Table 1 Big Data: Israel’s strengths and weaknesses

Strengths

 1. Strong high tech industry; out-of-box thinking

 2. Expertise in natural language systems

 3. Health plan databases

  a. All Israeli residents are members of a health plan

  b. Large number of members in each plan

  c. Unique patient IDs

  d. Diverse population

  e. The rate of transferring among plans is very low

  f. Health plans have many years of longitudinal data

  g. All primary care physicians and most other providers have electronic health records

  h. Health plans integrate high quality data from a large number of providers (including direct care professionals, labs, pharmacies, etc.) and do so almost in real time

  i. Growing national HIE system, integrating all health plans and all hospitals

 4. Health plans know how to use their databases for care improvement

 5. Health plans have a strong motivation to make care more efficient

 6. Limited number of health care system actors and less fragmentation; makes coordination easier

Weaknesses

 1. Storage and computational capacity in the health plans is large, but not as large as in Google, IBM, etc.

 2. Lack of guidelines on what health data may be put on the cloud

 3. Relative long negotiation times for high tech-health plan collaborations

 4. Lack of clarity regarding who owns the data

 5. Shortage of funds for evaluation studies

 6. Not getting enough input from patients on the Big Data initiatives

 7. Professionals and organizations who are very protective of their data

 8. Insufficient awareness of the potential of Big Data to improve care and make it more efficient

 9. Health plans viewing their data as an asset to be monetized

 10. Health plan data systems very focused on clinical data; only now beginning to pull in data on patient experience, patient preferences and patient-reported outcomes

 11. Slow-moving IRB processes