Transatlantic AI & Robotics: Scaling Innovation from Legacy to Market Disruption | LSI Europe '25

Addie Harris  0:05  
Okay, so we'll get started here. I'm I'm Addie Harris. We'll start with some introductions. I'm Addie Harris. I have a long history in medical device, most specifically in digital surgery and robotics. I founded a company called cardan robotics around 2014 it ultimately exited to Stryker, which is actually not how I know John, but a connection that we have. And then I worked at at J and J for about five years. I built out their digital surgery orthopedic robotics division within depuest. Did a number of acquisitions there ultimately commercialize the vellus digital surgery system. And since my time at J and J, I've tried to kind of bring it back full circle. I work with a lot of different startups, with funds, with incubators, really trying to take all of the lessons I have learned and do them to to help others to build great technology and just see you know, more and more innovations and advances made in the medical device market. Jean, would you like to introduce yourself?

Jean Chaoui  1:10  
Yeah, sure. Thank you, Addie. So my name is Jean Chaoui, and I'm Vice President for clinical applications and solutions under the digital robotics enabling technology division for Stryker. So I lead the research and development team for May CO, our robotic platform for knee, hip, shoulder, spine, and also our guidance navigation teams for neurosurgery and ortho and ENT, and glad to be here today.

Addie Harris  1:44  
Yeah, glad to have you here. So, you know, was so great to get to know you a little bit better. And I think we found in our a couple of our conversations, just how much we have in common. You know, both technologies we've worked on the time that we've we've worked on them, and I think we have the shared philosophy or understanding that throughout our career path, we had some really phenomenal experiences, and they provided us so much insight. Tell me a little bit about how you went from starting you know your first company in France, all the way through to that path as vice president at Stryker and still leading R and D teams, yeah,

Jean Chaoui  2:29  
sure, yeah, it was an exciting journey for me. So I am biomedical engineer, and I started a Master of Science, then a PhD in Computer Aided surgery. So this is all what I did in my career. And like in the middle of the PhD, I wanted to create my own company, because with the surgeons with we started to work on shoulder anthroplasty, and in 2009 there was no mature technology to help the shoulder surgeons. Like, from clinical standpoint, you have a lot of solutions for knee, for hip, for spine, but not on shoulder. And this is where I wanted to evaluate, like do a transfer of the research done during my PhD, and evaluate that through a startup. And in France, we have good, let's say, a grant system, especially at that time, so we had the grant specific to to do this industrial transfer of like public research. And this is how I founded the company. I got a grant of 200,000 euros, and I started the company called aimas cap in Brittany, France, and then we went through several of course challenges. We changed the business models with the evolution of the technology, going starting by navigation and then creating a whole ecosystem, including mixed reality, smart planning using AI and and patient specific implants and patient specific guides. And in 2017 we've been acquired by right Medical Group as the first team doing software for that company. And then, two years later, another acquisition by Stryker for right medical, including my team. And this is how I finish with with Stryker. But, like, amazing journey

Addie Harris  4:50  
of massive journey, yeah,

Jean Chaoui  4:53  
evolved, like business model and also technology, yeah.

Addie Harris  4:57  
So tell me a little like in those early days, one of, I think, one of. Wonderful things about starting a company in Europe is, many of the European countries have these grant programs, and they have research tax credits, and so they're, you know, it's wonderful for the very early phase companies to get started, but at some point you have to take that leap to the next level of funding, because one it's it's the grants themselves are quite burdensome to maintain and write and and you need that next level of funding to really kind of grow out and build your company. So when did you make that decision to kind of trance translate from the early almost call, it's free, it's non dilutive funding. To, yeah, to that dilutive funding,

Jean Chaoui  5:45  
yeah, absolutely. So grants are amazing in Europe, to start a project and to de risk, yes, let's say a good portion of your roadmap. But you cannot count on that for more than two three years. Of course, you can still get grants, but it won't be sufficient to scale. Yes. So what was important for us that very quickly, that means, in less than two years, to start providing services to to to other companies,

Addie Harris  6:20  
so realizing some revenues as a way to bring in some revenues.

Jean Chaoui  6:24  
And of course, you you should have, ideally, this type of revenues without diverging, like the team from the the like the principle roadmap, for example, we are working on surgical planning navigation, okay, 3d so I can provide 3d anatomy assessment for implant manufacturers. And as it was on shoulder, we targeted shoulder company at that time that was tornier then right medical, and that helped us to get some revenues, and also start to learn how, how this medical device industry work. Yes, again, I started as PhD candidate, and the team who started with me, same thing. We just graduated from the university. So also, it was perfect timing, two years to start creating value and also consolidating the roadmap and working hard on the regulatory side.

