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Yaakov Rosenfeld January 2015

CURRICULUM VITAE

1. Personal Details

Permanent Home Address: Margarita 43, Haifa, 34464 Home Telephone Number: 04 – 8340-379 Office Telephone Number: Cellular Phone: 0523-244-820 Fax Number: 04-9957-050 Electronic Address: yaakovroh@bezeqint.net

2. Higher Education

Year of Approval of Degree

Degree Name of Institution and Department

Period of Study

1985 MD Cum Laude The Technion Institute of Technology, Haifa, Israel Faculty of Medicine

1974 – 80

1988 Diploma in Obstetrics and Gynecology, Cum Laude

Tel-Aviv University, Tel Aviv, Israel School of Continuous Medical Education

1984 – 87

1994 Master in Public Health

Harvard University, Boston, Massachusetts, USA School of Public Health

1993 – 94

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3. Academic Ranks and Tenure in Institutes of Higher Education

Rank/Position Name of Institution and Department Dates

Temporary affiliation Ben-Gurion University of the Negev The Faculty of Health Sciences Department Health Policy and Management External Program for General Health Services

2001

Teaching associate

University of Haifa, Haifa, Israel School of Public Health

2004 - 10

Lecturer Adjunct track

University of Haifa, Haifa, Israel School of Public Health

2010

4. Offices in University Academic Administration

None

5. Scholarly Positions and Activities outside the University

Reviewer – The Journal of Assisted Reproduction and Genetics

Current Appointment June 2012 – Clinical Assistance Center

District of Haifa and Western Galilee, General Health Services

1997 – 2013 Coordinator of the District Committee for Advanced Reproductive Technologies, District of Haifa and Western Galilee General Health Services

Previous Appointments

2010 – 2012 Supervisor of hospitalizations in Gynecological wards District of Haifa and Western Galilee,

General Health Services 1995 – 2001 Coordinator of the Gynecology Service District of Haifa and Western Galilee,

General Health Services

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1995 – 2001 Director of the Akko Polyclinic, District of Haifa and Western Galilee General Health Services 1997 – 2002 Director of the Women Health Center, Akko District of Haifa and Western Galilee General Health Services 2003 – 2004 Director of the Resh Polyclinic, District of Haifa and Western Galilee General Health Services

Professional Projects Development of standard data collection tools for:

- pre-natal visits

- obstetrical ultra-sound examination

- menopause clinic

- infertility clinic

- oral contraceptive users

- advanced reproductive techniques control system (Application, authorization, reporting results, reimbursement)

1991 – Introduced Uterine Contractions and Fetal Heart Rate Monitoring to community clinics

1994 – Development of a pre-authorization system for elective gynecological hospitalizations.

1995 – Evaluation of the economic feasibility of establishing Pathology Laboratory in the District of Haifa and Western Galilee

1995 – Development of a model for the management of advisory medicine at the

District level

1996 – Development of a model for a Women Health Center

1997 – Formulation of the Vision Statement of the Israeli Society of Ambulatory Obstetrics and Gynecology

1996 – 97 Development of a clinical-administrative and economic control system for Advanced Reproductive Technologies at the District level. The system allows for appropriateness check in a process of pre-authorization on the individual level, and selection of a preferred provider according to cost-effectiveness data. The system enables cost - containment of advanced reproductive techniques.

The system handles about 2,000 treatment cycles each year at an annual budget of about 10 million shekels. The system saves about one million shekels a year with a 10:1 return on

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investment. The system was adopted by General Health Services' central management for the other seven districts, as well as by other Health Maintenance Organizations in Israel.

1998 – Evaluation of economic feasibility of ambulatory hysteroscopy

Leading an organization change in clinical practices for improvement of detection of women with symptoms of post-partum depression

1999, March - Phase I – Examination of the detection rate by current methods 1999, May – Phase II - Examination of the detection rate with the EPDS 2000, Nov – Phase III – Introduction of the EPDS as a routine screening tool 2001 – 02 - Phase IV – Introducing the program to senior officials in the central management of the service. Appointment of a central steering committee Presenting a strategic and operative programs to the central steering committee Appointment of three other Districts Full day introductory course for the local steering committees on detection and management of women with symptoms of post-partum-depression.

