Episode: 206 - Medtech MVP 2026: How Health Systems are Adopting Robotics Across Care Settings

At this year’s Medtech MVP, a panel of industry experts explored how robotics are changing healthcare beyond the operating room. Robotic technologies are being deployed across inpatient care, rehabilitation, logistics, and remote patient support. Moderated by Virginia L. Giddings of Edwards Lifesciences, the panel includes Amanda Baumann of Stryker; Nir Goldenberg of Mayo Clinic Ventures; Kate Jackson Hobbs of Intuitive; and Maggie Nixon of Capstan Medical. Together they discuss the workforce, financial, and reimbursement considerations shaping adoption and how AI advancement will affect the future of robotics. 

Medtech Talk Links: 
Cambridge Healthtech Institute   
Medtech Talk 
Medtech MVP

Edwards Lifesciences:
Edwards Lifesciences 

Stryker:
Stryker 

Mayo Clinic:
Mayo Clinic 

Intuitive:
Intuitive  

Capstan Medical:
Captstan Medical 

Transcript

Why Robotics Is Moving Beyond ORs

Announcement 0:04

At this year's MedTech MVP, a panel of industry experts explored how robotics are changing health care beyond the operating room. From addressing workforce shortages to enhancing care delivery, robotic technologies are being deployed across inpatient care, rehabilitation, logistics, and remote patient support. Moderated by Virginia Giddings with Edwards Lifesciences, the panel included Amanda Baumann at Stryker, Nir Goldenberg at Mayo Clinic Ventures, Kate Jackson Hobbs at Intuitive, and Maggie Nixon of Capstan Medical. Let's listen in.

Meet The Leaders Building Robots

Virginia L. Giddings 0:45

Well, it's great to see you all again. Yes. And I think just to start, I'd like each of you to briefly introduce yourselves and give the audience a feel for sort of the lens that you look at robotics from. And maybe we'll start with Nir here.

Nir Goldenberg 1:02

Sure. Happy to kick us off here. Nir Goldenberg, I'm a member of the executive team and senior director with Mayo Clinic Business Development, aka Mayo Clinic Ventures. Mayo Clinic Ventures is both the TTO and the health system venture arm for Mayo Clinic. We lead technology development, investments, commercialization, and strategic partnerships for the organization. Regarding robotics, we are actually in a pretty unique, I would say, position since we are representing both the end customer in the context of adoption of novel and innovative robotic solutions. But we are also, of course, working closely with the ecosystem, both with strategics and with startups in the context of early stage investments and co-creation innovation. And we are also trying, we're doing our best to lead the way with developing our own internal robotic technologies that are coming out of mail, out of our research labs. So we're kind of uniquely positioned on both sides of the equation here. I mean, we can refer to that further during this discussion.

Virginia L. Giddings 2:12

Yeah, that's great. And you're an investor in the space too. I'm sure you see a lot of these companies.

Nir Goldenberg 2:17

For sure.

Virginia L. Giddings 2:18

Yep. Yeah. So, Amanda...

Amanda Baumann 2:19

Speaking of these companies, thank you. The strategic and the startup are here. Hello, everybody. Good morning. My name is Amanda Bauman. About 19 years ago, I took a job in a research and development engineer for Mako Surgical Corp, and we were working on a surgical robot for partial knee surgery at the time. December 17th, 2013, Stryker acquired that company. And it has been quite a journey ever since. We've now completed over 2 million robotic procedures on hips, knees, shoulders, a little bit on spine. And still going over 46 countries. The robotic platform has taken off, robotics has taken off. So much has changed since I started in that role 19 years ago. And yet it's still so much fun. And I still do it every day. So I lead the team now at Stryker that does all of our robotics development for hips, knees, and shoulders.

Virginia L. Giddings 3:12

Yeah, that's great. And what a what a journey too. We've been there from the start. I'm sure there are a lot of more stories, right? So, Kate, it's lovely to see you and perfectly on time. We got a little ahead of things here. So...

Kate Jackson Hobbs 3:28

I know we got to get up early to get ahead of gas.

Kate Jackson Hobbs 3:30

Yeah, you do. Yeah. We're just trying to get through these panels quickly. Maggie, why don't you go ahead and give I mean your timing's perfect, Kate, because we're just getting into things.