Addie Harris  7:32  
So it wasn't just a change. And say you're bringing in additional, you know, monies to the company to so that you have fuel bigger than grant money. You're also learning about, okay, this is how we run a business. And how do we, you know, both service our customer, but then we take that money so that we're growing our business Exactly.

Jean Chaoui  7:51  
And the two to three years also, it was a good period also, to get some credibility with some business angels. And they were surgeons, like in this field, specific field of shoulder surgery, shoulder arthroplasty, but also, like, they are best in class, surgeons, very known in the field, that also helped to build, like this credibility, and of course, to build the right product to the right customers. So also, like business angels, it was very important for aimascap to survive to the third year, where right after that, we were able to get a license agreement because the product was ready.

Addie Harris  8:43  
So building that credibility as you were really building all of the pieces all along, you're building out your technology, you're building out your business, and through that, you're building out your credibility in the space. And that ultimately led to led to your first acquisition.

Jean Chaoui  8:59  
Exactly yes. So the license agreement, the CO development agreement, then after two years, three years of partnership, strategic partnership, that was a good timing for an acquisition. Of course, it wasn't. It was an option. So we had several bidders in 2017 but we finished with our first partner, which is also good, yeah.

Addie Harris  9:27  
So tell me about that process. You're acquired by your first partner, by Tournier. Is that right or no? About yet, right, right? Medical, so Wright had acquired Tournier by that time, right? Exactly, yes. And so you're acquired by Wright medical, and then a number of years later, Stryker acquired right so you went through two phases of acquisition. What was your experience with that? What are some lessons learned? How much of your team were you able to rank retain in both of those both of those acquisitions and. And what is the importance you think of that?

Jean Chaoui  10:02  
Exactly, a great question. First acquisition by Wright medical like in 2017 Okay, digital was cool, but we were still struggling how to monetize that, like surgical planning software, okay, it's good. We were able to monetize the guides, but like the guides alone, patient specific guides, they don't generate that money like implants do, however, but we feel that it is really an enabling technology, and it's a way to capture more customers. So we get to a right level of understanding in 2017 by the implant manufacturers that we need this. With this we need this technology. So first acquisition by Wright medical, very complex, Bob Palmisano, the CEO at that time, told me, Jean, I won't write medical to become software company selling implants, and he did everything he could. He invested a lot. I had the team of 17 engineers. We multiplied that by three in few months, and we consolidated a strong roadmap focused on adoption, adoption of the technology, and I can tell you, with like change management framework and focus coming from a group like rightmedical, in 12 months, we can do amazing things. And this is what we did the first year and the second year for the teams that the integration was very tough, rightmedical had it engineers, but no software engineer, and it took us several months to understand how to work, how to integrate, well, but we start

Addie Harris  11:59  
Very different, right? Very, I've seen that before, where companies assume, Oh, I have, I have an it apart department, or I have it engineers that are working on back end software. We've acquired the software team. These can just, and they're, they're so different, you know, you may be, you don't even quite speak the same language, actually, and so, so that's an important lesson, I think, for all medical device companies to understand how specific some of these digital technologies, the underlying pieces of them, really are in those in those times of integration, we are bringing a

Jean Chaoui  12:35  
company absolutely and during those several tough months for The team, you need to communicate very well and get their trust to wait, to be patient to get to the right phase of like integration. And what helped us is like the support, the support the funding comes like from the first days to scale the team so that that helped the team to stay that

Addie Harris  13:04  
your investment, there's this investment and then from the company,

Jean Chaoui  13:07  
and two way to face the the first challenges of how to communicate, how to speak, a language that leadership in right, medical never spoke before, but Right, the trust was there. The belief was there. If I speak about the integration from rightmedical to Stryker, that was smooth, like very easy, by the way, rightmedical is one of the best acquisition done by Stryker. If I speak about the numbers, the goals, so very successful acquisition. And today we can see that, like we own more than 50% of the shoulder market worldwide, the technology that we developed in some areas, like it's it's one of the most digital, like the digital the most adopted digital solutions within Stryker blueprint technology.

