01:15 What are the most memorable milestones that brought you to where you are today?

02:58 What is the driving force behind your passion for Health Technology?

05:43 What made you the jump into co-founding a startup?

07:14 What is the difference between being an intrapreneur that innovates within an organization, and an entrepreneur?

09:06 What was the value you found in collaborating with startups in your work at the Morris Kahn and Maccabi Research & Innovation Institute?

15:03 Let's talk about Alike Health, what does Alike do?

20:27 Obviously the US market is very interesting, why aren’t you creating a product for the German market?

22:15 Doesn't the scoring system create more anxiety with the patient? Will the patients know how to act upon it when there is no 100% certainty?

24:27 Do you give patients the option to call a live person and discuss or get clarifications on the report? 

26:12  What is the business model for your company?

28:35  You raised your seed round from a single investor – Pitango. Do you think raising a seed fund from one VC investor is advantageous?

29:33 How has the Israeli Health Technology ecosystem evolved over the decades?  

36:27 Where are we going with health? What is going to be the next revolution that we're going to see?

40:04 How is Alike.health closing the loop on data?

41:45 What advice would you give to someone who wants to do what you are doing?

46:15 If you could go back to your 16-year-old self, what would you tell her?

47:13 Why do you think there are less Women entrepreneurs and what needs to be done in order to change it? 

Gali: If we had to read out to your titles, we may need another podcast episode. You're an MD. You're a director of a leading Research and Innovation Institute. You're a professor of medicine. You're a board member. You're a digital health startup, co-founder. You've done so many things in your career. What are the most memorable milestones that brought you to where you are today?

Varda Shalev: So, first I'm a physician; I'm a practicing family physician. And I get all my energy I think, starting from the clinic, so I have a clinic with a partner for 25 years. It's in Rosh Haayin, and we have the same patients for 25 years, most of them. So, its longitudinally health, it's comprehensive health. And I think it gave me a lot of power to understand the problem of the system, the problems of the patients and how can we help them more. So that's a start.  I understood also, that being only in the clinic won't be enough for me. And that's why I went to do my postdoc in medical informatics back then, in 1998 at Johns Hopkins, where digital health wasn't something that anybody talked about. So, when I said I was going to do a medical informatics, nobody understood "Why?" and "What is it? Medical what?" And why did you go to do it in the US, and if you are a clinician do something clinically. And I think the power of medicine and computer is really high and I understood that we won't be able to manage medicine without computers. So, the combination of medicine and computer, that's where I found my place exactly.

Chen: So, where did your passion with HealthTech technology or health technology come from? I mean, what is the driving force behind it?

Varda Shalev: It's really interesting that you ask that. When I assigned to medical school, I was actually a medic in the army. And before then, I was sure that I was going to study computers and mathematics. So, when I applied to the university, I was in the army. I said, 'Okay, first, I'll write computer, mathematics and second, medicine'. And my mom called me and told me, 'They called me from the university and they said that medicine you should write first. So, I wrote it first.  And when I got to be interviewed for med school, they asked me, 'What would you do if you want to be accepted to med school?' I said, 'I don't have any problem. I'll go to computers.' So, they asked me, 'What's the connection between computer and medicine?' It was 1979. So, I told them, 'What is a physician? It's like a computer; you invest in the computer and then it gets you all the answers.'  So, I think when I finished med school, finally, I went back to my passion to computers and I combined them both. And I saw that it was very powerful. You can do a lot more while combining medicine and computers. When I started, I was very interested in computers, but with time understood that most of the power is the data, not only the computers. And another thing that if you can use data for decision support for physicians, you can also use it for decision support for patients. So that's the envelope of the story.

Gali: I think it's super unique to have somebody whose passion is computers, and they go and study medicine. I haven't met many of those.

Varda Shalev: Today you see more, but back then it was really unique and people usually couldn't understand why. And I think maybe I didn't understand either.

Gali: Well, now that you've co-founded a digital health startup. Can you tell us a little bit about what brought you to jump from being within the system? What brought you to jump in and decide that you wanted to co-found a startup?