Maggie Nixon 3:40

Absolutely. Awesome. So Maggie Nixon, CEO of Capstan Medical. I am a mechanical engineer by training. I spent the first 20 plus years of my career at Intuitive Surgical. So you're getting a little bit of double duty on Intuitive, but I was on the original cardiac team, Intuitive, and so which was really critical to figuring out kind of the needed capability in that system. And then I was through the shop for the heart and hit the prostate transition. I spent my first decade there in RD, then led clinical development engineering. Somehow that turned into roles in operations, quality, regulatory, and then eventually global leadership. So one company, it was about 80 people when I started there and about 12,000, 13,000 when I left. But in 2022, a my first boss, an Intuitive, , reached out to me. He's kind of been a serial entrepreneur. And he said, You gotta come meet this great team. He's like, Are you ready to go back to the heart? And and I came out to Santa Cruz, California, and met this incredible, you know, kind of talented engineering team, right? You make decisions on people and product. And with a novel implant technology, in an in a really capable catheter with about eight levers to drive on the back of it, and you need about five or six hands. And I made the tough decision to leave intuitive and pivot into the robotic space for this catheter technology. So Capstan Medical has an intra-cardiac robotic system with fully integrated implants. We're starting with mitral valve replacement, and we have tricuspid moving out of preclinical into clinical right now, but really figuring out how robotics can come in and give different types of tool to the interventional cardiologist in order to serve their patients.

Virginia L. Giddings 5:30

Yeah, that's great. Moving from pioneering in one area to pioneering now in interventional cardiology. She's not done. Yeah, she's not done. So, Kate, so in it, what the question was about like what lens that you see robotics from and just your brief intro.

Kate Jackson Hobbs 5:49

Yeah, absolutely. So I'm Kate Jackson Hobbs. I run the corporate development strategy function at Intuitive Surgical. Um, some of you actually might remember me from last year when I was on the investor panel and I was considerably larger because I was six months pregnant then. But I'm no longer pregnant, the baby's now eight months old. But I bring so my my background was actually 21 years on Wall Street at mutual funds and hedge funds. And in that, in that work, my favorite thing to do was geek out on exciting new technology, look at some of the long-term trends of where was the innovation, where was the technology that was going to deliver better solutions for patients, for hospital systems, and ultimately for you know the entire community. And with that lens, I ended up at Intuitive Surgical started just about a month ago. But in, you know, in what everything we do is anchored in the Quintuple aim. We are looking to provide solutions that improve outcomes for patients, that create a better experience for surgeons, for the care teams, that expand access to minimally invasive care and that lower costs to the system. We bring, as when it comes to robotic surgery, we really bring an enterprise lens. And so we are thinking about hardware, we're thinking about software, we're thinking services, we're thinking training, but really we're thinking about how do we bring durable solutions and a holistic opportunity to a hospital where we're able to consistently improve the quality.

Virginia L. Giddings 7:21

Yeah. That's great. So maybe before we get into deeper discussion, I just wanted to put it out to the audience that I'm gonna stop about 10 minutes before the end of the session and ask you all for questions. So if you could be thinking about that as you hear from the panelists now, I know with some of the other panelists, I just mentioned it because the audience has been very quiet this morning. So I just think do whatever you need to do, go get a cup of coffee, think about what you're doing. I was gonna say, should we bring in espresso shots? Perhaps, perhaps.

Where Hospitals Are Adopting Robotics

Virginia L. Giddings 7:55

So yeah, the next topic I wanted to touch on is where's adoption happening. And robotics has become synonymous with the OR for many people, but adoption is really expanding, you know, much beyond that. And I know Nir at Mayo that you have a lot of visibility to that. So maybe you could speak to that. Where where is Mayo seeing adoption of robotics happening?

Nir Goldenberg 8:21

Yeah, so you know, Mayo, I think most of you are familiar with our principal value, which is the needs of the patients come first. And we we always lead with that, and in order to execute on that, you know, we constantly elevate our practice, our research, and our education shields, in addition to constantly, iteratively investing in innovation in order to bring the best, most innovative care to our patients. This is one of the instruments for male innovation, right? In order for us to be able to maintain our leadership position as a number one hospital worldwide. Robotics is a perfect example for an area that you know we are when we are kind of meeting with companies, kind of seeing what we are all seeing in our ecosystem, we see that this segment is going through a significant transformation. So you're asking about adoption, adoption in Mayo. We're very intentional, we're very proactive, and we are adopting across the whole spectrum, both around care for patients across the whole spectrum, including you know soft tissue and beyond, towards you know, additional um use cases, you know, from obigeine to urology all the way to endovascular.

