Medtronic

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About 50% of U.S. adults suffer from high blood pressure, which ranks as the No. 1 preventable cause of death, heart attack, and stroke. Medtronic’s Symplicity Spyral is a minimally invasive intervention that sends radio-frequency energy to nerves surrounding the kidneys that become overactive among hypertension sufferers. The system was approved by the FDA in November 2023 and has been used to treat 25,000 patients globally.

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Medtronic ranks 119 with $31.2 billion in revenue (down 1.4%). The Ireland-headquartered medical products and equipment company has 95,000 employees and made a profit of $3.8 billion (down 25.4%).

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Aggregate sales hit $37.8 trillion last year—an increase of 19%, the highest annual growth rate in the list’s history.

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Colorectal cancer kills nearly 900,000 people a year—and it’s easy for clinicians to overlook. Medtronic’s GI Genius module uses A.I., built around 13 million images of colorectal polyps, to detect tiny polyps that human eyes might miss. Studies have found that using it in a colonoscopy decreases the “miss rate” by 50% compared with standard exams, increasing the odds of early detection and successful treatment.

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Total revenue for the world’s biggest companies fell 4.8% to $31.7 trillion this year—the first decline in half a decade.

The world’s largest medical device manufacturer has many of its operations in the U.S. but is legally headquartered in Dublin. Although the pandemic caused the cancellation of many elective and routine procedures around the world, the company still managed to eke out modest sales growth, up 4% globally, with big gains in respiratory, gastrointestinal, and renal products, as well as products to treat cardiac conditions. Operating profits, however, are down nearly 28% since 2019 because of increased cost of goods sold, R&amp;D expenses, and restructuring charges.

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This year's Fortune Global 500 generated $33.3 trillion in revenues and $2.1 trillion in profits.

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In March COVID-19 blocked medical supply chains even as the need for ventilators soared. Medtronic responded by sharing the design specifications for its Puritan Bennett 560 ventilator so anyone could build one. Since then, the company says, 200,000 entities have downloaded the specs, while Medtronic quintupled its own production to 1,000 units a week, keeping shortages at bay.

This year's Fortune Global 500 generated $27.7 trillion in revenues and $1.5 trillion in profits.

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Wal-Mart stayed on top as its sales crept closer to half-a-trillion dollars. Apple moved into the top five. And UnitedHealth Group continued its steady climb. 

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Geoff Martha, Chairman And Ceo, Medtronic In Conversation With Jo Ling Kent, Cbs News

Innovation Forum 2024: How Ai Will Supercharge Medical Devices

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Geoff MARTHA, Chairman and CEO, Medtronic In conversation with Jo Ling KENT, CBS News


