Digital Transformation and the Impact of VR/AR Technologies on Medtech | LSI Europe '22


Andy McGibbon

Andy McGibbon

Managing Partner, Sonder Capital
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Mei Jiang

Mei Jiang

Senior VP - Global Digital Innovation, Medtronic
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Travis Bond

Travis Bond

CEO, Altoida
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Richard Vincent

Richard Vincent

Founder & CEO, FundamentalVR
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A discussion about medtech's digital transformation.


Richard Vincent  0:03  

It's a pleasure to be here. Straight after lunch always a good time to, to get into an interesting subject like this. Firstly, thank you to LSI for hosting this first UK based European version of the conference, I think things are going particularly well, really good to have everybody here. I've got a fantastic panel here today, who really can address the subject that we're talking about, which is around the idea of how digital transformation is affecting and will influence the med tech industry going forward. So let me So Travis and the emir, why don't you guys introduce yourselves and tell us all about your particular area of expertise? About ladies first?


Mei Jiang  0:50  

Yes, my name is Mei John. Yes, my name is Mei John. I joined Medtronic late last year from HP. And I'm based in Palo Alto, California, traveled here two days ago, still working on my jetlag. Yeah, in the past 20 years working and living in Silicon Valley, I worked on four startups, one failure three exits. And then the other big part of my career is around digital transformation at large corporations most recently at Cisco, GE, and HP.


Andy McGibbon  1:30  

And I'm the person who managed to sneak up on the stage and pretend like I'm on a panel. My name is Andy. I'm with Sonder Capital. We're an early stage venture fund, we focus on seed and series A investments in transformational companies, of which many are digitally enabled, in one way or another. My own personal background is a mix of business engineering, did Stanford's Biodesign fellowship and through that got to know the other partners at Sonder. So when we formed up, that's what led me to today.


Travis Bond  1:57  

Great. I'm Travis bond, CEO of Altoida. I've been with the company since January, I joined the company to commercialize what has been a 12 year journey in training, basically a smart device to pick up on digital phenotypes of neurodegenerative disease.


Richard Vincent  2:14  

Great, well, you're all very welcome. And so let's, let's let's dig straight in. I mean, the subject matter digital transformation, and its impact on the med tech industry. That's such a wide topic. So maybe if we start with just focusing in a little bit, maybe we start with you, Travis, this time, what are the areas that have really drawn your attention? And what what are you seeing?


Travis Bond  2:41  

 You know, I think, you know, I was in med school and frustrated that I was running all over a hospital looking for different data to piece together to understand, you know, what I didn't understand, but I was going to read up and pretend like I understood that part of the gist of the medical journey is I actually created the world's first browser based electronic medical record. And I think for me, the sort of kind of blind spot that as an entrepreneur saw is that, you know, this thing called the internet, and in this case, it was Internet Explorer five could was really resonant on everyone's computer. And so from there, it really, you know, I think I saw it as a platform before platform was a word. And what I think about in terms of just the digital age is I do get a sense. I mean, fundamentally, and I don't think this is the sort of kind of the inner hype in oneself. I think that taking common devices, and basically allowing them and training them to do things that allow everyone across the ecosystem to diagnose, to track to manage to record, I do think that does smart device, right. So January 27 2007, right, change the world iPhone came out. You know, the other thing, I think in terms of just digital, if you think about the fact of how, you know, cardiologists clearly focus on the heart, but all doctors have a stethoscope. Right. And so, you know, the the aspect of managing cardiovascular, you know, symptoms or, you know, as a vital sign panel, everyone has a stethoscope that's basically in the healthcare field and can do that. I think really, you know, my last point is, is that neuroscience has probably been the last to lag behind and sort of this unlocking or realization that it is another organ system that can be managed beyond just a specialist.


Richard Vincent  4:25  

Interesting, interesting, Andy.