Varda Shalev: So, I understood over the years that I like to found things a lot more than to manage things. So, I founded the first medical informatics department in Israel; in Maccabi. And I was in charge of electronic patient record; patient portal, physician portals, all engines. Everything that you see today as a standard, we were the first to found it. So, founding; it was very strong with me.  Then I founded the big Data and Innovation Center in Maccabi. Again, I said to myself, 'I don't want to ...' I was the head of the primary care in Maccabi. I was in charge of all the family physicians, nurses, physiotherapists, etc. And I said, 'Okay, I want to found something' and I founded it. When I was in charge of it about 6 years, I understood that now I'm an enabler; another company will come, we'll do another research, I want to found something else.  And I want to found it out of the system, not within the system, because I was very involved within Maccabi already. And I want to do it for patients. So, I want to do something really different. That's what I did.

Chen: So, what is the difference between being an intrapreneur, an entrepreneur that works within an organization, and an entrepreneur, a person who starts stuff for him or herself?

Varda Shalev: So, that's exactly what they research now. I was enabler of many companies and I sat in a few boards, in many advisory boards, but it's completely different than co-founding it with somebody. So first, you have to have good partners. So, I found two good partners, Amnon Bar-Lev and Ohad Zadok; they come from different domains.  And you can say that the 3 of us is a lot to have, it's like, 'How do you make it work?' I can say that within Maccabi, the big data research and innovation was also something that is almost like a startup, but it's a startup within a big organization. So, I did my first step in my former role and now I see that it's still different, because you don't have Maccabi in your back. And I like it, I like challenges a lot more than anything.

Gali: So, I want to ask you before we jump to talk about Alike and what you're doing there. I do want to ask you about the research center, and the collaboration with startups for discovery, for innovation. I think, was Medial EarlySign the first collaboration that you did there, was that kind of the that beginning of how to change with innovation? Can you tell us a little bit about that process and what you learned from that?  I work at Accenture; I think you know that and what we say all the time is collaboration has so much value. And taking a startup and innovation and collaborating with a larger organization. That's where the value is. Do you feel that way? And was that part of why you decided to collaborate with startups?

Varda Shalev: Of course, there is nothing more than collaboration. But it started again from the clinic. So, I had this patient that came to me with advanced colon cancer and it's always a failure of the system. And I asked myself, 'How come I haven't diagnosed him before?' I started asking him, 'Did you have any complaints?', blood in stool, abdominal pain, everything was negative.  And then I went to look at his lab test. And I saw that his hemoglobin level is still okay. It's within the norm, but it's deteriorating within the norms for 3 years. And I was very upset because I stopped myself, 'Maybe I could diagnose in the year before; two years before.' So, I went to see in Maccabi, how many patients we have with colon cancer that the hemoglobin level is deteriorating and I saw that most of them was the same.  And I asked myself, 'Okay now, how do I make a tool out of it?', because I published it. I'm a professor at Tel Aviv University; I teach medical informatics and big data. And I do a lot of epidemiology. So, I published it as a descriptive work, but it's not enough. You want to prevent the next thing. And I started to think, 'how do I make an algorithm?' and you know it was 10 years ago; nobody spoke about algorithms.  And I was sitting between my selves, my role thinking, what should I do? Should I take more than one hemoglobin level decrease? Is it two exams that are decreasing? Is it two standard deviation? What should I do? And then a few scientists from Medial (EarlySign), Ori Geva and Nir Kalkstein, came to my office and told me, 'We are doing a lot with algorithms in finance', you know, algo-trading, 'but we want to do something good for society. Can you help us? Do you have an idea?'  I said, 'Okay, first, I have a lot of ideas because I'm a clinician and I always see the problems that we have as clinicians to take all the data and to implement it on patients.

But here, currently, we have a problem.' And we started having meetings near my house in Ra'anana, every Wednesday afternoon in a coffee shop, thinking about how can we make an algorithm. And we got to this algorithm saying that if you take CBC, complete blood count which is the most common blood test, age and gender, you can predict colon cancer. And then we'll be able to implement it within the system.  And whenever somebody's doing CBC will alert a high likelihood ratio, that you will have colon cancer. And while working with a Nir and Ori in the group, I learned so much that I couldn't get from my physicians. I'm from a family of physicians; my husband is a physician, my two daughters, my son-in-law. I have a lot of physicians in the family. And of course, we have a lot of friends that are physicians, but working with other domains is very fruitful.  And finally, we implemented it in Maccabi.