Addie Harris  14:03  
So you inspired really a vision, and those teams and the type of technology we're going to develop it, it sounds to me, is was a big piece of how you managed to really gel those teams together get products to market quickly. And those products are fantastic products that are being adopted by the market. And overall, it's driving adoption with with Stryker shoulder market

Jean Chaoui  14:23  
exactly, and then how to expand that from shoulder to knee to hip to spine. Have this ecosystem and software architecture, and this is what's amazing with Stryker today, we have great experience in how to integrate like high me tech companies in a smooth way, and leverage the talents and maximize the synergies between the Stryker legacy teams and the new tech teams joining Stryker, which is very important from like any. A strategy standpoint, talent strategy specifically related to acquisition, is very important.

Addie Harris  15:09  
It's critically important. And, you know, my time at j&j, we did a number of acquisitions, and a big part of those that I would really focus on it was, it was often somewhat overlooked, but I would often kind of pull back acquisitions if they were going to come back in my group and say, hey, you know, we're going to look at this. We're going to plan this. I want to understand, really, almost every employee that's coming in, you know, what is their specialty area? Who are they? How? What is our what are our plans there to retain them? Because it is such critical piece of that overall, bringing products to market, but also for having those deals be recognized years later as as really good deals, because I think that is really a fundamental piece to have to what drives ultimate revenue out of those, and that's what when you look back on the numbers of a deal, that's what tells you about a good deal. I want to talk a little bit about digital surgery. You talked about in 2017 I experienced at the same time. It was kind of this question mark, okay, it's really cool. We can see that it does some good things. But is it here to stay? Will it be adopted in the market? I think that is, is no longer a question. Digital surgery is here to stay. You know, companies all have a strategy about it, see that it drives, ultimately, drives adoption. We're hearing more and more terms, and I think, you know, as computer chips, as technologies, as everything really accelerates forward. We're seeing so many of these technologies coming to life today that for many years, maybe were known and understood, but we didn't have really that processing power to do them. So things like AI, we hear AI everywhere. Everyone has to have an AI strategy. But you know you what does it mean? How do we again? How do we how do we really monetize it? Augmented reality, virtual reality, mixed reality, often used interchangeably without an understanding of what the difference is between them. I'd like to get your thoughts on how you and how Stryker. Are looking at those? Are you looking at those as you know, technologies on your own? Are you looking at them as enablers or add ons to your existing portfolio? Yeah. What? What is that take?

Jean Chaoui  17:21  
And yeah, in Stryker, we extremely believe in innovation, digital enabling technologies, robotics, you know, from our history, the Meco the Meco history, the Meco experience is amazing today. We, we, we have like 2 million cases done with this system, with this amazing system, we have hundreds of 1000s of cases done with the blueprint solution for shoulder. We have also big numbers in anchor when it's related to prophecy solution. And I cannot count like we have over 80 digital solutions in Stryker today. So we know very well the value that we can create for our products, for our customers when we leverage digital in the right way. But it's also how to integrate this, this technology into our product, the standard medical devices, how to make them connected, how to to to build an ecosystem, and stop thinking about a product or a service or even a platform. It's bigger than that. This is when I speak about ecosystem, it's it includes platforms and, of course, services and products, but connected to each other and all of them creating the right value for our customers. So for sure, no doubt about the value. Now this is why we built a DR Dray, digital robotics enabling technologies, which is evolving every year, to embed all the ingredients for those magical recipes, like having the robotics talents, competency competencies with the surgical planning competencies with AI, with mixed reality, computer vision, cloud application altogether, the same space, global team. This is how you can see like amazing solutions coming to to the market. So we fully believe in that now, how it evolved, like mainly the ecosystem definition. This is what I see today, in an ecosystem you can provide, for example, a. Surgical planning solution like blueprint, where you leverage AI, whether to automate the 3d reconstruction of the anatomy, or to recommend the surgical technique with a confidence level or an implant type, and propose a smart planning so the surgeons, they don't have to wait or to think too much.