Andy McGibbon  4:27  

Yeah, no, I can talk about it maybe in more thematic element that we look at it from Sonder, which is kind of this trend of decentralization and healthcare, broadly speaking, you know, as things move out of the hospital to less acute settings, whether that's to the home and one extreme or even even, you know, further upstream, closer to the hospital, there's a spectrum there. But in every case, this has to be digitally enabled somehow, you know, from our perspective, there's, there's some way where, you know, there's only so many people out there that can deliver health care, and how do you really start now thinking about delivering this in a more decentralized way? to more people in less acute settings, and you know, in many cases, I know May, you might touch on this as well, but being able to head off the the case of whatever medical condition it is that you're facing. And so I think as we think about that, from an investment theme, you know, technologies enable that are very important in our portfolio, you know, I'll pick one but avail med systems, if you're familiar with the story, proximity as well, these kinds of things that help shift care further out from the hospital, just tremendous value that will be created, there


Mei Jiang  5:32  

With COVID, healthcare is increasingly leaving the building leaving the hospital, right. And in, you know, we receive care now more in community to base the home base, you know, virtually, from anywhere, right? So what is what is the focus, what's the new job to be done for the digital leaders of the future, I think when technology is mature enough, is become second, it becomes secondary, it's really about people follow where people are, meet where people are, and the meet their needs, where they are, right. So that's why we really want to our biggest focus is human beings, the people's right? I just joined the Medtronic 10 months ago, and at Medtronic, we all remission comes, you know, we have a six powerful words, right, elevate pain, restore health, and extend the life, I think it was digital, we want to breathing new, new meaning to this mission, not only we want to extend the life, we want to elevate life, not only we want to help patients, we want to help singling 100% You know, house, people outside hospitals.


Richard Vincent  6:49  

Fascinating. And so we've heard a democratization really in the way that technology was being used driving that through. And then that idea of pre diagnosis that actually you're getting in in the way of the condition before it develops too far, I guess, particularly with perhaps light such as yours. So I guess as a next question, with that theme in mind, what are you seeing in your organization or in your portfolio that's really driving that through?


Travis Bond  7:23  

 Well, I'll go, you know, one of the things I think is just fascinating is that, you know, Pharma is not staying in their own little corner anymore. When you talk about sort of digital strategies for clinical trials, they're now not just decentralized, right? And they're in in our case, we're certainly with our current clients, and we're helping to make the next generation drugs. And so you know, you can use our tests, say, seven times a month and the normal CNS trial would you would get data points two or three times a year? I think what is incredible is to watch that each of these pharma companies, quote, unquote, have a digital health division. And so when they think about what digital can do, or or sort of this hypersensitive technology set can do in the drug development, they're already looking into commercialization stage. So in many of our clients, it's not only just building the drug, but it's like, how would you activate the consumer in terms of awareness that they have symptoms that would be consistent with the disease, that their treatment is his diagnosing? As well as the provider? You know, one of the things that we don't think about is, you know, we think about the provider, of course, but in the sense that a provider is, you know, 40 times a day, especially in the ambulatory care, they're kind of turning the door and going into the unknown. So what is your chief complaint? And so they kind of have to think about from A to Z. And so the question is, is it providers or or manufacturers of therapies are saying, How can I help the provider to more quickly and accurately determine that they have they the patient have something that our drug can treat? When you think about Alzheimer's and dementia? It's two and a half to three years before you get a diagnosis. And so you think about missing the entire therapeutic window of many of the diseases of the brain? Right? I mean, it's just crazy insane. So I do think that what I've seen it just as a trend, is it Pharma is no longer just about the drug? But is it? How do you how do you commercialize that therapy across the entire ecosystem? While you're actually building a drug?


Mei Jiang  9:15  

I'll even take this further, Travis, I think I mean, instead of waiting for, you know, patients to have, you know, diagnosed based on their symptoms in the future, I think there was a clear shift from survivor or efficacy of the new drugs or new therapies to pre viver as opposed to survivor, right. So how you actually use this medical, clinical human intelligence to anticipate and to provide some early diagnosis, early detection, right as a guidance, so we can potentially, you know, help people to to identify, you know, some early signs, now symptoms earlier in their life. Life. And this will be a game changing, you know, opportunity for everybody if we can make this happen.