We found more than 100 patients with colon cancer that wouldn't have been diagnosed without it. And we had a lot of hours of thinking together and enriching each other from different domains. And back then I was in medical informatics, and then the head of primary care. But then I started thinking that I should found a big data and Innovation Center and work with startups and collaborate with people that are different from me. And that's what I did.  And I think it was a win-win from every dimension. And now he tells me, of course, when I founded my startup. But also, in Maccabi, we started collaborating with everybody; we understood. I understood that we have a lot of data but sometimes we make mistakes. Because we say, 'Aah, data is the new oil. We have a lot of data, let's keep the data.' That's a mistake. You have a lot of data; think how you can collaborate with the data. Don't keep it. If you keep it, it's a waste, nobody will gain from it. That's a mistake that they find is very common.

Chen: Yeah, there's a lot of data. The question is, what you do with it afterwards. And that's the magic.

Varda Shalev: Exactly and many times people talk about privacy, I can't let you use the data because of privacy. But they always say that behind the word privacy, there is a lot of laziness and ego; a lot more than privacy. Because with privacy, we have many ways to manage privacy and security. You need the goodwill and you need to understand that the real subject is the patient. That's why I can tell you that working in the clinic twice a week, reminds me every time that the patient is the issue. It's not me, it's not Maccabi, it's not my startup, it's the patient. He generates the data and we have to give him back the insights that can help him a lot more than today.

Chen: Being humble, that's for sure. So, let's talk about Alike Health, what does Alike do?

Varda Shalev: So, in Alike, actually, we took advantage of the 21st Cures Act which means last April 2021 in the US, they implemented a law called anti-blocking (information blocking), which means that every citizen is eligible to get his data from his provider in a file format. So, it's not like in Israel that we can just look at the portal and get our data. So actually, it's very powerful and I think we need to do it in Israel as well. Because it gives the patient a lot of power to use many applications, many smartwatches and things like that. As long as you put your name and password in your portal to your provider, all the data gets down to the application. So, we've built in Alike those connectors, that you can download your data from your provider. And then when we have the data, we can anonymize it, you pick yourself a name and nickname. And then we do many things.  We show you, first, the data and I know the power that you see an electronic patient record and you don't understand it. You don't understand ... Even very smart people, even physicians.

I have many patients that are physicians and professors themselves, but from different domains. And they don't understand all the nitty gritties of the diagnosis, lab test, procedures. So, we take everything and we first explain it to the patient; when he looks at it, he has all that explanation.  Then we have a lot of insights on the data that we provide the patients. If we spoke about the colon score, we can do it patient to patient. Because when we developed the colon score, it was very easy for me as one within the system to implement it in Maccabi. But when we wanted to implement it in other HMOs in Israel and the world, it's very difficult. Because you have to go to the manager of IT to see, 'How do you combine IT with a colon score etc.', in Medial (EarlySign). 

Actually, it was very difficult for the company that was founded based on the colon score. But you can go directly to the patient and tell him, 'I calculated your risk for colon score and it's high. I think it's good for you to do colonoscopy'. So actually, we can put all those insights in the system. We can show you how patients like you are treated with other drugs and what are those drugs on water; what are the classes of drugs that you can use on your disease. But it's only your EHR, on your disease.  And on top of that, we created a social network based on patient similarity networks that we show patients like you. So, you have a score that you can see other patients with a score like yours with the same comorbidities, procedures, lab test, and you can talk to them and understand what they're doing with the situation.

And I think it's different from a Facebook group, for example, because we look at you holistically; you are not a disease.  We look at you like a family physician. You have a lot of comorbidities in your age and gender, and then we can give you insights. And now with COVID, it's a lot easier for me to explain. Because if I will let you talk to somebody with COVID in a different gender and a totally different age, different comorbidities. It's not worth it. You want to talk to somebody with the same comorbidities; same age. If you are pregnant, second trimester, you want to talk to somebody who is pregnant at second trimester, etc. So, it's like Tinder for patients. It's the combination of Tinder ways and patients for health.