Nir Goldenberg 9:40

And then outside of the clinical care, outside of the procedural and surgical space, we are adopting surgical solutions across, you know, I would say more administrative and operational use cases. Good examples are you know, we intentionally we are scouting and seeking for innovative solutions to adopt into our labs business, which is a very big business for now. Pharmacy, additional services, including food and so on and so forth. At the end, if we can improve our operations around these non-clinic clinical settings, this could allow us to actually enhance the care that we provide on the clinical side. So adoption happens across the whole spectrum, and our mandate is to be connected to the ecosystem and find the best, most prominent technologies and companies that could collaborate with Mayo in order to bring that innovation into our health system.

Maggie Nixon 10:36

Yeah. I mean, I would just love to comment on the shift in receptivity in the market to robotics as a technology. And it's like I'm sitting right here between thank you, thank you, because because man, in 2000, you would walk into a clinician's office and be like, we've got this great piece of technology, we'd really love you to give. They would laugh you out of there. Like they would legitimately go, I do a great surgery. And they did. It was not a hit on their capabilities. But now I expected, you know, 20 plus years later, to sit down with cardiologists and have the same response that I had to cardiac surgeons. And I'll be damned, it couldn't be more opposite. Like it is, it is about time that we get a tool that actually lets us do these things that we want to do. And it's just, there is just an overall receptivity to it from a clinician standpoint. And I know we don't have an MD up on the panel, but it is it's just it there's been so much paving of that road. And it really is the orthopedics and the soft tissue robots that have done that.

Virginia L. Giddings 11:46

Yeah, and it makes such a difference with innovative technologies if you have the pull there, right?

What Clinical Value Actually Means

Virginia L. Giddings 11:51

So yeah, and this I think gets to like the next, the next point that I wanted to touch on was clinical value and how, like, and and particularly for you, those of you who are in this business of developing robots, like how are how is clinical value seen? Like, what are sort of those metrics there of like how clinical value is defined? And maybe I'll start at the end with Kate and hear from from you on that.

Kate Jackson Hobbs 12:19

Well, you know, I'm gonna start sounding like a broken record here, but it keeps coming back to just consistently improving outcomes. And so we want to shorten the learning curves, we want to enable collaboration, we want to provide more insights, but it's about providing that better experience, the better outcome for the patient, allowing the surgeons to have a better ergonomic experience, to move faster. And all of that leads to the financial value, but also the clinical value and the improved outcomes over time.

Maggie Nixon 12:54

Yeah. And I it has to be anchored in patient value. It's it otherwise, it's just a piece of technology for the sake of technology. And so at at Capstan, it was a team that deconstructed mitral and tricuspid interventions. They were going, why are there so many great catheter-based options out there in the aortic space? Why is that not translating to these other areas? And so when they deconstructed that, they they're like, there has to be more anatomically compatible implants. Well, all of a sudden, if you've got a more anatomically compatible implant, you need different range of motion, stability, control in your catheter. And then by the time you had that, we as we jokingly say we did not start as a robotic company. We backed into a robot because we're like, now if we can get, if we can treat more patients, everybody has to be able to do it. So then all of a sudden you have a robotic system that reduces the complexity from a user perspective and all that different range of motion and capability. And so it's it's really backed into solving the for the patient.

Kate Jackson Hobbs 14:01

Yeah. Well, and that's kind of the you know, the highest and best use of robotics. I was having this conversation with someone yesterday about the Society of Robotic Surgeons. And it's like the, you know, part of the challenge there is that it it focuses on the technology, but it's really the robots as a means to the end. The robot is not the end, but a robot as a way of driving better outcomes and better solutions. Because if it's not driving better outcomes and solutions, then it's just taking up space and eating up costs.

Amanda Baumann 14:26

What do you do here? Yeah. Just taking up space in the hospital. One other thing, if I may add on clinical value, definitely patient first, patient outcomes in the orthopedic space. We see lower revision rates, we see shorter time in the hospital, faster time to get home, less opioid pain use. Um, we're seeing all kinds of benefits to the patients. We're also seeing, like you said, surgeons would have laughed at us 20 years ago, patients would have laughed 20 years ago. And now patients are like, well, I want the robot, I want this, I want that. This foundation, right? Is so different into it, too. Right. Yeah. And then I think also building on so the patients doing better, the hospital's doing better. We also talk a lot about the surgeon and the healthcare provider and the wear and tear, especially with an orthopedics that puts on the person who's slamming the hammer all day long. They end up our hip surgeons end up being shoulder patients. S o we're also focusing a lot on how to reduce that physical and the mental load on the hospital staff. So anything from robotics to help cut the bone easier, but also where are we going with data with AI? We have AI algorithms now to help plan the surgery ahead of time, help with that, those decision support tools so that once you get in there, it's like measure 50 times, cut once, do it all ahead of time, know what you're gonna do, use the algorithms to reduce the mental load and that the physical load on swinging the handle.

