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Modernization efforts help Israeli health care provider extend legacy functionality

Digital transformation moves that Meuhedet made during the pandemic, such as moving some of its IT operations to the cloud, are still paying dividends.

Meuhedet is a health maintenance organization in Israel that provides medical services for 1.2 million patients. Pivoting an organization of its size typically isn’t easy, but that’s just what its IT department did during the height of the pandemic, and many of the moves it made during that time are still paying dividends.

Prior to the pandemic, the IT team at Meuhedet mainly played a support role. But when Chief Information Officer (CIO) Katy Bar-Shalom joined during the pandemic, she knew there was an opportunity for IT to be more impactful.

“We had a chance to change our skin and become very important in the ecosystem,” says Bar-Shalom. “We wanted to lead through tech and improve patient care in the process.”1

To do this, Bar-Shalom started a modernization effort that included eliminating a local database and moving more of Meuhedet’s IT operations to the cloud in order to centralize management and improve deployment and performance. One of the first projects Bar-Shalom and her team took on was building a remote patient-monitoring center to keep tabs on people with COVID-19. The goal of the project was to cut down on the number of face-to-face interactions and reduce the risk of spreading the disease. Initially, it used a spreadsheet to interface with Meuhedet’s legacy electronic medical record system built on a mainframe.

But the team quickly realized this solution couldn’t keep up with the pace of data needed for the project to run efficiently. So it moved to a more modern customer relationship management (CRM) tool that allowed care teams to see more frequent and better-organized patient updates. However, connecting the CRM tool to its legacy mainframe required significant work, which Alon Yaffe, chief technology officer and vice CIO at Meuhedet, described as the biggest challenge of the project.

“It made us change our thinking,” he says. “But this transition was like an opening shot. It showed us that we can do anything. We can now build processes that are clinical and standardized around the data and tools that we already had, and we can help our medical teams to better, more personalized care.”2

Now that the link between legacy systems and modern applications is built, Meuhedet is moving on to new use cases. The remote patient-monitoring center that was built primarily to support COVID-19 patients is now being repurposed for patients with chronic conditions such as chronic obstructive pulmonary disease and diabetes. Next, the team is working to develop a system that would automatically surface relevant information for doctors about the patient they are seeing. The goal is to be able to deliver this information in a one-page format without the doctor even having to know what they’re looking for.

Bar-Shalom said all of these applications are being intentionally built on top of the existing legacy mainframe because it is good at what it does, which is bulk processing of data. It may lack the bells and whistles of more modern interfaces, but now that the team has built the interface layer, it’s able to add more advanced features such as patient tracking and analytics.

“The vision is not to move on from legacy systems—because they work,” she says. “The things they do are good, just not good enough. But with layers, web services, and applications, we can enlarge and bring new data and insights to our medical staff.”


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  1. Katy Bar-Shalom (chief information officer, Meuhedet), interview, July 7, 2022.

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  2. Alon Yaffe (chief technology officer and vice chief information officer, Meuhedet), interview, July 7, 2022.

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Cover image by: Natalie Pfaff and Jim Slatton

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