The program for detecting women with signs of Post Partum Depression was adopted by General Health Services' central management of nursing services as a standard of care as of 2002. Israeli Ministry of Health followed the same path.

6. Participation in Scholarly Conferences

a. Active Participation

Role Subject of

Lecture/Discussion/Comments

Place of

Conference

Name of

Conference

Date

Lecturer Application of a computer aided diagnosis system for evaluating patients with amenorrhea

Vienna, Austria

The 1st world symposium on computers in the care of the mother and the newborn

March 1987

Lecturer Prevention of abortions and premature deliveries by cervical suture in patients with congenital uterine anomalies

Tel-Aviv, Israel

The 9th convention of the Israeli Society of Obstetrics and Gynecology

1987

Lecturer The Quality of documentation in the gynecology service in the

Tel-Aviv, Israel

The 3rd National

November 1995

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Role Subject of

Lecture/Discussion/Comments

Place of

Conference

Name of

Conference

Date

district of Haifa and Western Galilee

convention of the Israeli Society of Quality

Lecturer Quality evaluation of upper GI series

Tel-Aviv, Israel

The 4th National convention of the Israeli Society of Quality

November 1997

Lecturer Continuous nursing education as a leverage for organization change: Effective detection of women with symptoms of post-partum-depression (poster)

Haifa, Israel The 5th National convention of the Israeli Society of Quality

November 1999

Lecturer Development of organizational infrastructure for detection and management of women with symptoms of post-partum-depression.

Haifa, Israel The 2nd quality conference of the district of Haifa and Western Galilee

March 2001

Lecturer Quality improvement of the detection of women with symptoms of post-partum-depression. (poster)

Tel-Aviv, Israel

The 4th annual meeting of the Israeli society of ambulatory obstetrics and gynecology

November 2001

Lecturer World record in IVF cycles? Who is counting? And How?

Jerusalem, Israel

The 4th International Jerusalem Conference on Health Policy

December 2009

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b. Organization of Conferences or Sessions

None

7. Invited Addresses

Presentation/Comments Name of Forum Place of

Lecture

Date

Mental syndromes associated with pregnancy and puerperium. Development of an organizational infrastructure foe detection and treatment

The 2nd annual meeting on community medicine

Tel-Aviv, Israel September 2002

Post partum depression – theory and practice

Haifa University, Dept of inter-disciplinary studies A course on mental health reform

Haifa, Israel December 2003

Depression after delivery: A distinct clinical entity or just a coincidence

Ministry of Health, The Northern District Continuous nursing studies

Zfat, Israel December 2004

Hormonal changes and psychological elements of pregnancy and puerperium

Haifa University, Faculty of Social Welfare & Health Studies. The post-Tsunami medicine and Society program for health workers from Sri-Lanka

Haifa, Israel August 2005

Hormonal Replacement Therapy for Menopausal Women – Updates

Clinical Pharmacology for Nurses in the Community District of Haifa & Western Galilee

Haifa, Israel June 2010

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8. Colloquium Talks

Date Place of

Lecture

Name of

Forum Presentation/Comments

August 2010

Hertzeliah Israel

Fertility committees conference, General Health Services

IVF cost containment at the District level

9. Research Grants

a. Grants Awarded

2014 - Pfizer foundation – 12,000 IS

Why do Israeli women, who do not want to conceive, not use effective

contraception?

b. Submission of Research Proposals

2009 -Influences of economic incentives on In-Vitro-Fertilization treatment patterns

General Health Services, Division of Health Policy, Department of Research Not funded.

10. Scholarships, Awards and Prizes

1993 – 94 Fellowship grant from The American Physicians Fellowship Inc. for

Medicine in Israel

A grant for MPH studies in Harvard, Boston, Massachusetts, USA

Nov. 2001 The best poster award.

The 4th annual meeting of the Israeli Society of Ambulatory Obstetrics and Gynecology. Quality improvement of the detection of women with symptoms of post-partum-depression.

2001 – 02 Distinction in “YAHALOM” – The General Health Services Patients’

Satisfaction Survey, Women Health Center, Akko.

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2000 – 01 Distinction in “YAHALOM” – The General Health Services Patients’ Satisfaction Survey, Women Health Center, Akko.