Gali: I think it's amazing that finally there's a way to get to your data as a consumer. And I do understand that this law in the US is what's kind of moving you; that's the target. But there's a similar process happening in Germany, for example, where there's a demand from the healthcare systems to provide this data to the patients. This is a very business question. I mean, obviously US is very interesting, why wouldn't you also create a product for Germany?

Varda Shalev: We will, but you have to focus. A startup is between focusing and being flexible. So, we'll be flexible and we'll see the opportunity. But you have more than 300 million patients that you have to deal with and dig with. And I'll say, it's a lot of work. Actually, we have a few 1000 patients on this system already. I think in a year, we'll have about 100,000 patients. There is a lot of work to do now in the US but we'll go to Europe.  And we had the debate amongst ourselves whether we should do it in Israel as well. It's difficult here because we don't have this law and we'd have go to one of the HMOs and to do an agreement with them. So, it takes us off from our focus but I think we'll do it because Israel is Israel. We are you know citizens. And we'll have to do something here as well but we started in the US. I'm sure we'll get to Germany as will and to other countries.

Chen: So, I understand the one thing the system does, the app, the system connects you to relevant patients like me or patients that are relevant to me. But doesn't this issue of score ... And this is something that I'm constantly thinking about. Let's say you have an 81% chance of something or 73% or 92%. Doesn't that actually create more anxiety with the patient? Will the patients know how to act upon it because of course we want 100% certainty in everything, don't we?

Varda Shalev: Yeah. The percentage is the likeliness between you and another patient. So, each patient that you see in the system, you see what's the level of likeliness between them. So, even you and your brother are not 100%; maybe well 90%, maybe 80%. So, it's not about anxiety. Now knowing the system, it's constantly a question about anxiety. And again, like I told you about the privacy, I have the same issue about anxiety. When we started the electronic patient record, we said, 'Okay, let's give the patient the lab test results. And all the physician said, 'No, it will give them anxiety you know, they won't know what to do about it.' And I always thought it's a matter of culture, first and second it will happen whether you want it and whether you don't. So, let's do it right, but let's do it first. 

Because always the question of innovation, 'Do you want to be the first one or the second?' I never want to be the second. I always want to be the first one, even if you have to take some risks. So, you have to think; you have to take ethical issues, you have to ask questions via the patients. But if you want to be innovative, you should be first. So, when we gave back the imaging results and pathology results, there are always questions, 'Oh, the patient, poor patient.' But when you want to get your ultrasound result, you have more anxiety when you don't have the result than if you get the result even if it's a worse result. You want to know it now. And your physician is not him, he will be back two weeks, he went abroad, you know the system. So, thinking about the patient will help him with anxiety by letting him know more and more within the system.

Gali: In your product, in the Alike Health product, do you have a services support angle? Do you give patients the option to call and discuss or get clarifications? Or is it just a technology kind of application for them?

Varda Shalev: At the moment, we don't have a lot of medical support; physicians within the system. I'm by the way within the system, they can ask me questions. But with time we'll be able to refer patients to the right place for their question. So, when we think about monetization, which we are not thinking about it a lot now, because we want to get more and more users. We'll have a marketplace and we'll have also freemium services. So, we'll be able to help you with those questions, more and more. But I think that, knowing from patients is very powerful. Even the patient themselves is a big support group.

Gali: What is the business model?

Varda Shalev: So first, it will be free for patients, because we want everybody to input their data. We are not going to sell the data. We are going to provide you with all the insights and to provide you with social network. But now that we know everything that can help you; we can refer you to a clinical trial, we can refer you to certain physicians or physiotherapist, etc... We can put a lot more algorithms. It can be algorithms that analyze your imaging or pathology. It can be colon score, and more.  So, it's like in games that you have the game and you have freemium services. We'll have more services on top of the data.

