has long-term civilian applications,” says Halperin. 

“How blood is given to a wounded person is something that we are absolutely sure will be relevant for emergency care,” he explains. “The work we do on physical rehab is very relevant for aging populations. The AI product designed for psychiatric diagnostics is going to be relevant for the whole mental-health crisis globally.”

He also adds that Tengable hopes to develop an application to help women who have had breast cancer and undergone a mastectomy or other type of breast surgery regain their sense of touch. 

“It’s not just about treating loss of limbs; there are other applications beyond trauma care,” he says.  

Biomed Israel

Halperin will be speaking on the first day of the life-science and health-tech conference, which takes place every May. 

This year, Biomed Israel’s 22^nd consecutive year, 150 startup companies will take part in the three-day conference, which usually attracts senior executives, researchers and investors from across the world. 

Other session topics this year include cancer therapeutics, hospital at home, breakthroughs in AI and drug discovery, healthier aging, and women’s health.