11. Teaching

a. Courses Taught in Recent Years

Number of students

Degree

Type of Course Lecture/Seminar/Workshop

Name of Course Year

External Program for the General Health Services sponsored by The Department Health Policy and Management, The Faculty of Health Sciences, Ben-Gurion University of the Negev

International Health Care Systems

2001

20,24,26,29,14 MPH School of Public Health, Faculty of Social Welfare & Health Studies, Haifa University

Epidemiology of Gynecological Diseases and Infertility

2004 - 2010

10,18,14 MPH School of Public Health, Faculty of Social Welfare & Health Studies, Haifa University

Instruction of Graduate Projects

2010

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Supervision of Graduate Students

Details of

Publication

Date of

Completion /

in Progress

Degree Title of Project Name of

Student

2004 MPH

The association between an elective induction of labor and urgent caesarian section

Carmit Lupovitch

2005 MPH Knowledge and positions of Arab women in the Akko area about mammography

Shadiah Shiban

2009 MPH Informed consent: from Hippocrates to the Internet

Geva Barzilay

2010 MPH Promoting rational use of BCP by Women in Carmiel

Orna Nissan

2011 MPH Factors influencing on compliance to RSV vaccinations

Maiah Asulin

2011 MPH Evaluation of an intervention program to prevent caries in kinder garden in Abu-Snan

Raniah Jurie

2011 MPH Association between prior expectations and satisfaction from ergonomic intervention in the work place – Intel

Inbar Gilboah

2011 MPH Association between dexterity and work accidents – Coca Cola

Dr Mati Wexler

2011 MPH Evaluation of an intervention program to prevent accidents in kinder garden in Majd El Crum

Najuah Hamud

2011 MPH Factors influencing on compliance with screening programs to detect fetal malformations in Um El Fahem

Faridah Mahajnah

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2011 MPH Association between improvements in cardiovascular health indicator and actual morbidity and mortality

Alla Artul

2011 MPH Association between early surgical detachment of tongue tie and the quality of lactation

Ulla Facher El Din

Instructor of Thesis projects

Details of

Publication

Date of

Completion /

in Progress

Degree Title of Thesis Name of

Student

Nov. 2011

MPH Knowledge and positions of IVF patients about multi-fetal pregnancies before and after informed consent

Ilona Voskoboinikov

Nov. 2011

MPH Physical activity during pregnancy and pre-term deliveries

Tamar Sharon

Nov. 2011

MPH Adoption in the Moslem community in Israel

Amira Daher

Declined MPH Eating Disorders and Infertility

Elinor Tiberger

Aug. 2013 Master in Plastic Arts Therpy

Art therapy for mothers with post partum depression

Afnan Watad

12. Miscellaneous None

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PUBLICATIONS

A. M.D. Dissertation Application of a Computer Aided Diagnosis System in Evaluating Patients with Amenorrhea. December 1984 Technion Institute of Technology, Hebrew, 55 Pages, Instructed by Dr. F. Weiner and Prof. I. Timor Presented at the First World Symposium on Computers in the Care of the Mother, Fetus and Newborn, Wien, Austria, March 1987 Published in the Journal of Perinatal Medicine, Volume 15 (1987), Supp 1, p 42

M.P.H. Dissertation Quality Evaluation of Clinical Management of Patients with Irregular Uterine Bleeding Harvard School of Public Health, English, 25 Pages, June 1994 Instructed by Dr. Richard Bohmer and Dr. Kieth Isackson Presented at the Gynecological Department of Massachusetts General Hospital, June 1994

B. Scientific Books (Refereed)

None

C. Monographs None

D. Articles in Refereed Journals

The order of the listed authors appears according to their relative contribution

Published 1. Jacob Bornstein, Bruno Pascal, Yonina Sova, Yaakov Rosenfeld, Haim

Abramovici The vulva clinic Harefuah Volume 119(12) pp 413-6, December 1990

2. Nir-Caein R1, Nahum R, Yogev Y, Rosenfeld Y, Fisher M, Kaplan B

Ethnicity and attitude toward menopause and hormone replacement therapy in Northern

Israel.