So, we are still not at this level but we foresee it. I always say that, 'You have to look very far, but to act very short here.' So, we see the future, it's there. But we act now, on the day-to-day levels; more users, more data in the system, the granularity.  When you make such a product, it's always a question about granularity. When you talk about hypertension, there are a few types of hypertension. But if we'd start with all the types of hypertension, we won't have enough patients within every group. So, we start with one group and then we develop it to more and more groups. So, the granularity, it will be a lot more granular with the time, and then we'll have the services as well.

Gali: I mean, why did you choose one investor (Pitango)? Do you think that has an advantage over having multiple investors when you're looking for seed funding?

Varda Shalev: I'll tell you we are not we have another investor already. So, we have $5 million as a seed but we have another four and a half already. And it's not from Pitango. So, we have not only won already, so it's not a valid question anymore. But when we started, we wanted to go with a good VC that can go with us for the next step or second step. And Pitango is really a very good partner.  We have Guy there as a manager and he does a very good day job with us. He helps us a lot. And I see that when you have a good product, you will have more and more investors as well. But they we have Nir Kalkstein also invested and Amnon Bar-Lev invested himself. So, it's going well.

Chen: You have a long perspective of the Israeli health tech system, how it has evolved over the decades. So, what is your perspective on that? I'm talking about the ecosystem. What will happen with the ecosystem moving forward on a local and on a global scale?

Varda Shalev: Yeah, those are good questions you asked. When I founded the Big Data Innovation Center, I said to myself, 'Okay, I have the best data.' Because I think Maccabi has very good data; I was in charge of it for many years too. We had good data and I knew that it was longitudinal and comprehensive. So, I started using it. But at the same time, I started thinking, 'How can we be first also in another 10 years?' And then I decided to found a biobank, because I understood that having only EMR data is not enough.  And when I look back, they decided to make Psifas as the biobank of Israel and they didn't. Right now, they have their many committees, a few CEOs, and they didn't. And when I think about it, why did I succeed to do it? Because I did it very slowly and quietly. So, we didn't have in Maccabi, a big committee thinking, how should we make a biobank? What should we do in the biobank? I said to myself, let's do a dry biobank first. 

A dry biobank, it's something that, I called it as a name. I didn't expect it to be taken as a term. And actually, I wrote a paper for Harvard about the biobank. So, that's the first time that the name is used; dry biobank. So actually, I just did an informed consent, which is a very wide informed consent for patients, asking them to be part of the biobank. And I didn't have any budget. So, I went to Iris Grossman, she was in Teva.  And she was in charge of Innovation and Personalized Medicine. And I told her, 'Teva is a big company. If you can give me a budget for one person, I'll create a big biobank.' My CEO told me, 'Why would she give you?' But she did it. And I took Daniella, and I told her, 'Daniella, let's do a big table and look at all the biobanks in the world. And look at all the informed consents in the world, and think about it as ourselves.' 

And in most of the biobanks in the world, it's anonymized. You take the blood, and then you anonymize everything, you take data, and you work in it. But I understood that Israel is completely different. I can't be part of Maccabi having your data and your genetics, and not coming back to you if I found an actionable gene. If I know that you have Long QT, and you can die while playing basketball, or if you have BRCA and you can die from cancer.  So, I said to myself, I must come back to the patient. I'll ask my patients to be part of the biobank. They will be anonymized in the research. But we'll be able to go back to them and the Ministry of Health, they didn't like it the beginning. But I told them, I have to sleep at night and I want to sleep knowing that they have a few actionable genes within the system. I'm in charge of these patients and of the research, and I want to go back to them. 

So, the only thing that we did is a dry biobank. And we collected, I saw that more than 50% of the patients when you approach them, they say yes. Even though they're fasting in the morning, they have a kid on the shoulder, they have to run (busy). They agree because they want to be a part of something that is big. I think, when I thought about with Amnon Bar-Lev without the like, and the patients want to help each other. That's very important.  So first, we did the dry biobank. And then when we had all the informed consent, I said, 'Okay, now it's very easy'. I have their full consent, I put it in the computer. And now when a patient comes to one of the collecting points to labs, I can just tell them, 'You're a part of the biobank. Whatever you take, we'll take one more.'