Andy McGibbon  10:08  

Yeah, and I think I think digital transformation, you know, there's there's a lot of ways you can take that it is, in some ways broad, and also, in some ways not new. You know, 15 years ago, I was working with Genentech to figure out how they can digitally transform the organization. And, yeah, sure, every day, they're still probably talking about that. So I think digital transformation, I see it as a process as opposed to a goal, it's happening, and it will continue to happen in one way or another. And I think it transforms many elements of healthcare. I mean, you know, we talked about integrating it into the device itself, or the device itself being digitally enabled. We talked about, you know, things like availe, or other platforms that move care or support the moving of care to other places. But also, I guess, you know, thinking about how it's used in our portfolio, I think it also unlocks in the devices themselves capabilities that may have been very difficult before, I think of one portfolio company in particular, that uses everything from 3d scanning, advanced computer modeling, and 3d printing of metals to produce the end product. And I think those are all technologies that when you combine them in a digital way, they can treat, you know, they can get a scan, and send back a device to treat the patient in less than a week. And you know, when I think about what that does for healthcare, I mean, that's pretty powerful. Because you start talking about shrinking treatment cycles, not only to mention, the ability to detect things earlier


Mei Jiang  11:31  

in the future, healthcare will be no different than any other goods and services on demand, personalized, truly personalized.


Richard Vincent  11:40  

And what about in the place of delivery? So we've talked a lot about the end patient and how it impacts them. What about if we come up the level a little bit and think about at the point of service delivery of the electronic medical records have been continued to arrive and have an impact and cause lots of issues as well along the way, but But what are you seeing there? When we think about the delivery area? Clearly, again, as you mentioned, the idea of hospital at home, decentralized care away from the core hospital location has been going on, but what do you observations there for for this transformation?


Travis Bond  12:18  

I'll take the first stab at that it again, what we've seen in terms of, you know, sort of unlocking neurology, you know, obviously, we're sort of focused on that right now. But is how can more providers treat more disease in the, you know, there are 250 diseases that have mild cognitive impairment as part of their profile. Half a dozen of those brought belong in neurology, right. The other 200 Plus are seen by GYN family doc gerontologist, you name it dentist, right in. So the point of it is, is that how do you get in front of things that are impacting the brain, and thinking oh, and so we're working with one pharmaceutical company, who now has an dimension indication for a drug that treats diabetes. And so now, when you think about all the providers around the world who treat diabetes, neurologists don't, right, and so the I think it is about what we're seeing in terms of this, this sort of transformation is, those things that are affecting CNS can be and should be treated by a broader amount of providers. And I think that's really important. You remember, last point here is remember, if you think about just diabetes in the arc, you know, when I was in med school, we never talked about pre diabetes, we talked about you are diabetic, and therefore you get these set of drugs, right, and this is how I manage the disease. Now, it's all about pre diabetic while you're on that, you know, threshold, and we know plenty of people who have been effectively you know, through diet and other means are now been able to really bring down you know, this this overused blood sugar and manage the disease before it ever became a disease. And so I do think that there are a lot of things that affect the central nervous system that are of the same paradigm.