Jeff, thank you for being here. Really appreciate it. Yeah, it's good to be here. Well, you're here on a big Asia Swing Whirlwind tour. Whirlwind tour. But I have to say, first and foremost, I am from the great state of Minnesota. You are running a Minnesota company and it takes us Hong Kong to get together. I love it. Um So you're on this Asia Swing, you just came from Beijing. You were at the China Development Forum. How was it? Well, I'd say it was very, uh I'd say very insightful. Uh you know, uh Premier Lee has addressed uh uh a cross section of multinational CEO S about the economy, about the business environment, about where they're going. And you know, a couple takeaways that I had was one, they have a lot of confidence in, in where they're going with the economy. I know the the growth has been low, lower historically than historical growth in China. But they're, they're, the Chinese government is very clear uh that they're what they call new productive forces that are driving the economy in a healthier way. So they don't want to do a big stimulus like you saw in the western world in Europe and us. Uh they don't wanna overly rely on commercial real estate, which they've done in the past and they really want to transition to more of a tech economy. And then they're investing in tech ev life sciences, which medical technology is a part of that. Uh And they were very clear that the um you know, that it's an open environment for multi multinational companies. So it was, it was good to hear that you were encouraged by it. I was encouraged. Well, that's exciting because, you know, Medtronic has had a challenging few years in, in terms of China, but a lot of companies have and I know that there are plans to expand, you already have a major presence in China. And so I want for the audience's purposes like paint the picture of what Medtronic is in China and your, you know, your five year goal for sure. Uh Yeah, so we have a big presence in China. We, we've been there 35 years since our 35th, the company is 75 years old. We've been in China for 35 years. We really helped pioneer the medical technology market in China. And don't just think we always, we take our latest and greatest technology in China. Um but we also uh and, and sell that and help, you know, help a lot of patients, but we also train a lot of physicians. Uh We do the Chinese health care system is a bit different. They don't have uh residencies and fellowships that you see in Europe and the US and other parts of the world. Um After the Chinese doctors graduate medical school, many of them rely on the Metronic to train them on the latest and greatest. So we've trained hundreds of thousands of, of doctors. We have two big training centers, one in Shanghai, one in Chengdu, a little further west. We have um R and D there for the world R and D for products that are designed for China. We have manufacturing there mostly for China. We don't, we don't have a big reliance on supply chain there. It's more in China for China. So it's a, it's a big presence and we've, you know, helped the Chinese government evolve the ecosystem, the healthcare ecosystem. We also have two venture funds there that we invest in local uh start up companies as you think about, you know, you're back to double digit growth in China as of your last quarterly earnings. That was good to see. And you're also aggressively investing and deploying A I products. And I was wondering, you know, you've got Medronic has what you said 7775 years of medical data and you're using that to inform A I models for surgery, endoscopies. Am I saying that right? Endoscopies? Yeah, thank you. Um You know, all kinds of really essential technology for people's health and So we have something we wanna share with everyone. And if your gig and it's a video that we wanna run to show how Metronic is using A I to detect polyps in colonoscopies. And I don't know if we can pull that up. Now, please to show the audience, you know what, how this Metronic technology works. Do you guys have the video? OK. Well, there it is. OK, everyone. We're going into a colonoscopy. So this is, this is a colonoscopy. That's what when a physician is doing a colonoscopy, they're doing it through a camera, right? And the camera goes, you know where and on the left, you see the, the colonoscopy without G I genius. And on the right, you see it with G I genius. That green box is really highlighting for the physician, a polyp and these polyps have a high propensity to turn into cancer. And as you can see from the difference from the left to the right, it's hard to see that polyp, I mean, and these G I docs, these gastrointestinal, they're doing 8 to 10 of these colonoscopies a day. And even if they're fully alert and fresh, they still miss these, but as the day goes on, they get their eyes get tired, they miss even more. And so we found in our clinical research that 26% of polyps are missed in a colonoscopy 26 26%. And that drives a lot of uh cancer. And so with this technology, you know, we're, we're picking those up. It's about 99.9% sens sensitive and 99.9% specific meeting. We see it almost all the time, virtually all the time. And we, we don't have false alarms, false alerts like uh and so we've to get to this, we, we trained our a deep learning algorithm with 13 million colonoscopy videos uh to train that algorithm in order to get this technology and it weaves right into the surgeon workflow. It's just a great example of how A I is improving health care. And this is a big cancer, cancer prevention play. And uh we're really excited about this. Well, what's really remarkable about this technology is that colorectal cancer is the third most common cancer worldwide. And so I don't know if you know the answer to this question, but how many lives do you think this technology has saved or will save? Oh, it'll be hundreds of thousands and it's quickly becoming the standard of care in the US right now. It's still under 10% because it's brand new, but it's growing quickly. Uh And uh you know what we, and we've done consumer research on this patient research and we're finding that, you know, you know, as you know, there's some mixed views on A I people are nervous about it, probably this that but when it comes to their health, they would much rather have an A I colonoscopy than a non A I colonoscopy. They would, much patients would much rather do, uh, an A I guided surgical, you know, um, a procedure than non A I guided. Now, what they're not comfortable with is the surgeon or the physician going away. But they do want the, the idea of A I making that surgeon better. And so it's basically giving the surgeon even more capability and strength and accuracy. It's doing a couple of things. Yeah, it, it's, it's helping them sort through complex data faster. Uh And I can give you other applications but it's also helping them identify patterns. Um And it's, it's um tho those are big ones and it's, it's in surgical and surgeries. It's, it's almost like a driver assist technology in the or so that's better outcomes and you're actually personalizing some therapies over time as well. So knowing the success of G I genius, what comes next for you? Like, how are you using this innovation to power other types of medical A I technology? So look this, we have five FDA approved, we're doing most of this right now in the US and Europe, we're not doing this in China yet. We have to set a separate A I platform in China. We'll work on that. But um you know, we're using this in cardiology, we're using this in, in neuroscience. Uh we're using it in diabetes. So a couple of examples, we have A uh for type one diabetics, we have an A I algorithm that, you know, predicts where the sugar is going to go and helps and helps the, the our technology, the insulin pump uh determine when, when the dose insulin and how much and and is really improving diabetics time and range uh kind of an acceptable blood sugar range that, that has meaningful long term outcomes for patients. We're using it, like I said, in surgeries to, to like take spine