So, if you take blood test, we'll take another one. If you take urine, we'll take another one. And within a very short time, we had a you know 1000 and more patients within the system.  And it didn't cost us any money because we used the system. So, I tell this story to say that we have to use our culture and our abilities here in order to build it different than in the US or in Europe. Because really, we have a treasure here; and that's what we did. And now when you have the lab test and you have the blood and urine, you can of course, very easily go to genomics and use it and do a lot more research. So, always do whatever you can do with the data now, but think far to see how you continue to be first; continue to lead. That's what we have to do here.

Gali: We were talking about the, I guess, computer revolution, which became the data revolution. We just touched on genomics. 10 years from now ... And you're the one making the wave, I can see it throughout your whole history. Where are we going now with health? What is going to be the next revolution that we're going to see?

Varda Shalev: Yeah. So, when I founded the biobank, we will not the first to have a genetic biobank. And I understood, the genetics is not all and you need biology. It's not only genetics, biomarker. And that's why I decided when I founded it, not to take once for genetics. But each time that you come, we'll take some more blood, and then you can go to biomarkers.  So, if somebody has cancer now, we have 5 or 10 blood tests, we can look for biomarkers. So, I think the market of biomarkers in proteomics will be a lot more in the combination between phenotypic data, biologic data and patient reported outcomes of patients will be very, very strong. And that's why we also started and also in Alike, we collect a lot of patient reported outcomes. So, we have your EMR data, but we throw to the system, many polls and questionnaires. And we collect a lot more data.  Because many times we as physicians, we care about the things that are interesting and important for us. But it's not very rare to see a patient that had a successful operation and he can't walk or he doesn't enjoy the operation. So, we have to collect all the data. And now we have to do the integration between genetics, biomarker, patient reported data and EMR data, and then we'll have a lot of power.

Gali: And this is for probably personalized prediction. That's the goal at the end of this.

Varda Shalev: Of course, and that's what we actually did in the research institute; we started with all those projects. And the same thing we're doing with Alike; we take EMR data, we take patient reported outcomes, and we'll go more deeply. But I think since in medicine, we have so many dimensions. In order to predict well, we need all the world (data) to be inside. Even Israel is less than 10 million, it's not enough. So, we'll have to collaborate with the world as well. And Alike is above, I was in Maccabi, now we can do it around the world. And I think we'll be able to predict a lot more personalized, while having so much of data.

We'll need a lot of computing power. But remember 20 years ago that everybody told me, 'There is not enough power to do on EMR data, a big analysis.' So that happens anyway, we don't have to care about it; it happens. We have to care about the medical data and the patients, and to see that we are not only waiting until we'll have everything. But to implement or to have; implement and do more. Implement and develop more.

Chen: You're actually closing the loophole on care, aren't you? You're getting information from the patients and giving something back. And helping patients understand that there doing something meaningful not only for themselves, but for others too.

Varda Shalev: I totally agree. And I think you have one machine as a patient, it's yourself. So, you have to be, as a patient, a lot more involved in your treatment. And many times, people ask me, 'But the patient, they ask questions from the internet'. That's what they have. If we provide them with more personalized data, and more understanding, they can be part of the system smartly. And I can tell you, as a physician, that it's a lot easier to treat a patient that understands, because the adherence to treatment is about 50%. 50% of the patients won't take the medicine at all, or will take it improperly. If we want them to be treated well; we have to explain to them more, give them the data, help them and see them part of the system. So, I have actually the system, the physician and the patient. And the patient is actually the leading one because there is conflict between the patient, the physician and the system.  The patient has a lot of time, with physicians, who don't have this time. He has a lot of incentive; we have many times less incentive. The system, they have budget limits, and etc., etc. So actually, we can use the patient's time as an incentive in order to treat him better.

Chen: So, Varda, what advice would you give to someone who wants to do what you are doing?

