We were packed and on the bus early today for our 8:00 AM appointment with the chief medical officer at the 669th Airborne Division of the Israeli Air Force housed at Tel Nof Air Base located about a half hour south of Tel Aviv. We were not permitted to take photographs while on the base and while the CMO was giving his presentation, there were two intelligence officers present to make sure he did not say anything against the rules. We were given a very thorough briefing of the activities of the 669th including a lengthy discussion of the role they played in the immediate aftermath of the Haiti earthquake in 2010 when the physicians and medics were sent to Port au Prince to establish a field hospital that treated hundreds of victims during the time they were in country. We were shown their search and rescue gear and got to see their training hanger where they can simulate virtually any environmental condition to allow their paramedics to practice their skills at rescue and patient evaluation.
Once we were escorted out of Tel Nof, we drove back to Tel Aviv where we bid farewell to our guide, Nathan. He was wonderful and was an absolute treasure trove of insights and information. We headed for lunch at a wonderful seafood restaurant in Old Jaffa named, Old Man and the Sea (note the Ernest Hemingway allusion). Small plate after small plate of Mediterranean inspired salads and wonderful pita bread followed by your choice of whole fish that was likely swimming nearby not long before. Simply seasoned and grilled, the only hassle was that you had to work around the bones.
Once lunch was done, we went to headquarters of Maccabi Healthcare System in Tel Aviv where we were met by Dr. Rachelle Kay, Deputy Director of the Division of Finance and Planning and Director of the Maccabi Institute for Health Services Research. Maccabi is the second largest HMO in Israel with 1.9 million members and 5,000 employed physicians. They have contracts with every public hospital in Israel and owns Assuta Medical Centers. Last year, Maccabi rolled out a comprehensive electronic health record connecting every one of their physicians to their hospitals. This EHR allows every physician access to a dashboard looking at multiple quality indicators. Data is pulled from a data warehouse that contains comprehensive clinical information for each and every Maccabi patient. We were joined by a number of other key Maccabi staff members who shared with us the work they were doing in medical informatics, telemedicine and quality management. The only comparable non-federal US health care organization doing similar work is Kaiser-Permenante. I was very impressed with their dedication to using data to make good clinical and administrative decisions. Dr. Kaye did acknowledge that for the first time Maccabi was running a deficit and this was an important focus for the organization.
Just as the lights for the second night of Hanukkah were being lit, we got back on the bus for the long drive back to Jerusalem. It was comforting to get back to Jerusalem where we knew our way around. It was a bit like coming home.