Mei Jiang  14:05  

Yeah, very important thing you are touching upon Travis. I think in the future, actually, even today, the most complex, the most advanced the system is human body. And as a human being, we tend to have a multi mobile conditions. So one disease I mean, today, the I think the healthcare system is set up to treat individual areas of concerns or health conditions. But in the future, I think we need to treat human as a whole body. Right, how we actually fully understand the correlation, the interaction, you know, from across your kidney, your heart, your liver, your brand, you know, as the whole body. This is coming. Yeah,


Andy McGibbon  14:50  

I agree. Maybe I can pick up on a thread too. They kind of lay down about how do we enable more providers to treat more patients and I think, you know, when I think about them, for providers part, there's a lot of elements to that. And I think, you know, a big piece of that is really coming back to the theme of democratization of healthcare, and how can you help the skill level of the average physician to be able to do something that maybe they weren't able to do, whether that's procedural or giving them the knowledge of, you know, whether that's the diagnostic diagnosis of a condition or the actual treatment options. But I think there's something to be said about, you know, technologies like FundamentalVR and the like, where you can start training physicians to do things better. That also extrapolates into the world of surgical robots, and that has been the premise of surgical robots in large part is you can now have the average physician doing something that maybe only the top few percent could do previously. And so, you know, again, come back to our portfolio, there's a company that's doing this in a way that, you know, if they get the recipe, right, they execute the way we hope they execute, all of a sudden, you have the entire new procedure, well, actually existing procedure, but being able to open up to so many more patients than previously could be done, not only because it's expanding technically what the device is able to do, but also because now more providers are going to be able to do that.


Mei Jiang  16:13  

It's, it's all about democratization, right? I mean, you don't have to just rely on people who have gone through 10 years training medical school, to become a specialist or sir, you know, the best surgeon in the whole world. How can you help other Junior, you know, surgeons or experts to actually leapfrog and to to leverage the technology to become the expert before you know it?


Richard Vincent  16:41  

Yeah, absolutely. And I think, you know, often you see, across all of these different lines of adoption, what one of the limiting factors is the human factor. So I may be the world's best neurologist, but actually, to impart that knowledge on to everybody who needs that procedure is going to be incredibly slow and complicated and expensive. time consuming, is limited, ultimately, by my ability to probably get on a plane and do the time on the road. So to digitize that, to take that expertise, digitize it and virtualize it. And this kind of segues into the other part of our heading here. So VR and AR to virtualize that and actually bring that knowledge, that capability to anybody to democratize it and take it to anybody in any location. That's a really exciting prospect, right?


Travis Bond  17:37  

Yeah, I would say it's the future, I went to medical school in University of South Florida in Tampa. And we actually built a big training center downtown to you know, probably, it was Dr. Classo, who is our Dean, who then went on to run Jefferson Medical Center that had said that in people I remember when he was talking about, I'm going to go down and build this center where surgeons can come in and train and then we can record it, and we can have other people do the surgeries that they would never get to see. But we're going to do it in this virtual environment. And I can remember, people thought he was a little loony. And you know, of course, that was 10 years ago or more, but the fact of it is, you are right, I think that it is, you know, we've all, you know, experienced online training for, you know, if you want to go do something, just go to the internet, and there's some course on it that you can, you know, Coursera or anything else, but I do think that you're right, you know, it's just sort of this training arc as a provider, you do understand that the universe for years, it's any question fair game. After that, it's like, okay, I can forget about this, like, forget about that, you know, ophthalmology, anything outside the eyes and entrepreneurs, because the wealth of knowledge about the human body cannot truly be are you just, you can't command it. So I do think that, you know, a thoracic surgeon said, you know, even I'm going to go in this area, but being able to unlock more surgeries for a person who understands the surgical field understands the instrument, why they do it, and be able to sort of cross string to an appendectomy or whatever. I do think that is important. I would touch on that. I do think that virtual reality is key. Because I do think that we as a sort of population are, you know, through meta through gaming through other things, or sort of this parallel training of comfort with the technology, right? Not everybody gets a laparoscope, and now everybody gets his pair of VR goggles. Right. And so I do think that that is sort of the helping of just sort of comfort of technology as a whole that I think more people embrace it. Oh, yeah, I can learn new tricks, and I'll do it this way.