Varda Shalev: Many people have asked me that. I don't see a short way. Since I have ... I told you, I have two daughters in medicine. I always tell them, if you want to be an innovator in medicine, you should practice medicine, always. Because many physicians that finished medical school come and tell me, I don't want to specialize. I want to go directly to innovation, I'm good at computers.  So, I tell them, in a few years, you can practice the sentence, 'When I was a physician.' Because you won't to be a physician anymore. Medicine is changing all the time; the patients are changing. My patients are not the same as they were 20 years ago. They demand from the system different things. they have access to data; many things have changed.  So first, you have to practice medicine. If you want to do real innovation medicine ... I think also to be a manager in medicine, you can't be a good manager if you don't practice medicine.

And if you don't specialize, you can practice. And many of them specialize, and the system is so difficult. So, they leave and they go to manage or administration or to innovation. But then you don't have the power, the real power to understand the medicine and to ask your patients on a daily basis.  So, I think you should practice medicine first. Second, I think academia is really important. So, I continue teaching; I teach in Tel Aviv University and I teach in Harvard Medical School where I teach entrepreneurs in medicine, most of them are M.D.s. My last class, they have done a case study in Harvard on KSM; on a big data innovation center with. By the way, Sami Sagol and Morris Khan invested in this KSM and I teach it. And I am in relationships now with many physicians that are entrepreneurs in Harvard.

So, if you teach, you learn from your students and you collaborate with young people. And it's very, very important. So, teaching in academia is also important because you ask yourself questions. You doubt, you learn how to doubt when you a write and do a lot of research. So, practicing research; collaboration is critical.  You can't do anything by yourself. And many times, collaborations, I didn't know how they will would evolve. For example, or a Professor Roy Kishony from the Technion. I remember that he called me from Technion and I didn't know him. He's in computing, biology and he told me, 'I'm interested in bacteria and I know you have a biobank, da, da, da'. And I said, 'I'm not really interested in bacteria I'm interested in people but let's meet.' 

And we started meeting and we had so much fruitful collaboration since then. Yesterday by the way, he was here in my house, and we spoke about research as well. He took his path for bacteria, but I implemented it for patients and we could predict a lot better the right treatment of antibiotics while collaborating. So, I think collaboration is critical; if you are a good collaborator. And maybe the fourth thing is courage because many times you're not very popular when you're doing innovation. Everybody will tell you; you can't implement it, it won't succeed, who needs it? And I remember when we started even the electronic patient record, everybody told me, 'No, who will work on the computer? Physicians are not for computers.' So, you should go your way. And if you practice it and you can show that you do it, it's even better.

Gali: So, I get the last question. If you could go back to your 16-year-old self, what would you tell her?

Varda Shalev: Do more sports. I didn't have ... I always tell my family that the only thing that I am regretting is, that I started playing tennis only 7-8 years ago and not while I was a 16 or 10. That's why my grandchild is playing tennis already when he's 7. So, all the rest, I think go with your heart, go with your passion. And I can say that I did it. Then take your path, check to see that you are not burnt out. If you don't feel the passion, move. Because it's very important. If you have it, everything will be okay

Chen:  Gali, I know you said last question but I have to ask Varda about women in the HealthTech, MedTech industry. Of course, you've been doing it for such a long time. But there aren't that many women. It's growing of course and changing, but  the proportion of women to men is not identical. Why do you think is that and what needs to be done in order to change it? And I guess that it’s connected to your fourth point before which is courage.

Varda Shalev: Yeah, I think it's improving. When I started it was really ... Nobody spoke, women, computers, what are you talking about? So, now it's better. But still to be a woman, it's more difficult than being a man when you have a family etc. I see a lot of improvements. When I see my second generation, the spouses, the men in my family are very involved with the kids. They take care of them. The women have a lot of courage to go to specialization that are not very ... In my generation, we wouldn't take it because it was very difficult.  So, I'm optimistic actually. And I think I don't like when they say 'Okay, let's take two and two, three and three.' I don't like it.

I think we should start very early when you are a child, to educate you as a woman that you can do as a girl. You can do everything. You can achieve everything but they don't like the rules. I don't want to be selected to a board because I am a woman.  I think with time, we are going in the right direction. I think in Israel because of the army, many times the men come from the army and take the places of a women that are within the system. So, we have to think about it. If we need so much army within the cyber and all those areas of innovation; and they are not so innovative in the army many times.

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