Addie Harris  20:21  
An AI is beneficial there, just for members of the audience who don't have the full background is a lot of those pieces were actually done by teams of engineers, absolutely. You know, for the past 1015, 20 years, when there was surgical planning, right, sometimes it was a tech or a rep that would sit with the surgeon, and they would help them through the software, through the planning. I mean, some really eager surgeons would learn how to do it themselves, but for the most part, they had somebody with them. Or it was an image of a patient's anatomy, a CT image, an MRI, whatever it was, it was sent back to the main, usually to the rep, who sent it to the manufacturer, and then a team of engineers went and did the construction. So it's incredibly, you know, not only time consuming, but labor consuming, cost consuming, yes, and so, so that's a great example of where AI can come into place, yeah. And suddenly, then you have kind of more your, your, your true SAS model that companies want, where this can be done for much lower cost,

Jean Chaoui  21:24  
absolutely on the back end, on the back end, and to have aI embedded in the infrastructure, and then AI on the front end, where it happens when we train our AI models, to plan, to think like our surgeons, and propose that through features, clinical features for our customers. So this is AI, then at the same ecosystem, so the software is enabling AI, or the AI models empowering the software, then the output of the software would be robotics guidance, or it would be smart tools, intra op tools, hand held robotics, or it would be guidance, navigation in general or mixed reality. So we just changed or adapt the output. Even I don't need to change the output, it's more output adaptation. And this is an ecosystem for customers who are looking to have robots. We have the software portfolio AI features adapted to a robotic procedure for the market segment where they are more oriented navigation, or like handheld smart tools, we adapt the output for for this segment, same for patient specific guides or patient specific implant. It's all about how you start from the image and you go to the guidance. Or like the implant itself, if I speak about additive manufacturing and patient specific

Addie Harris  23:07  
so what I'm hearing is all of these technologies really are enablers, and it's about understanding when and where is the right place to use them both to kind of enable the procedure, enable the clinician, whoever they are in that patient care journey, to do their job better, more efficiently, more cost effectively. For Stryker, for the company, it's about understanding where they can, like, realize that most value, whether it's, you know, on the back end, reducing reducing cost and having a better outcome, whether it's on that exact patient care and with that interface, you know, maybe it's because of those tools reducing training times, allowing maybe a lesser trained care provider to be able to do something as well as a highly trained care provider, or that highly trained care provider to do it more quickly. All of that's really important

Jean Chaoui  24:04  
if I speak about smart planning, like function, whether if it's for knee or for shoulder, when we trained our AI model on 10s of 1000s of surgical planning, adapting to the surgeon preferences, and taking into account all what's going on related to the surgical technique. We can the solution that AI recommends or initiates is like very high level and would help a lot, a lot of surgeons to to have a planning like a high volume center.

Addie Harris  24:47  
Yes, I mean, so many times from surgeons, when I'll speak to them about, you know, kind of your your top surgeons in the field, about, well, how do you know, you know, can be any, any type of procedure, from, you know, orthopedic to heart to. Or whatever, you know, how do you know what you're looking for, how exactly you do this difficult thing? And, you know, sometimes there's really specific advice I'm looking for this certain thing, and a lot of times it's just, I've done it so many times, I just kind of know, right? And I think that is, you know, as we, as we start to look towards things like, like like AI, where you can have those inputs that are training the models, those little things that they're like, I just sort of know, if you have the tools in their hands that can they can watch them or follow them along as they're doing it. It can actually pick up on that thing that maybe that surgeon can't quite put into words exactly, just brilliant.

Jean Chaoui  25:40  
This is a big challenge, like when, like, for the engineering team, research and development teams, when we get all these inputs from our marketing and sales teams, we need to balance, like, requests and inputs from our key opinion leaders to what would need the lambda surgeon, which are not 80% like over 90% of our customers. So this is a challenging exercise, so we can think how to provide the right solution for all those surgeon segments, for key even for key opinion leaders, they are asking more on alerts, like how AI could alert me, yes, before doing any mistake. So of course, they are not asking to tell me, okay, which surgical technique, which implant, and how to do, but more alert standpoint. But also, I met a lot of young surgeons asking for this technology, like they started with this technology. So they've

Addie Harris  26:48  
trained, like, it's just now, it's part of their training. It's not a question of, oh, is this, you know, is this going to replace, I know I'm already, I'm already too good for this technology. I don't, I don't need. They've trained on this, they see the value of it, and they view it as an integral part of of their tool set.

Jean Chaoui  27:06  
Yeah, which is amazing, because when I started, like 10 years ago, even a lot of surgeons were debating the value of enabling tech digital and enabling tech. What? What I feel the last five years and, and, or specifically, the last three years, the last nine

Addie Harris  27:28  
years, it's been amazing.

Jean Chaoui  27:30  
Just no more a debate. Yes, it's not a debate at all. So yeah, it's amazing. It's a momentum for digital and for all this innovation. Yeah, and yeah, and mixed reality, for me, it's a wearable, AI. So I don't look at this

Addie Harris  27:47  
on the as a decent, a great way to say it's like a wearable.