Clin Exp Obstet Gynecol. 2002;29(2):91-4

3. Yaakov Rosenfeld, Avshalom Strulov Clinical reports on IVF cycle rank – reliability and validity Harefuah Volume 148(1) pp 22-26, January 2009

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4. Yaakov Rosenfeld, Avshalom Strulov

Improvement of the clinical reports on IVF cycle rank Journal of Assisted Reproduction and Genetics (2009) 26:99-103

5. Yaakov Rosenfeld, Avshalom Strulov Informed consent, Israel 2009 – is it informed? The case of IVF & ET Israel Medical Association Journal Volume 11(7) pp 407-10, July 2009

6. Elena Shneyer,, Avshalom Strulov, Yaakov Rosenfeld

Reduced rate of side-effects associated with separated vaccinations of MMR and DTaP-Hib-IPV vaccinations Israel Medical Association Journal Volume 11 pp 78-81, Dec 2009

7. Yaakov Rosenfeld, Menahem Fisher Safe quadriplet pregnancy after IVF – Is it? Letter to the editor - Harefuah Volume 153, p 622, October 2014 Accepted for publication The added value of Art Therapy among mothers with post-partum depression in Arabic Society at Israel Afnan Hamed-Agbariah, Yaakov Rosenfeld Harefuah November 2014

E. Articles or Chapters in Scientific Books

None

F. Articles in Conference Proceedings

1. Lissak A, Dirnfeld M, Rosenfeld Y, Sorokin Y, Abramovici H The conservative surgical treatment of ectopic pregnancy The annual meeting of the Israeli Fertility Association Weitzman Institute of Science, Rehovot, May 22-23, 1986

2. Rosenfeld Y, Weiner F,Timor I

Appllication of a computer aided diagnosis system for evaluation of patients with amenorrhea The 1st world symposium on computers in the care of the mother and the newborn Vienna, Austria, March 1987

3. Rosenfeld Y, Abramovitci H, Direnfeld M, Atad J, Pascal B, SorokinY

Prevention of abortions and premature deliveries by cervical suture in patients with congenital uterine anomalies The 9th convention of the Israeli Society of Obstetrics and Gynecology Tel-Aviv, 1987

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4. Lissak A, Auslander R, Dirnfeld M, Kahana L, Rosenfeld Y, Sorokin Y, Abramovici H

The effect of prolactin on ovarian responsiveness to gonadotropin administration in patients with severe polycystic ovaries The 6th World congress on In Vitro Fertilization and Alternate Assisted Reproduction Jerusalem, Israel, April 2-7 Abstract published in book of abstracts, p 56

5. Lissak A, Auslander R, Dirnfeld M, Kahana L, Rosenfeld Y, Sorokin Y, Abramovici

H The effect of metoclopramine on induced cycles by GnRH agonists with severe polycystic ovaries: Preliminary report. The 4th meeting of the European Society of Human Reproduction and Embriology Barcelona, Spain, July 3-6,1988 Abstract published in Human Reproduction, 1988, p 24

6. Sorokin Y, Klien O, Calderon I, Dukeman R, Rosenfeld Y, Abramovici H

The impact of routine non-stress testing in all low risk pregnancies after 40 weeks. Society of Perinatal Obstetricians New Orleans, Louisiana, February 1-4, 1989 Abstract published in book of abstracts, p 343

7. Gonen Y, Rosenfeld Y, Direnfeld M, Abramovici H Can endometrial assessment by TVS in menopausal women predict the results of progesterone challenge? The 47th annual meeting of the American Fertility Society Orlando Florida October 1991

8. Rosenfeld Y, Porat A, Alter Z, Halpern E

The Quality of documentation in the gynecology service in the district of Haifa and Western Galilee The 3rd National convention of the Israeli Society of Quality Tel-Aviv, November 1995

9. Rosenfeld Y, StrulovA

Quality evaluation of upper GI series The 4th National convention of the Israeli Society of Quality Jerusalem, November 1997

10. Rosenfeld Y, Delman I, Solomon Z, Assaf R, Lipsker C

Continuous nursing education as a leverage for organization change Effective detection of women with symptoms of post-partum-depression (poster) The 5th National convention of the Israeli Society of Quality Haifa, November 1997

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11. Rosenfeld Y, Zinger T, Jacobs S, Noy L Development of organizational infrastructure for the detection and management of women with symptoms of post-partum-depression. The 2nd quality conference of the district of Haifa and Western Galilee Haifa, March 2001

