Nava Dolev doles out advice – ”The message we want to get out there is that you don’t need permission to get more information.’When 75-year-old Miriam (not her actual name) needed an emergency hip replacement, she heeded her surgeon’s advice and opted for local anesthesia. Unfamiliar with Miriam’s medical past however, the surgeon didn’t know about her acute sensitivity to sound. Miriam, on the other hand, had never undergone surgery and didn’t know what to expect.
The result was not good. Hearing the team working on her, she panicked and her blood pressure soared. Surgery was halted and a second surgery – under general anesthesia – was performed soon after. Miriam still suffers from night sweats and panic attacks she says are a direct result of the experience.
“It didn’t have to be that way,” according to Nava Dolev, the Israeli founder and director of Daat National Health Information Resource Center. And if Dolev has her way, in the future it won’t.
A business administration specialist with nursing and midwifery credentials, Dolev founded Daat in order to bring information to the patient. A call center based in Jerusalem, Daat (Hebrew for ‘knowledge’) fields incoming phone calls from medical patients, providing comprehensive and extensive information about their health conditions.
Dolev says the idea was sparked nearly three decades ago when she was living in Palo Alto, California. “I was very interested in the US Law of Informed Consent and the economic issues behind it,” Dolev told ISRAEL21c. “The idea of involving the broader public in personal medical related decision-making – creating awareness – was eye opening.”
In the US, the Informed Consent Doctrine refers to a patient-centered approach requiring that significant medical risks be disclosed to a patient, as well as risks which would be of particular importance to that patient. The informed consent doctrine is generally implemented through pre-operation discussions with patients and in a broader sense, includes educating the general public in understanding medicine and de-mystifying medical conditions.
Educating the public also makes economic sense. According to studies conducted by California’s Kaiser Permanente Managed HealthCare Organization, information creates less illness and cuts hospital stays by an average of 2.8 days. The incentive for the medical system is obvious.
“In the States, medical information was coming out to the public. Clinics, information booths, blood pressure testing sites… they were in shopping malls! My inspiration came from the clinic at the Palo Alto Mall right across from Macy’s and McDonald’s,” Dolev said.
Dolev returned to Israel in 1990 and proposed the information dissemination project in conjunction with Hadassah International and Hadassah Israel. It took her eight years to convince the Israeli medical community to follow the US lead, because doctors feared information would lead to increased malpractice suits. But Dolev showed them statistics: In the US, malpractice suits decline with awareness.
“No one wants a million dollars instead of a leg,” Dolev explains.
Modeling San Francisco’s Planetree Health Resource Center – one of the United States’ largest, free public medical/health libraries – Dolev recruited medical personnel and database managers and began offering free medical information to the community at large in the late ’90s.
Patients call or write with health-related questions and concerns and in turn, volunteers screen the information and then research databases, medical texts, clinical trial extracts, therapies and medical journals. Information is tailored to a patient’s needs – non-FDA clinical trial drugs in Washington won’t work for a patient in Israel – and a personalized packet is mailed out.
And it’s all for free – an important tidbit in lieu of the hundreds and even thousands of dollars per year it costs to access medical sites. Today Daat also works in conjunction with Yad Sarah Organization, a 6,000-volunteer run organization known for transporting the infirm and delivering medical equipment to private homes. And most recently, Dolev’s Daat program is looping back to the US.
Because the program has built a reputed database and information network, US hospitals and researchers also lean on Daat for information. The National Library of Medicine, for example, routinely queries about research or clinical trials being conducted in Israel on Jewish genetic disorders or diseases. Most recently, a call came in from the National Institutes of Health for data on Israel’s latest cystic fibrosis research.
Daat also helps Americans who call in needing information, particularly if they are being treated in the US for Jewish genetic disorders.
“A woman in Baltimore relied heavily on us for information and resources prior to surgery for a rare genetic disease. We get these type of calls pretty regularly,” Dolev says.
“People are very happy with the Daat service,” Yad Sarah spokesperson David Rothner told ISRAEL21c. “Psychologically, getting knowledge has a healing effect on the physical.”
In 75-year-old Esther’s case (again not her real name), the results have been heartwarming. Diagnosed with bladder cancer, surgeons suggested she undergo bladder removal. As a heavy smoker with emphysema her family worried she may not sustain the general anesthesia.
Her children – doctors and psychologists – tapped into Daat’s network for a range of solutions and chose to opt for radio and chemotherapy. So far, the results have been promising: The cancer has rescinded and the less radical solution is working.
The Daat Jerusalem Center averages 300 calls per month and has disseminated information throughout the world in 70 different languages. Plans are currently underway to open branches in Tel Aviv and in Beersheva.
“The message we want to get out there,” Dolev concludes “is that you don’t need permission to get more information. We’ll give it to you with pleasure.”For more information, contact Daat by telephone at 02-644-4500 or e-mail at firstname.lastname@example.org