Andy McGibbon  19:27  

Yeah, I think yeah, I agree. 100% VR, and AR I think you have a have a significant role to play in healthcare, especially on the training, you know, where we see it today, I feel like most often actually implemented is in the training side of things. You know, putting on my my Biodesign fellow hat. The some of the struggle I've had in some of the instances of VR is what is driving that? I mean, I think there's there's always the technology push side where we can do something. And so now the question becomes flipping that on Ted, what need Are we truly solving? And I think, you know, in this case, we're talking about a need for improving the training of medical professionals in one way or another. But I think broadly speaking, as we start thinking, you know, what is next? I think it's gonna be important, number one, to keep the need in mind. And number two, I think, you know, it is going to take some time for the people side to change. You know, it's something we see all the time, you know, VR is happening, I still haven't really done VR in the way that, you know, I think the next generation is going to be doing VR in the same way that the generation before didn't have smartphones. And so I think, you know, there is going to be a bit of adoption curve and it does come back to the people at some point.


Mei Jiang  20:40  

Absolutely. And if we all agree, like we did earlier, that the future of healthcare is all about democratization aquity the accessibility to the high quality of care ubiquitously across the world, right. So, we covered in the past you know, a few minutes we talked about the provider side right me how we get you know, the the provider or the specially this the onboard fast enough right cut, cut down the onboarding challenge in there. But if we take a spin and look at, you know, from the consumer from the people's point of view, imagine a little girl from a small village in South Africa, and the people they are are still struggling with, you know, supply of, you know, food or clean water. If this little girl right here suffers a real disease today. She does not have a lot of options like you, all of us do here. But imagine the future at Medtronic. We talk about Metaverse and VR AR Metaverse, right. And we call it the Maddy verse, right imagining the future we create together with ecosystem partners, a virtual male in Metaverse, and anybody as long as you have Internet access Wi Fi, you can go there and get a second opinion get a diagnosis online. Right. I mean, remotely, wherever you you know where you are. This is actually the I think that the future future endgame for healthcare, democratization. Yeah, for to make everybody's life easier in our health system, but also ultimately, to improve the quality of life for everybody.


Andy McGibbon  22:25  

Can I ask you a question? And I'm curious, also to hear your perspectives on this. I think one of the the areas and you know, and this applies to VR, AR, but also I think digitally more more broadly. But the question is the business model, I think, you know, when we think of how medicine has been operating for decades and decades, and you know, to a large part, how the med caps have thought, or the large cap med techs have been thinking about, you know, what is a successful product and how to how to sell it, the business model is oftentimes a question and we'd love to hear everybody's perspectives on, you know, what's worked, what hasn't worked? And I know, it's a little bit of a tangent on the theme, but it feels very relevant, because from an investor's perspective, that does become a big question.


Travis Bond  23:09  

I'll go first. I mean, I think certainly, you know, at least the United States, I mean, healthcare is kind of a coin operated event, right? I mean, if it doesn't pay, then, you know, then you sort of kind of going around to see who will pay for it. And, you know, there's safety net issues and so forth. I think, you know, procedures, you know, there are quantifiable events of things that can happen that make income predictable. And that's very, very important in healthcare where, regardless of where you are, I do think, though, that digitalization has the opportunity to bring down the per unit price, but increase adoption, right. And so then we have the sort of the WalMart where it's not selling to the classes, but it's sell to the masses, right. And so I do think that, you know, as I think about like, how we price our tool, which is very different in Brazil, versus, you know, a phase two Alzheimer's trial or their share of wallet is magnificently, different magnificently, by the way. But I think that you know, the use cases around like we have an academic partner who is doing a, you know, cognition study, post Ebola recovery. Now, we implemented that remotely, we couldn't get anybody to go to the Congo. That's a joke, but that was part of HR if you were on a pip, okay, you're going to do implementation Congo Ebola clinic, but that was a joke for anybody in HR in the room, but we'd really to the point where we sent five iPads that were had cellular service, right and since what Rene was saying is that you can go to the small villages, you can democratize and now you can actually have an understanding of critical injury to the brain due to a virus COVID long haulers right. And so I do think that digitalization has two challenges one is you cannot find it in a mass. But where do you find your price point when you say that your equivalent to performing a thing was one penny on Amazon servers? I mean So, but I do think that you have to somewhat take a leap of faith and recognizing that it's precision and accuracy and other things and so volume does, I think it is important part to train IA, which is really at the core of many of our digitalization technologies. But yeah, I think what I think it's going to be one of those challenges is going to be use case specific. But I think digitalization at least gives us the flexibility to price it.