12. Rosenfeld Y, Zinger T, Jacobs S, Noy L Quality improvement of the detection of women with symptoms of post-partum-depression. (poster) The 4th annual meeting of the Israeli society of ambulatory obstetrics and gynecology Tel-Aviv, November 2001

13. Rosenfeld Y, Strulov A

In Vitro Fertilization – Reliability of Cycle Rank Reports School of Public Health Faculty of Social Welfare & Health studies – 3rd Annual Research Fair University of Haifa, June 2005

14. Rosenfeld Y, Strulov A

World Record in IVF Cycles – Who is counting, and How? The 4th International Jerusalem Conference on Health Policy Jerusalem, December 2010

G. Entries in Encyclopedias 2014 – Hypercoagulability in Pregnancy Elana Yure, Yaakov Rosenfeld Wikipedia (Hebrew)

2014 – Tubal Ligation Ariel Abaev, Yaakov Rosenfeld Wikipedia (Hebrew) H. Other Scientific Publications

None

I. Other Publications

None

J. Other Works Connected with my Scholarly Field

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2012 - An active contribution to the newly developed national IVF data base

Not published

2012 - Testimony before the State Comptroller about IVF treatments in Israel.

2012 – An interview with the magazine "Parents and Children" [Hebrew: Horim ve-

Yeladim] October Issue – about IVF – the dark side of the moon.

2012, Nov. – A local radio station interview about the systematic approach to

diagnose women with signs of post partum depression.

K. Books, Articles and Other Works Submitted for Publication

None

L. Summary of my Activities and Future Plans

Being a specialist in both Obstetrics & Gynecology and in Health Care Management, my

carrier naturally revolved around the inter-disciplinary zone of these two specialties.

Past Research Projects

- Introducing Uterine Contractions and Fetal Heart Rate (UC&FHR)

Monitoring for the first time to a community clinic.

This first project was probably the most revolutionary and influential of them all:

With some 15,000 deliveries each year and an average of three UC&FHR monitoring per

delivery, transfer of these encounters from secondary and tertiary hospitals to the

community serves several goals:

- Clinical service is delivered near home, rather than far away.

- Attending staff are board certified rather than residents in the beginning of their

professional training.

- There is a shift of power from hospitals to the community. Personnel of the

ambulatory service are the ones who decide whether a patient has to be sent to

hospitalization, rather than the hospital staff who has an economic incentive towards

hospitalization, whether it is required or not.

- Huge saving of public funds (about one million IS per month) is only a secondary gain

(i.e. some 200,000,000 NIS since the program began).

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- Introducing UC&FHR monitoring to the community paved the way for establishing

High Risk Pregnancy clinics which can take care of women with gestational diabetes,

gestational hypertension, previous Caesarian Section and so forth.

- In-Vitro-Fertilization (IVF) pre-authorization system.

Israel is the industrialized country with the highest number of IVF cycles in the world, per

capita per year. 2002 international comparative data suggests that the number of IVF

treatments in Israel is twice as high as the country in the second place, and five times

higher than the average. If we were, as a nation, at a bad place at the early years of this

century, we continued to go in the wrong direction towards the end of its first decade:

number of IVF treatment continued to rise from about 20,000 a year, to about 30,000.

At the early days of IVF, the decision whether a woman should have this treatment was

perceived as the prerogative of the IVF team, at the hospital. Conducting a pre-

authorization process in the community, before referral to treatment was unheard of, and

almost inconceivable. The pre-authorization system enables us to verify that treatment is

reserved for patients who do need it, and avoided when they do not. Introducing this

change took some time, but today it is in the state of "it goes with-out saying". The process

was adapted by the central management of General Health Services for its other seven

districts. Similar processes are currently operated by the other three HMO's in Israel. It is

estimated that this system saves about one million IS per year.

- A screening program for detection women with symptoms of Post

Partum Depression.

Post Partum Depression (PPD) is the most frequent complication of maternity, affecting

about 15% of pregnant women. Until last years of the Twentieth century national health

care systems, neither Ministry of Health nor General Health Services had a formal program

to detect these women. An early study in four primary clinics in Akko suggested that

routine follow-up methods diagnose only a quarter of the expected number of women with

signs of PPD (4%). Introducing an already validated questionnaire – the EPDS –

Edinburgh Post-natal Depression Scale, to the primary clinics enabled attending staff to

detect the expected number of women (16%). Using EPDS to detect women with signs of

PPD had been done in Israel in other places before. However, it has always been done in a

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scientific study context, in a limited place, for a limited period of time. The unique

characteristic of our work was that it was not intended to be terminated after the study was

published. It continued to be operated ever since, to this date. Using EPDS to detect

women with signs of PPD was recently mandated by the Ministry of Health, to its all

maternal and child centers in a similar protocol to the one that was introduced to the four

primary clinics in Akko some twelve years earlier.