Virginia L. Giddings 15:54

Yeah, and the physical load with like the constraint on physician time and all of like, all of that. I mean, I feel like that's, you know, as you and I were talking about it, it was the first time I'd really thought about that. That that is a huge benefit and value to the system. Like if you can retain physicians, make their make their work easier so it's not as much wear and tear on their joints. It's huge.

Amanda Baumann 16:17

More fun to come to work. We all want to have more fun at work.

Virginia L. Giddings 16:19

Right, right, right, for sure.

Announcement 16:22

Are you enjoying the conversation? We'd love to hear from you. Please subscribe to the podcast and give us a rating. It helps other people find and join the conversation. If you've got speaker or topic ideas, we'd love to hear those too. You can send them in a podcast review.

Virginia L. Giddings 16:39

So Maggie, one of the things we had talked about earlier was about, you know, robotics as being fundamentally enabling, but they're also a part of this broader sort of technology, you know, ecosystem.

Robots As The Data And AI Hub

Virginia L. Giddings 16:53

How should we be thinking of robotics alongside data, AI, imaging, navigation, all of that? Like how should, you know, I think we've had there was a thinking around robotics of this machine can do what a person does and be able to replicate the best physician. But how has that thinking evolved?

Maggie Nixon 17:22

Yeah, I think it, and Amanda, you started to hit on it, right? Like because it's everywhere. Well, because I view the robot as a tool for the clinicians, but an integrator for the tech stack in the hospital. So it's almost like the lightning rod, right? So you have all of these patients that are diagnosed and they have all this imaging available to diagnose their disease state. Well, then how are you leveraging that imaging into your procedure? You now have a computer in the loop. You're now able to pull insights out of your preoperative imaging, pull it interprocedurally. Then in your interprocedural imaging, there's so much great innovation happening on auto-recognition of structures and all of that. Now imagine being able to take that insight and map it into your interventional device, right? And so you've got all of that, plus you've got the complexity within the system that's being managed.

Maggie Nixon 18:17

So, you know, cognitive load on those clinicians, and they're focusing on their intervention rather than how do I actually drive this device, right? Yeah. And then you take all of that and you go, oh, well, you're grabbing all of that kinematic data. Like think about all of that rich data that is going into correlating it to outcomes, right? So, okay, well, now you've got data on these sorts of this, this data set gives this type of outcome, this data set gives this type of outcome. But that's also what fuels the innovation pipeline. What range of motion are you using? What aren't you using? Can you simplify things? Do you need to add a little bit more? All of that fuels the innovation engine back in. So I that's why it's it's it is an integrator on how to take all of those elements within the hospital's tech stack and bring it into the clinic to better serve patient outcomes, right? It's just very grounding when it comes to that.

Virginia L. Giddings 19:16

Yeah, and Amanda, how is how is that? Yeah, no, I just think building on that. Is Stryker thinking about this as well?

Amanda Baumann 19:23

Like, oh, oh yeah, I think I think everybody's thinking about it. But like to Maggie said, you now have a computer in the room. So you have a computer preoperatively because you have images, you have plans, AI generated, not AI generated. We have all kinds of data that can help us. What we we call them decision support tools. So I like you mentioned, we don't have any MDs on here, but it's it's not about not having the MD, it's about all of that that that MD is giving. Giving in their head for years, versus just saying, like, for example, in orthopedics, like instead of going, oh yeah, every time I get a 72-year-old female who has this, this, I do this. We're we're able to work towards putting that in front of them, not making the decision for them, but just saying, by the way, the last hundred seventy two-year-old females you did, this is what happened. I mean, this is this is all getting more and more possible with robotics being the tool, like you mentioned, it's like the means to how do we get more accurate? How do we track what we were doing? The robot brings the computer in. Yeah. And now we have all of that information and we have the clinical study backings, like, you know, we have the physicians who are passionate about this, the researchers who are passionate about it, and just make it a little bit easier instead of doing all that calculation in their head, remembering everything, it the robot really helps.

Maggie Nixon 20:36

And we haven't even touched on the piece that Intuitive has taken really seriously, which is the training. So we're able to bring our virtual device to like the night before a procedure, the clinician can be sitting down with a controller connected to their laptop, driving through the anatomy of their patient for the next day. Talk about like dry running patient procedures, right? And it's their custom patient, you know, mapping. So by the time they're like, then they're done that, right? Like talk about something that impacts simulator. Yeah.