surgery, very complicated surgery. We have a I guided surgical plans because surgeons were doing all this math in their head. Your spine is a complicated kind of load bearing part of your body and you change one part of it. It has big implications. The A I is helping them determine what to do and then it guides them throughout the surgery. We're using A I to detect arrhythmias, uh heart arrhythmias. So for a that, you know, heart arrhythmias can cause a FB that causes stroke. Uh And so these are some areas that we have already FDA approved uh A I driven uh technology. So it's very exciting and, and we want to scale this to, to all of our areas and and beyond. And as you scale and you have these big hopes to bring this technology here to Asia to China. How do you address the concerns about data security and these sort of concrete but sometimes nebulous worries about the dark side of A I in our health. Well, it's, it's a great question and like, look what I see. I'm an optimist. I see all the upside here, but I get the point you're making. So we've set up uh what we call our own A I compass, which are basically guiding principles uh around things. Like you're talking about data, privacy and security and transparency and what we call beneficial use. You're using it for the good of humankind. And we, but we put that together based on our interactions, we're continually engaging with the, with the ecosystem. So physicians, health care systems, governments regulators because there's no one overarching regulation yet for A I, it will get regulated at some point. But, but we can't wait for that. We've got to do it ourselves. We definitely can't wait on the US. Government to regulate. You know, we've got to do it ourselves. And you know, I, you know, I heard Sarah Malton say the other day, he's, he was inviting regulation in the space. Um Yeah, but we're, we're not waiting for that. We're working with stakeholders, anybody that will uh engage with us on this and, and continue evolving our, what we call our A I companies. So then talking about regulation, you know, you have this Senate A I forum happening in the US. Uh We were on this very same stage yesterday talking about A I regulation in Asia as a multinational company that is working so heavily in China and obviously in the US, what's your hope for A I regulation? Where should, what should the first step be? Well, if you're talking about uh you know, the security concerns, um I look, we're, we're, we're planning for that, we're planning for because these, this is A I is developed on, on local like patient data. Uh And I think when it comes to China specifically, as we expand all what I just showed, talked about to China, we're going to have to use do that on China patients data in conjunction with the government. And it's something I talked about with the Chinese government this past week. I mean, they're very keen to do it, but we're gonna have to do it on a separate platform in China and keep them separate. But the learnings that we got from what, what we're doing in the US and Europe, we can apply those learnings. But the data, the models will have to be customized for Chinese patients and Chinese healthcare systems and kept in China as we sit here and look at the next five or 10 years for medtronic in China. What's your 10 year horizon and your ambitions for what medtronic is able to accomplish in China? And I know you do business also in Japan and elsewhere. We anyway, there's people, we, we're there, we're there. Uh And uh but China is a big market for us and we're very proud of what we've accomplished over the last 35 years. And like I said, you hear it in the Chinese government officials, uh even the, the health care officials, but even just like the Ministry of Commerce, they're very appreciative of what we've helped them with. And um but, but I think the next 35 years we're going to have to, to remain competitive in China, we're going to have to localize, we're gonna have to look, we import China relies on the US uh for its advanced medical technology by and large. And um but they're, they have a burgeoning uh MedTech ecosystem and these companies are going to make products customized for c higher volume local supply chain, lower cost. Uh We're gonna have to, to do that. And, and so I think localization is gonna be a big piece. How do you localize that? You have to set up uh that infrastructure on the ground R and D? So what we call marketing people that work with the physicians and the hospitals? What do you really want? What features are you prioritizing? You have to have your R and D team to, to work with them to develop these technologies and, and, and manufacturing uh to, to, to make it also a local supply supply chain. Uh So all of that has to be localized. We have done it for parts of the company, but it's still a vast minority. We've got to do it for a much broader swath of our, of our products or technology. We have two minutes left and I was wondering if anyone had a question. If you wanted to raise your hand, we'll get a mic over to you. Any questions from the audience, I'll let you guys think on it for a second. I think going when you look at how artificial intelligence is impacting your overall strategy, you've been now in a CEO CEO role for three years. Draw me the contrast when you started, what were you thinking about when it came to A I strategy versus now as you look forward, you know, when I, when I started, when did the switch flip or maybe you already flipped before you got the job, you know, right out of the gate. I had the opportunity to meet with the heads of the big tech companies, you know, Google Apple, et cetera, one on one, they came and spoke to our employees and, and that having that kind of direct interaction uh really stuck with me in terms of the opportunity and that they basically were saying in different words, but you have an opportunity because you have that 75 years of data to shift the company from strictly a product company to more of a data company. We're not getting out of products. I mean, we make devices, surgical tools, robotic, surgical, yeah, we're not gonna get out of that business, but the the value creation for the company was, is all there today. Mainly it's going to shift to balance between value creation from the devices and the equipment to also the data. So we're going to become more, we're becoming, we are becoming more of a data company. Uh and that swings to hit me pretty early in, in, in my tenure and we've been working towards that not understanding how to basically turn that data into better health care outcomes and, and business models as well. We have a lot of executives and CEO S in the audience and I wonder from your position of great influence in A I and, and health care technology. What's your advice to other executives across industries when it comes to embracing but also managing how A I affects your business and your customers. I think you, I think you need to lean into it hard, first of all and personally, you know, you know, personally and play with them, uh you know, chat G BT and these things, you know, it, it was in conjunction with your it team. They'll tell you we have our own Metronic chat GP T but, but also engage with the different stakeholders. I've learned so much like I said, talking to the tech companies, talking to other companies in different industries in terms of how they're A I in their offerings to their, to their customers, but also internally to drive efficiencies. So that for me has been the biggest thing is actually playing around with it myself a little bit and seeing the power but but engaging with others as many people as will talk to me about this and I learned so much from talking to other companies and, and the tech companies as well. Jeff Martha, thank you for bringing insights from Beijing and CD F here to Hong Kong and I really appreciate all your time. Maybe next time we'll be together in Minnesota. Yeah, that sounds good. I'll see you, see you on Lake Min. That would be great. Thank you so much. Appreciate it.

