Chairman & CEO / MedTech's Top Search Consultant / The Mullings Group Companies / Board Member / Angel Investor / Keynote Speaker
The true adoption of AI in medtech will face a series of decisions by some of the its leaders in the next few years. Let’s look at the original digital native company that dominates surgical robotics, the most complex of medtech platforms, and has one of the largest market caps ($148B) in the industry. Intuitive. Intuitive continues to operate like a street savvy startup allowing them to remain agile and dominant. The D5 platform is another proof point of their prowess in the surgical robotics space. But without the decision to make massive investments in the current software architecture and AI-based infrastructure, the true incorporation of Data & AI will face challenges. “What else is under the hood?” on the recent release of the D5, have not yet been revealed, perhaps for several reasons, which likely is based on FDA regulations, as well as its limited capability of the delivery of data driven AI-based advisement in its current state. Imaging is at the heart of data and AI. The recent release of chips by Samsung and Nvidia tied and multi-spectral imaging technologies being incorporated into surgical robotics platforms is advancing at a rate that could not have been forecasted and producing data in orders of magnitude beyond what the systems were foundationally built upon. Leadership wrestle on a regular basis with how far ahead do you let a platform technology go in the absence of recurring revenues to rationalize the investment that is going to be required to bring the true value of all the “data” that can eventually be monetized? - The original open-source code that got them foundationally started and still resides at the base of some aspects of their system needs to replaced in order to unlock the real data from their platforms. - Investments required will easily be in the range of $100’s of millions to realize the capabilities of software, firmware, and hardware to process these LLM’s that can unlock incredible advisement, learning, and training. These massive investments will be required at the expense of near-term profit margins for the higher value of data & AI to be realized and eventually demanded by their users. It is much easier to have Boards, the C-Suite driven by incentives, and investors for share price, to sign off on building more capable manufacturing facilities, additional installation of capex, and expansion of company footprints on other continents than pull the trigger on this decision. Currently, Intuitive is not being pushed by anyone in the market of surgical robotics. An opportunity to expand their already massive moat with data & AI is likely wrestled with regularly. When is the distance between you and your competition enough? It will be of great interest to see how Intuitive decides to pave the way with the decisions they will make in the ongoing pursuit of Data & AI as they navigate the current state of the FDA, investors, profits, patients, and surgeons. See you at #SRS2024 in next week.
Steve Bell
6mo
Love it. This is the next battle front - but as you rightly say "when" do they need to pull the trigger? Do they need to pull the trigger? Ultimately any AI & data must bring meaningful benefit and economic impact to the customer for it to be adopted on a daily basis. It must help improve workflow and outcomes whilst reducing costs. How much of that can be done in hardware improvements and how much incremental does the promise of AI bring? What's the trade off for Intuitive ? There are some new startups that are coming at this from the opposite angle where intelligent "AI" software is the core and then you build the machine to implement what that software is capable of... Watch this space!
Bill Hunter
6mo
I study every move Intuitive makes. Looking for a “how to” manual in digital medtech? Look no further.
Santosh Iyer
6mo
Data is only as good as the insights it provides. What edge is it going to drive and how big is the opportunity? I agree that imaging is a crucial component for the intraoperative side, but current approaches cannot go subsurface effectively (multi-spectral is still surface level). There are a few companies that are working to bypass this, and I likely think they are prime acquisition targets once they demonstrate clinical value. I also dont think the data and AI conversation only applies to surgery, but also any interventional procedure (endoscopy, oncology, radiology, etc) or chronic condition (diabetes, heart disease, etc). Zooming out, the ideal source for medtech data / AI insights is something effectively equal to spatialomics (measure physical tissue and molecular structure at a patient specific level) to unlock new capabilities. Right now it’s done outside the body (ex. pathology), but some smart chemist or physicist is going to figure out how to miniaturize sensing to go in the body. The revenue implication from transitioning to "cellular-level decision making" for a physician will likely be tied to 10x improvement in some dimension of diagnosis or treatment outcome.
Marcus Bland
6mo
We are excited to share and launch dV5 at #SRS next week with the surgeons that had the vision of the Standard decades ago. What is awesome to see is visionaries like Vipul Patel, M.D., F.A.C.S. sharing his dV5 significant case series with the entire society. We are just getting started sharing “what is under the hood” of 5th gen.
Powerful Insights - the value of AI is indeed comprehensive visualizatiom that fosters both engagement and accelerated decision making. Responsible AI and governance for reproducibility (training LLM's) will be the staples of great companies. AI will electrify the MedTech ecosystem and expedite the diffusion of innovation.
Joe Mullings you are spot on with this! INUITIVE will be leading from the front on this.
Stanley Chong
6mo
Amazing insights and takeaway on the "real world" deployed cutting edge of digital tech in the medtech space 🙏
Ethan Mills
6mo
Great insight Joe Mullings. I agree the distance is far between Intuitive and competition both large and small. I'm curious to see how quickly they can navigate these challenges to capitalize on the massive data monetization potential.
Urologist at MS Urology Clinic, PLLC
6moI would think that the “data” needed for AI to learn needs to be more comprehensive than just that provided by video data from actual robotic surgery. Integration of preop labs, imaging(CT, MRI, US, etc), intraoperative hemodynamics, healthcare records(Epic, Cerner, etc), post op outcomes(recovery, pathology reports). The question is how can a company, such as Intuitive, do that with silos of essential “data”.