Virginia L. Giddings 21:10

So Kate, I want to I want to hear from you, and then Nir I'm gonna get to you. Yeah. So let's hear from you on your own.

Kate Jackson Hobbs 21:16

I know the AI panel is this afternoon, but we could just keep going, like lead us, lead right into them. But you know, obviously, Virginia, you've touched on an area that's that's super exciting to all of us, and I would imagine everyone in this room. I mean, what what we're seeing is increasingly this platform is about so much more than the robot in the room. It's about the the hardware and the software and the AI, the learning, the services, the training, but all of that leading into data and insights. Where, you know, we're where we're in a position now where we have over 10,000 instruments across the globe. We've got 100,000 trained surgeons and cumulatively upwards of 20 million procedures, all of that generating data. That we're now able to use to support surgeons in making better decisions. And so we think about our AI capability stack, kind of starting with all of that data from all of the procedures leading into the My Intuitive Plus app. Building on top of that, we have SimNow2 and Case Insights, which are creating better insights for our surgeons. We've now introduced My Intuitive Plus with telecollaboration to help these surgeons connect with each other. And increasingly, what we're seeing is that we're able to offer better decision support, enable surgical guidance, and leading towards augmented dexterity. Now, as we've recently introduced force feedback, that's a whole nother class of data that we can use to drive insights and drive better outcomes. And ultimately, the robot becomes the vehicle. But the data and the insights and the AI, that's what enables the continuous learning and improvement. And so when we think about our QuinTeple aim, we think about the opportunity to drive consistently better outcomes. We are really just getting started.

Virginia L. Giddings 23:05

Yeah, that's amazing. And the power of data is, you know, transformative. Absolutely. So, Nir, from your perspective.

Nir Goldenberg 23:13

I think it's pretty fascinating. Historically, you can see, you can observe and see this pendulum of innovation between hardware and software, right? So you can see, you know, we had an era where we had significant innovation around, you know, microprocessors, GPUs, sensors that kind of led that first generation of robots, right? Clearly now, we all know we are in a very, you know, within this pendulum, we're in a very software AI-oriented phase, which is kind of when I'm kind of observing, I'm seeing two things that this phase is going to create. One, this phase is going to force all the robotic companies to truly adopt meaningful, impactful, clinical AI. And some companies, if you're honest with ourselves, some robotic companies, their their DNA, their core DNA is hardware. So they need to kind of adapt with this phase and truly develop, co-develop, create, and integrate again, meaningful, clinical, impactful AI. And then the second thing which I think is coming our way is this AI and software wave or phase is going to is already creating the next generation of robotic systems, which is fascinating. And I think that the companies that will react quickly and leverage this explosion in software and AI and translate it into the next gen of the robotic systems will win the race eventually. Mainly today, we're looking on a couple of segments, right? There is more and more competition, right? More and more companies are stepping in and competing, including with some of the kind of market leaders in different segments, including Ortho and Soft Tissue.

Amanda Baumann 24:48

We take it as a compliment.

Nir Goldenberg 24:49

Exactly. Exactly. But that's kind of it's pretty fascinating, and I feel that we we need to kind of be aware that this is happening now and we need to leverage this phase of AI.

Paying For Robots When Budgets Hurt

Virginia L. Giddings 25:00

Yeah, so this is like this is all incredibly exciting. But then there's the cold, hard, hard, stark reality of you don't want to just let us geek out. Yeah, that technology sounds really cool. But you know, health systems are really strapped and capital is very expensive. So I think, you know, what you know, how are the healthcare systems working through justifying like how are these capital investments justified in the healthcare system? And and near, I'll I'll lead off since you're with a healthcare system, you're probably you have to start. You're probably part of daily conversations about this, like cool tech, but do we have the money to do it? And how do you justify that?

Nir Goldenberg 25:48

Yeah, I think some of you refer to that before, like the cost dimension is just one dimension, right? So at the end, everything you said is true, right? You know, capital is expensive and it's hard to acquire and deploy and adopt expensive capital equipment. But for companies and systems that are generating value proposition beyond just the cost dimension, right? That includes enhancement or elevating of efficacy, safety for patients or accuracy, right? Rob robotic systems could, if you're developing the right innovation, be way more accurate compared to a human. And then beyond that, if you can also, again, beyond the cost dimension, if you can also assist, the innovation can assist with time reduction and you've mentioned like ease of use and reduction of burden on the surgeon, these are all kind of additional value proposition buckets beyond just the cost or the financial bucket that if you if companies can lead with that and execute and provide that value proposition to health systems and to patients, that makes the feasibility of you know enhancing their market share and penetrating the market and having a bigger install base with health systems, you know, to be way more feasible and more successful. So it's not all about the cost. Cost is one dimension, and there are additional dimensions that need to be considered constantly.