Current Research Projects

Improvement of diabetes control in IVF patients.

Why do Israeli women who do not wish to conceive do not use contraceptive

measures?

Probabilities of getting pregnant by IVF within one year of starting treatment.

Influences of economic incentives on In-Vitro-Fertilization treatment patterns.

Data collection is completed, and statistical analysis is now beginning.

Co-operation with the Israeli Health Policy and Research Institute

The District of Haifa and Western Galilee of General Health Services is in a unique

position: It has different reimbursement methods with some of its suppliers of IVF

treatments: some are paid per treatment, others – per "success" (12 weeks pregnancy). This

position enables us to investigate potential influence of economic incentives on treatment

patterns.

There are clues in the literature that such an influence does exist, with relation to insurance

policy coverage. There is no report, however, to the best of our knowledge, with relation to

agreements between HMO's and suppliers, as there is none about payment per success.

If such an influence is detected, with indication that economic incentives drive attending

staff towards treatment patterns that are more intensive than usual, and potentially

hazardous, such information can be brought to the tables of policy makers, and eventually

bring this phenomenon to a halt.

Late and invisible costs of IVF treatments – early planning of study

design. A "data mining" project.

Co-operation with General Health Services' Central Management.

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It is suspected that late and "invisible" costs of treatment of IVF babies because

of neurological disabilities are much higher than the direct costs of the

treatment itself.

It is already well known that IVF treatments are associated with a tenfold rate

of twins pregnancy compared to the general population, twin pregnancies are

associated with pre-term labors, and pre-term labors are associated with

cerebral palsy as well as diseases of sensory organs (eyes and ears) and

respiratory system. In spite of this well established chain of events, multi-

embryo transfers are still common. It is hoped that if and when hard data about

long term economical implications is brought to light, the frequency of these

man-made disabilities will be reduced.

Planned Projects

Eradicating occupational violence from the Israeli health care system

Penetration of EPDS as a screening tool to detect women with signs of

depression in hospitals in northern Israel – At the Helsinki approval

stage.

Planned Publications

Adoption in the Moslim community in Israel, with Amira Daher, and Dr. Lital

Keinan.

Clinical practice in Akko in Fertility Clinic suggested that Muslim patients decline the

possibility of adopting a child even after many years of treatment. The purpose of this

study was to find out why. It was found that there is a discrepancy between State Law

about adoption, which dictates "closed" adoption, and the Kura'an low which favors

"open" adoption. A change in State Low in a way that will make it sensitive to religious

requirements of the Moslim sector has the potential of lowering the barrier to adoption in

this community.

Knowledge and positions of IVF patients about multi-fetal pregnancies before and

after informed consent, with Ilona Voskoboinikov and Dr. Lital Keinan.

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This study is a natural continuation of an earlier one (Informed consent, Israel 2009 – is it

informed? The case of IVF & ET). The purpose of this study was to evaluate, to what

extent, if any, knowledge and positions of IVF patients about multi-fetal pregnancies

change during the process of getting their informed consent to the process. Do they grasp

and use their ability to prevent the most significant preventable complication of IVF, i.e. –

multi fetal pregnancy.

The results of our study show that they do not. A prompt action is required to convey the

message that they have power to increase their chances of having a healthy baby, and that

they should use it.

Contribution

There is a common notion that higher quality in medicine is more expensive. Being a

young resident in Obstetrics and Gynecology, a small paragraph in the introduction of the

Williams' Obstetrics text-book caught my attention: "Two thirds of maternal mortality in

the USA is avoidable." My understanding was, and still is today, that research and

development of effective ways to utilize available knowledge for the benefit of public

health can have twice the effect, at a lower cost, and faster pace, compared to trying to

compile new knowledge. This is what I am trying to do ever since. Professional projects

and scientific studies are intertwined with this single goal in mind.