Jean Chaoui  27:51  
Ai, wearable. Ai. So again, an ecosystem where you can couple all those technologies together in the or, yeah.

Addie Harris  28:00  
So what advice would you give to innovators? You know, that's a lot of what we have here. You know, as they're maybe developing out the strategy in their company, from all of your experiences, what would you say? What are a couple of lessons learned, or key jewels that you would give them

Jean Chaoui  28:23  
the first one. And I keep saying this to my team, the source of inspiration should be like the way how the physicians are working, whether if it's the consultation room or the operating room, this is where our engineers should start thinking, and should come again to think, to rethink what they are working on,

Addie Harris  28:48  
watch and understand the environment regularly,

Jean Chaoui  28:52  
even the surgical techniques they are like the technology They are evolving today, like the knee alignment techniques today, trends, phenotyping and functional alignment. They were they are different from what we were thinking five years ago or 10 years ago. I can't tell you the same examples, in spine, in hip, in shoulder, in foot and ankle. So we need to keep evolving our competencies and skills on the technical side, but also on the clinical side, so we can propose relevant solutions. So this is the first challenge.

Addie Harris  29:36  
So stay dynamic is kind of what I'm hearing like stay dynamic with exactly

Jean Chaoui  29:41  
yes, yeah. So very close to our customers and not only rely on the marketing to get the message. And we cannot innovate in front of our screens, for sure. So this is, I would say, my main

Addie Harris  29:58  
yeah, stay dynamic and get your. Yourself into the field. Understand, understand your you know your customer, your user, the environment and what they're using. It absolutely used to tell you know my industry, I would say, look, look for the problems, like ask the questions, but beyond the questions, I want you to watch and look,

Jean Chaoui  30:15  
yes, the second one I would say today with what's going on when we look at the compute power related to AI, which is doubling every two to three months. According to the Stanford AI Index report,

Addie Harris  30:29  
compute power used to double. It was 10 years, and then it was five years, and it's just incredible.

Jean Chaoui  30:37  
Yeah, it was every 18 months. Yes, but today, if we speak about the AI compute power and the number of parameters, the hyper parameters, the number is evolving in an explosive way every month. If I'm not telling you every week, it depends on the the topic that you are looking at. Every month there is for healthcare, a new AI model that we need to test to leverage to see if we have the right application or not. And so that would make our engineers, if we don't, if they don't evolve the right way, two years, we would be obsolete as engineers, and we could not serve our business.

Addie Harris  31:23  
So don't think I'm going to learn about AI later. You need to learn about it now and to continue that yes, practice

Jean Chaoui  31:30  
Yes, and we ready, like if needed to have classes and training basic trainings about some topics so we can again, jump faster. And today, the you know, with AI models, they need this explosive computation like cost. So you need a lot of money, you need a lot of data. And this is why, if you observe what's going on. Now the wide majority of the AI models, they come from the industry and not the academic institutions, because you need those three components, talents and money and data. But I would say there is still a huge opportunity, and it's still vital to have partnership between the academic institutions, the industry and, of course, of course, the healthcare professionals, so we can build the right solutions. Industry alone, it won't work. Universities alone. They don't have what they need to get this level of AI power today. So when we need the collaboration,

Addie Harris  32:45  
collaboration, right? Yes, yeah, continuing to, kind of, you know, pull all of that research and that understanding out of the universities, but really, with that, that firepower and everything that comes from, yes, yeah, from big industry, exactly, yeah. Well, with the remaining moments that we have, I wanted to open it up to the floor for questions. Lisa. 

Audience Question  33:10  
Hi, I'm with Mayo Clinic, and I had a question. Do you have any advice for young surgeons that are entering into med school that have aspirations to innovate in the space? 

Jean Chaoui  33:25  
Yeah, absolutely, we had great experience of having like partnership to do a master or PhD between clinicians and engineers. So imagine a topic, whether if for a six months project, or for a three years PhD, where you see physicians working on the clinical side of the topic, and in front of them engineers developing tech blocks to solve Like the clinical need related to that. I can tell you, every single project we leverage this, it was amazing success. And in solutions like blueprint, 90% of the innovative features they came through this kind of collaboration. So I would say, stay close to the engineers, because amazing things would would happen.