Virginia L. Giddings 27:15

Right. So I'm sure, you know, Amanda, you know, the rest of you probably work through this with healthcare systems. Is it you taking the lead on putting together the value package or the hospitals pulling for it? Like what does that look like?

Amanda Baumann 27:29

All of the above. Yes. Putting together the value, you know, whether it is patient outcome value. There's also many studies done on value to the hospital system, right? Being able to pull in patients or paying more attention now. So there's a volume game to it. There is there is that capital expense with the robot. So the other thing we do is say we'll get more for it, right? So if you're gonna place a robotic system, can it do more things than just one type of surgery, right? So I guess I haven't been bored for 19 years. So we've added five or six other indications so you can buy the same capital output and get multifunctionality to it, which I'm hoping is also value to the hospital, value to getting surgeons cross-trained, getting surgeons comfortable with the technology. So it's really about making the most. Yes, we work on clinical value from the patient as well as making the most out of that capital expenditure for the hospital.

Kate Jackson Hobbs 28:32

Well, and and also as as we think about, you know, not just the clinical value, but we think about what's constrained in the hospital. So absolutely, you know, capital is constrained, but you know what else is constrained? Staff, bed space. There are a lot of areas where the hospital is stretched incredibly thin and doesn't have you know any relief coming anytime soon. So if we can get that patient out of the hospital two or three days earlier and free up some space, if we can make the procedures go faster, if we can enable the care teams to move faster or not have to have as many people in the room, all of those kind of make life a little bit easier for our hospital customers.

Kate Jackson Hobbs 29:12

But, you know, one thing that really impressed me when I arrived at Intuitive talking to our commercial team, that purchasing decision and that capital placement, that is just the beginning. And that is the beginning of our journey with the hospital to build a durable program that creates clinical and financial value for that hospital. And so, you know, when I remember our CEO saying to us a couple of years ago or telling me as I was looking at the investment, he was like, you know, Kate, there's 60 people who touch the robot, six zero. And so when we look at the kind of value we want to create, it's we've got to create as much value for the first person who touches the robot as the 60th person, but really coming down to how to create we create that holistic, durable solution that consistently improves outcomes.

The Hard Part Of Implementation

Virginia L. Giddings 29:58

And that's a perfect segue to my next question, which is about the implementation challenges, like sort of the nuts and bolts, is like what's the most challenging part? Is it the ROI? Is it the ROI justification? Is it like the physician training? Is it like the IT or hardware integration? Like what what piece of this is the heaviest lift in that process?

Nir Goldenberg 30:24

I think you know it's a case per case, and there are so so many different robotic systems, right? So it's hard, we can't really compare apples to oranges, right? So sometimes most companies do a good job around you know the commercial side of things when they're already commercializing their solutions. So the ROI, the economics make sense, right? At the end, most companies, right? Beyond that, if we're talking about the bigger systems, there is kind of an infrastructure constraint, right? We need to think about, for example, you know, can systems allow OR to be ORs to be modular, right? To be flexible, to be adaptable to other types of procedures and so on and so forth. So there is an infrastructure barrier, but many companies, I'm talking about the bigger now, bigger robotic systems, are thinking about um that when they're designing their next generation of systems and are actually providing very cool, I would say, design features in order to help health systems with easier deployment or precurement of their capital systems, again in the context of modularity and so on and so forth.

Maggie Nixon 31:30

Yeah, I'll actually chime in on this one because this is something that I think I think there should be expectations put on the manufacturers around how they're thinking about this. And it should be done from the very beginning. Like this is this is we we even in our first in-human study, we were explicitly going, we're bringing a brand new technology into an a cardiology lab that is not used to having a robot in there. And and we need to learn as much as we can. It wasn't just the learning that we needed clinically of the implant. We went to big centers, we went to little centers, we went to highly experienced interventionalists on the left side of the heart, we went to brand new clinicians that have only done a handful of procedures on the left side of the heart. We needed to see how this piece of technology integrated through their logistics department, their central processing, their cath lab management, their leadership. Like we we sat down with the directors of of the the the cath lab, the head nurses. Like we were engaged at every touch point because we needed to extract all of that insight because we think it's on us to figure out how this piece of technology is going to meet the needs of the clinician, but also the the institution, right? And so it's not providing that patient value unless it is integrated so well into that institution.