Mei Jiang  25:27  

Yes, I work for Medtronic today. Right. And my my colleague, actually is Mark Palmer is sitting in the audience, right, he actually I want to repeat what he said, a couple of days ago. For Apple, they want to sell iPhone to everybody. And as a medical interventional Tool Maker, we hope nobody needs to use hover devices. Right. So I think it was increasingly digital, you know, digitization coming our way, for establishing incumbent, you no matter tech companies, we will and we are starting to explore new opportunities in the US, you know, beyond the hospitals in beyond doctors beyond interventional tools. What are the new radical new normal business model? We need to look at? Right, instead of focusing on high touch? High, you know, high, high profit, medical hardwares? What is overall our new job to be done in the consumer world? At the population scale?


Richard Vincent  26:28  

Yeah, I think you're right. I think you're right. And to pick up your question, Andy, I think, you know, from my perspective, I think things evolve over time. So I think if you look at our space of medical training and skills acquisition, I think at the beginning, you go searching for innovation budgets, people who are interested in new technology and how that develops, then you've got to transition from that, because that is only going to take you so far. So where do you go next? Well, I think in our case, you say, well, tap into what's happening today, you know, roughly $18 billion a year is being spent by the likes of Medtronic, j&j, etc. on medical training, you know, that they're taking it to the healthcare professionals and saying, we need you to get better, because that's that oil is our business. That takes you to a certain point. But to go beyond that, you've got to hook it to those patient outcomes. So then you need to be working with the insurance companies to say, Okay, let's look at the health economic benefits here. And see if we can go from skills acquisition, to real outcome at volume and prove an impact there. Otherwise, it's important, but it's It tops out. And I think you have to make that journey through.


Andy McGibbon  27:43  

Yeah, absolutely. I just, I think it's so interesting to me, because in many ways it you know, this idea of decentralization, broadly speaking, and specifically in the digital context, you know, to the point of kind of taking a Walmart model where you're now, you know, it's, it's a very different model than Medtronic has operated in the past. And so, you know, everybody has to get around that insurance companies, the large gap med techs, investors, and I think that's going to take some time, but it's the way we're going, it's the way we need to go to do all the things that we want to do in terms of healthcare, and probably why we're all here, you know, working on med tech, so


Mei Jiang  28:17  

yes, we all hear this mantra nowadays to disrupt or wait to to be disrupted, waiting to be disrupted will turn out to be very ugly. Right. So I think every company, including Medtronic, HP, or any company, I think are getting more active, you know, thinking about what's next, what's possible beyond over existing business models.


Richard Vincent  28:41  

Yeah. So, so just picking up on that point of business models, particularly focused on some of the new innovations coming through, particularly in robotics, I guess, the business model, there's changed quite significantly, you know, you're seeing now a lot of organizations that are coming in selling entire ecosystems on a SaaS based model. And, you know, the number of robots that I've heard, we're running a razor blade model going forward? What's your perspective on that? Because that's quite a big change from going from a CapEx proposition through to a consumable proposition, and I'm interested in your perspective on both how from a strategic standpoint, that's viewed, but also, when the healthcare providers are met with that proposition and how they see the constant purchasing.