Addie Harris  34:28  
Thank you. Brent,

Audience Question 2  34:30  
Hi Jean, great to have you here. Thank you for coming. Congratulations on your distinguished fellow ship award. Congratulations on that. I was really curious to learn how you from a drae leadership commercial perspective, Andre link with your business development team around acquisition strategy and what that looks like. We're seeing Stryker come a little earlier, perhaps in some other business units care ai, for example. So really curious to how you work together tactically, as well as thinking about what strategically might be. Be on the horizon in the future?

Jean Chaoui  35:01  
Yeah, excellent question. And I think this like tech division that you see it today in almost each big companies. So it's it's all about maximizing the synergies of all those talents. So in the same way, how we serve our business units with the right solutions for their customers, we also help them in any question related to MNA, of course, when it's related to our know how and experience and expertise for now, like our division didn't apply any acquisition for us, because, again, in our model, we search the business units for now.

Addie Harris  35:57  
Any other questions? Well, wonderful. There's one there. Sorry, I didn't see it. Oh, unless you you've one here. Thank you very much. All right, hold on. We'll pass the mic up to you next. But go ahead. 

Audience Question 3  36:11  
Thank you very much for your talk. Can you talk about some of your business challenges that you had? Can you share how did you go around it, yes.

Jean Chaoui  36:23  
So the business challenges today, like mainly, for example, in the Stryker world, it's how to monetize those innovation, innovative solutions. So it's still a topic while, like 10 years ago, it was no way to it's cool technology, but we cannot sell it today. No the topic. If we look at any software technology outside of the healthcare, and even sometimes inside the healthcare, we have subscriptions for software. If you need the cloud space to stock your photos, maybe like your photo applications is free, but you still need to to pay to get, for example, a memory storage space. So this is today our challenge. It's to go maybe beyond the enabling, tech driven business model like to sell more implants, to sell more products, maybe to have a value in the in the digital products themselves. And we start seeing this today, maybe a lot of software, they are free, when it's about simple, easy cases, primary, we see more and more that when we help the surgeons to solve complex problems like revision, there is a strong willingness from the hospitals, for example, to Okay, to pay this kind of services. Again, this is one example, but this is the main challenge, to

Addie Harris  38:12  
put it, putting value on the software. It's, that's something I've discussed with various people over the years, is it's, it's so important to put value on the software when it's yeah, when it's passed on to the customer, exactly, I think one last question,

Audience Question 4  38:30  
Hi, thank you. You have a transatlantic word in the title of the panel. So what's your view on remote surgery, remote interventions, even Intuitive Surgical now demonstrated capabilities for doing even transatlantic, trans Continental, continent surgery. So do you see applications within Stryker, Addie, you have tremendous experience with robotics in general. So what's your take here?

Jean Chaoui  38:59  
Yeah, absolutely. This is an interesting space that we are investigating.

Jean Chaoui  39:07  
And if we are working on connectivity and how to optimize the latency of our solutions to the maximum, it's also like to enable these kind of applications remote surgeries for the right procedures, but so we start seeing some application. They are still early stage. We are far like from a huge adoption of that, but we have all the ingredients and the components also to make that happen when it's needed. But we are following this very well with our key opinion leaders.

Addie Harris  39:46  
Yeah, I mean, I would say the same thing, you know, there, there are all the components there, you know, I think latency late, so it's a big issue. Issue for a long time. I don't think that's so much of an issue now. It certainly won't be an issue in the future. I think it's more about when is it the right time and space to have something like a Trans Atlantic procedure? If you have a doctor with the right specialty, with the right tools, where it needs to perform the surgery, that doctor should be the one performing the surgery. I think if you look at cases where maybe it's a particular specialty, maybe as Surgeon isn't available, and some like, we start to kind of see those edge cases where I can see that maybe making sense, and there are the right pieces there now that it could happen. But it's all about, if we think about kind of like the doctors, it's oath, it's, you know, you want to use the right tools, the best tools do the best thing for the patient at that time, not just for technology's sake,

Jean Chaoui  40:49  
exactly, and this is for surgery, but we already have applications like care ai, and outside of the surgery, where we speak more about virtual care,

Addie Harris  41:00  
virtual care. I think covid really drove it, but it's it's so commonplace now, yeah, it was because it was necessary, and now that it maybe isn't as necessary for all, because we're not all stuck in our homes. It it's about okay, where does it apply best? Where does it make sense? Exactly? Yeah, I think we're at time, little over time. But thank you so much, John, wonderful conversation, and yeah for the time today. Excellent. Thank you.