Virginia L. Giddings 32:56

Yeah, and I think that's so eye-opening and what Kate was saying earlier about 60 people touching touching the robot along the way. We've got about three and a half more minutes before I pause for like audience questions. And, you know, if there's like not a lot of questions, then we can get back on this subject. But I sort of wanted to do it like rapid fire because I did really want to get your thoughts

2030 Forecast For Health Care Robotics

Virginia L. Giddings 33:22

on this. And we'll start with Nir, which is you know, in 2030, what do we think? This is tomorrow. This is right, we get like 30 seconds. In 2030, how do you imagine this? Like, what's it gonna look like to have robotics implemented in the healthcare system? So yeah.

Nir Goldenberg 33:42

So we are going to see, we're already we're going to see that's affect way more robots deployed across again the whole spectrum of health systems. We talked about non-clinical areas, SPD, pharmacy, operation, operations such as food services and so on and so forth, laboratories, right? And we are going also to see way more robots deployed across clinical setups, procedural and surgical, from big robotic systems all the way to more tactical but very valuable robotic systems that are focused on specific specialties or use cases. So this is already happening. It's not a question, is this happening? This is a wave that is happening. Again, I talked about this pendulum between AI and hardware and robotics, and this phase of AI is now creating, kind of giving birth to the next robotic systems that are going to be deployed in the next five to six years.

Virginia L. Giddings 34:38

Yeah. So, Amanda, first Stryker. 30 seconds. So what's it what are you doing?

Amanda Baumann 34:44

Well, 2030 is about tomorrow.

Virginia L. Giddings 34:46

Yeah.

Amanda Baumann 34:48

Literally this morning working on a project schedule for 2030. But I think just to pull on Nir's point about hardware and software, and it's both. And it's advancing the hardware so that the hardware becomes, if I can say more and more invisible. So it's there, but it's it's integrated better. It's modular. We touched on that. You know, we can come in and out of rooms or it's built into the room, as well as all of that software, machine vision, AI, everything that we're talking about, like care AI and ambient intelligence is enabled because that hardware and that software is coming together. So it's going to be both because you got to put the camera in the room, but the algorithms that run there, there's so many companies now working on like these platforms of yes, there's a robot, an SPD cleaning something, but that one piece of hardware isn't just learning, right? It's feeding the network, it's feeding the whole platform so that that whole machine gets smarter. So the data is going back to Stryker and you're learning from it and improving. In in that example, yes. Or I mean, we're not in SPD robotics, but yeah, all of those. And there's companies now that are saying, hey, come and teach our robot your expertise, teach our robot to clean floors or yeah, you know, clean clean instruments. Yeah.

Maggie Nixon 36:02

I'll add on two things into this. I think we'll see it at every level of the patient journey. We're gonna see robotics at the imaging, at the in the clinic, we're gonna see it at the ASCs, we're gonna see it in the the ORs. So there will be a level of robotic interfaces all the way across. But I think one of the most things, the things that is gonna most evolve in by 2030 is collaboration between robots. This is not just from the data. I actually think there will be specialized robotic capabilities that will be collaborating interprocedurally. And I think this is gonna unlock so many different insights between the different elements of patient care. I think you'll even start seeing AI in the anesthesiology sort of space. So that kind of collaboration, knowing when you you are in a humodynamically challenged part of the procedure and managing that with anesthesiology and syncing that up with the imaging, right? Like you can just imagine how how all of that intersection will just unlock capability to collaborate. Like true personalized medicine. Oh, absolutely. Yeah.

Kate Jackson Hobbs 37:10

And I guess what what we're envisioning is is integrated platforms that hardware, the software, the robotics, the AI, the data, you know, all kind of coming together, centered around the surgeon and the patient. But, you know, it's not about replacing surgeons with humanoid surgical robots. It's about giving our surgeons superpowers.

Virginia L. Giddings 37:31

Yeah. Right, right.

Maggie Nixon 37:32

Oh, and we haven't even talked about humanoid.

Virginia L. Giddings 37:35

Right. Well, we can we may be able to have time for that. So I'm seeing from Jason five minutes, which is enough time to take a couple of questions, I think.

Audience Q and A On Leadership

Virginia L. Giddings 37:45

Are there any questions from the audience? The coffee didn't work, or perhaps there's if you can make your way up to the mic, that'd be great. Yeah, you're at the yes.

Audience Member #1 38:00

Hey everyone, my name's Renee Chang from Talencio. Thank you. This has been so fascinating to listen to. So we have, I just want to call out four out of the five panelists that are women shaping robotics. And we might not have seen this landscape five, 10 years ago. So I my question is if you were to give some advice to the younger female generation, what would you give about leadership and how to navigate what you've already navigated?