Andy McGibbon  29:29  

I'll take a bite on this one, just to maybe kickstart the conversation. I think you take Intuitive, you know, 100. With the market correction, maybe it's not quite 100 billion anymore, but has been, has built the competitive moat, in the hospitals by placing the capital equipment. You know, I think Medtronic and others as they're starting to think about their robotic platforms. And, you know, it's all the startups out there. Yeah, everybody, it's we're not really making any money or maybe we're losing money on the actual capital equipment. It's all about the disposables. You know, the hospital has limited real estate, they only have so many rooms and so much room for so many machines to fit in there. And so, you know, that becomes your competitive moat. It's important, I think, from a business model perspective, it makes it aligns incentives in many ways between, you know, the company itself and the providers depending on scale. But broadly speaking, I think it makes sense. The challenge being real estate, and how do you knocked out an entrenched incumbent? You know, again, there's multiple ways to do it. But right now you're going up against Intuitive in large part, you know, I know J&J And Medtronic both have active robotic programs that are out there. And there's a lot of startups, but how do you how do you what value prop? Do you need to sell to really get it out there? I think? I don't know. It's an interesting question. But yeah, I think from a business model perspective, makes sense. I mean, that's the way the world seems to be moving. And no reflection is not necessarily a robot in the way that we think about it. And for those of you that were here, last night theory, Antoine talk about reflection, medical, it's largely the same kind of cell there. I mean, that's a huge piece of capital equipment. But I can tell you, the investors that are invested in reflection, see a renewable and recurring revenue stream as a high likelihood there that opens up a lot more potential, just from a market cap perspective than what would otherwise be there.


Mei Jiang  31:21  

Yeah, I think by the end of day, innovation comes down to one word, it's really culture, how you think differently, how you operate it differently? Right? And I don't have an answer for you today, on the stage, what what is the, you know, the new world we are looking at from Medtronic point of view. But one thing I know for sure, right. You know, I actually had a bland experience, but in both startup and large corporation environment, right. So I know it's exposed opportunity and a challenge to learn, you know, for for small mice and the large elephants to to learn how to dance together. It's the most challenging but a huge opportunity, if downright, I think a weakened to have the best of both worlds, the creativity, agility, and the global scale. But to do that, particularly for, you know, large established incumbent companies, we need to learn how to come up with the right playbook. Right to you to actually tap into the power of the broader ecosystem and abandon not invented here mentality.


Richard Vincent  32:34  

Yep. Picking up a couple of themes that that that were discussed earlier. So you talked about the metaverse and the whole area of metaverse. Metaverse has been hyped up a lot over the last few months. So I guess, two questions here, and you can pick up on either part of these one. If the metaverse or indeed, the metaverse is going to exist, who builds it? And do you own parts of it? First one, and then secondly, and this is the bigger, bigger question. And this This goes beyond just that. What about data? You know, everyone talks about data being the oil, everybody wants, we're a data business, we're actually we're not really into, into whatever it is. It's all about the data. How do we fight to own or do we own the data? Particularly again, back to that point of if there was a Metaverse and you were looking for seconds? That data exists there? Who? Does anyone own it? Is it is it handed over to the infrastructure? What are your reflections? Like?


Travis Bond  33:38  

I don't know that. I know. I mean, some clever kid would probably say blockchain. I don't really know. I think it's fascinating. We dealt with privacy issues for so long. I think it's it's it's going to be an interesting problem to deal with. But with the irony of though it is and we do think about privacy, you know, more people don't really care about their data, they really care about their health. And so sometimes I think privacy issues have gotten in the way of innovation. Clearly, everybody knows if you open up Facebook or anything else, you've shared everything about yourself, you download Tiktok everything about yourself. So I don't know that, about ownership so much. I do think it will be about what is the perceived trade off? What do I get back? How is it a better experience? Is it a better outcome?


Andy McGibbon  34:26  

Yeah, I'm gonna say data is the new gold since I come from a family of gold miners, but oil works to I think this is the ultimate question around the data. And it comes back to you know, in the same way that we're talking about the capital equipment being taking up, you know, this real estate. Now, the data is funneling through that same piece of capital equipment in many cases, you know, at least in the surgical context. And so, who owns that and how that's shared and and, you know, these are tricky questions, and it coming back to the example of a veil that's a that's a, you know, it's a digital surgery. experience, I mean, it's a console. For those of you that don't know, it's a console that goes into the operating room or Cath Lab kind of records, plugs into the imaging and clinical support, people can kind of dial in remotely with an iPad mark up on the imaging, all those kinds of things. You know, there's gonna be a lot of data that goes through there. Would Medtronic be interested in that data? Probably, with Johnson and Johnson be interested in that data? Probably. Now, the issue is, are you a utility where you're kind of, you know, pulling the data and you can be a broker of that data? Or are you Medtronic, and you're owning the data? I think that's maybe a little unresolved question in my mind.


Mei Jiang  35:36  

Yeah, the ownership of data is such an interesting topic. Right? I don't think I mean, we can claim all the medical device makers own the data, or the providers on the data, who owns the data, consumers themselves. And to traverse point to consumers, people will decide based on the outcome, based on the value, you know, what's in it for them, they will make a wise choice, radically different choices in the future based on value creation for them, if they actually give up some of their, you know, rights in the data ownership. So what do they get in return? And this is a ecosystem question. And we need to look at this from the value chain point of view, right? Who owns different strategic strategic control points, owning the access to the data, but by the end of the day, consumers people own their own data?


Richard Vincent  36:31  

But how can they own it if they don't know where it is? If it's distributed across 1000, different iterations, you know, you mentioned just a couple of platforms, but we have data, you have data, we all have data. I don't know where my data is, it's everywhere. So how can I own it?


Mei Jiang  36:47  

Yeah, that creates a creed. You know, timing is perfect. This is a great opportunity in here, particularly off to COVID. Or we are still intimate, you know, the end of the COVID. Right? So that actually, you know, provide a tough question for everybody. Right? I mean, where do we actually get access for the data? And for what, and nobody has an answer today, but I think we'll we'll find out together to to end this point, right? Can Medtronic or other med tech companies or providers become a broker or super integrator of the data? Right, so we will have a single source of truth? We are far away from that. But that day is coming.


Andy McGibbon  37:32  

Yeah, I do think it's interesting. And I guess, you know, coming back to that same question from a, you know, going the consumer out, you know, there has been movement there. I mean, you think of like Apple and you can now integrate like, I just pull my EMR into there my entire EMR it plugs into Stanford or UCSF or whatever hospital system, and you can pull your data in question is now as a consumer, what do I do with that data? And what do I not do with that data? And what do I think I should do about that data? And what do I, you know, and all of a sudden, you have kind of, you know, a bunch of Doctor Google's kind of walking around wondering what they should do, because this, that or the other thing, and so, I think, I think it's valuable, I think it's important to move that way. I think also that along that journey, there's gonna be a need to be a lot of education, a lot, of course, correction, because we're going to do things wrong, we're gonna have to go back or left or right to fix it. But


Mei Jiang  38:20  

You're, you're so right. I think there's maybe a logical layer, there are three layers, right, me, you know, show me where the data is, in a in a consolidated way. And the next layer is tell me what's going on here. And ultimately, you know, do it for me. And I think I mean, yes, a lot of hyperscalers are making the effort to to show show people what's happening here. Right. But But what the consumers will be doing with with those data and the insights, that's a different story, and I think people will trust the more the, you know, the companies who have a deep know how, in people's house, then just general AI, develop development environment. Yep. Yep.


Richard Vincent  39:09  

No fascinating, unconscious, we are on our time. So I think we've covered a lot of areas here and this topic of conversation. I guess, the key theme that ran through that really was around democratization. And using this, this technology to really transform the ability to put medicine techniques, drugs, understanding into the hands of as many people as possible. I think that that ties into a lot of other sessions we've seen today so far. It's been fascinating. We could we could keep running, I'm sure but with time against us, Travis. Thank you, Andy. Thank you, Mei. Thank you. It's been great. Thank you for joining us.



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