Amanda Baumann 38:29

Oh, I didn't see that coming. Nir.

Virginia L. Giddings 38:34

Sorry. We probably need another like couple hours to come out of that.

Amanda Baumann 38:39

But I think the thing there is really it's you you mentioned the next generation. It's whether our children are our nieces and nephews or like society as a whole. It's that we're all in this together and we all have to play to our strengths. And it wasn't like if I go to the engineering button, it wasn't like one parent was like, oh, well, you should be an engineer. You know, it was like, sure, you can play with Barbie, sure, you can play with Legos. Like it doesn't have to be one or the other. But I think it's really just working with companies that are open-minded, flexible, and really playing to strengths. And anybody who wants to go after it, just go after it.

Maggie Nixon 39:18

Yeah, I think it's it's it's as simple as getting comfortable with being uncomfortable, right? And it's really when it comes down to it. And but it's okay with that. Like there's this feeling that you can't be uncomfortable.

Kate Jackson Hobbs 39:28

Nope. Look for it. Okay. I think, you know, also persistence and resilience. And of course, that is, you know, across everyone of every background, but I think there's a unique set of challenges that that women deal with, you know, both around bias, but also around bearing children. And I say that as someone who, you know, has has three children at home, including an eight-month-old. And I was here last year, and I'm here this year, and there's a whole team at home enabling me to be here. But, you know, it's a it's a much longer conversation. I actually write pretty openly about some of these topics on on LinkedIn if you'd like to follow me. But it really, you know, if I were to kind of boil it down, it's persistence, it's resilience. You know, I think we can all say when we were coming up, I don't know that I ever saw panels that had like any women, much less four out of five women. So, but that clearly didn't stop us, and here we are.

Virginia L. Giddings 40:18

Yeah, and I will say for this panel, I did not have my thumb on the scale in any way. I was referred to, you know, the top experts at these companies. And and I don't know, things are things are changing and change is slow, but it's it's meaningful and it happens. So, like , we have a question back there.

Audience Member #2 40:38

Yeah, absolutely. My name is Zishan from Vaskidine. A very nice conversation. Just when we talk about robotics, of course, you know, high-tech. Panelists' perspective on global competition. Of course, Kate highlighted the needs. I've heard from surgeons in India and China, like how much they want to do more patients they can't, but also their companies making those things. So just your perspective, you know, how do as a company to navigate global competition and also how do you deliver it to globally to sufficiently.

Kate Jackson Hobbs 41:07

Just so I'm clear, you want to know about global collaboration or also how do you address global competition? So we are so excited to see so many other companies, you know, seeing the value, seeing the opportunity. Um, we're so excited to see that the technology is now catching up such that it can be democratized. And so, you know, we are we're over here kind of we we, you know, day in, day out, we seek to provide the best clinical value, whether you're a surgeon in, you know, rural India or a surgeon in Manhattan. And we're we're so excited that other people see the value as well. And really at the end of the day, I think we're all kind of looking towards that same North Star of improving the experience for patients and surgeons and care teams and improving access and lowering costs.

Amanda Baumann 41:55

I think just to add to that, I was gonna add when we were talking about the 60 people who touch the robot and our experience now in over 46 countries, including we just placed our hundredth Mako in India, you learn a lot. That's very different in different countries, right? All over the world. Who touches it, who's responsible for things, who who do you work with in the hospital? And I think it comes down to having those teams of people who are close, who understand that specific customer. And also there's so much more opportunity, if we could just bring it back to the patient, sometimes outside of the US, where you have patients who have waited even longer within the world of orthopedics, where they've waited even longer, they need even more help. And that's where this data loop of I have preoperative imaging, I know what to do intraoperatively, and I can go in and do these hard, scary cases, but I'm not afraid because I planned it out ahead of time. You're actually seeing sometimes more clinical value in different regions of the world.

Virginia L. Giddings 42:48

And I think, you know, we're probably gonna have to wrap here because I was getting the signal from Jason, but

Global Competition And Closing Thanks

Virginia L. Giddings 42:54

I can't. That's probably like we probably need like a robotics panel like part two, because there's so many, so many topics that we could continue on and discussing. But with that, I'd like to thank my panelists, Nir, Amanda, Maggie, Kate for joining me here. This was just a terrific discussion, and I appreciate you all being here and having this today. So, with that, I'm sure they'll be available afterwards to to have conversations with you.

Nir Goldenberg 43:23

Thank you.

Amanda Baumann 43:24

Thank you.