Shaista Asif, Co-founder and Group COO, PureHealth  Geoff Martha, Chairman and CEO, Medtronic In conversation with: Alyson Shontell, FORTUNE

Fortune Global Forum 2023: Health Care’s Big Moment 

Moving to a very different topic. Um The integration of A I into global health care holds the potential to revolutionize the industry while addressing and overcoming the challenges that arise along the way. And while there are clear benefits, there are also concerns. In fact, the World Health Organization recently outlined what called key areas of regulatory consideration with regards to the utilization of A I and health. The idea is to offer countries guidance to help regulate A I and the health space while harnessing its potential. They include the importance of transparency, documentation, risk management, data validation, privacy and data protection and collaboration between stakeholders. Today, we want to talk about the innovations, challenges and benefits of digital tools and health to help us lead this. I'm going to have fortune editor in chief Alice Allison Chantelle is going to join us on stage along with Shisha Asif, who's a co founder and group coo of pure health, the largest integrated health care network in the UAE the cross category ecosystem that covers hospitals, clinics, diagnostics, insurance, pharmacies, health, tech procurement, and more. And then we have Jeff Martha, the chairman and CEO of Metronic, a global leader in health care technology with a team of more than 90,000 people in 150 countries. Please welcome them to the Fortune Global Forum. That's we think that's the wrong. Good afternoon, everyone. Great to see all of you. And, and we're actually working for being here, mission set up a nonprofit and that's, that's something we wanna talk about. Like that would be really interesting, do that. Uh And now my mic is working now, you can really hear me great. Um So, hey, guys, backstage mics are on. Ok, here we go. Um OK, so on the way to start, well, one thing I realized with is like the state of health care today, I think we're in this transition from it being um a really reactive industry where you go to the doctor when you're sick, you're not feeling good, you go get a test done or something. Um But it's really not that helpful for preventing things and being proactive with things. Um So where are we in making that transition as health care as an industry from being really reactive to proactive? All right, you want me to start? Well, first of all, a good job, but now now getting the interesting start there and, and thanks for having me. Um look, so Metronic, we treat um we deal generally with pretty sick people, right? We're a global leader in medical devices and cardiology, neuroscience, surgery and diabetes and uh like I said we're dealing with people that have been diagnosed generally. With the problem. We do some diagnosis but mainly therapy. Uh and they're, they're fairly sick people generally. And so what we try to do at this point is be more proactive at preventing an escalation, right? So that's really what we're doing. We're not really at the wellness stage, I will say though that um with the advent of A I and the explosion of data, we're using that to move upstream. So today we treat two patients every second. That sounds like a lot. But when you do the math, it's 80 million people a year. The world has, you know, over a billion people. So there's for us to move upstream to be more proactive. It is around data and A I I believe is the key. So just in in our world today, um you know, as we move up, we are using uh data and A I to to be more proactive and to identify problems earlier and prevent that escalation. So like one example I can give you a bunch. 11 would be like diabetes management. So we, we provide for insulin dependent diabetics, a closed loop system here of a insulin delivery device like a pump, they wear tied tethered to a, you know, a continuous glucose monitoring system all tied together with an algorithm and we're testing their blood sugars every five minutes and using A I to predict based on their past behavior, what's going to happen and try to microdose insulin uh to avoid uh a high sugar, high or low. Uh And so we are preventing escalations using so that's kind of more like what we're doing and over time wanna move from these sick people to less sick to high risk to more what, you know, preventative. But we're, we, we've got a ways to go on that and Shasta, I know um I wanna hear your thoughts on this as well, but I know an important initiative for you is longevity. Um And there's a lot of progress working around health spans so that you're not just living a longer life, but you're actually enjoying more years of your life and able to do more with the longer years of your life. And you have a 100 and one by 2071 initiative. Uh Hopefully, that's the time for me to make it. That would be great. Um But I'm curious, where are we in that path? And, and how does uh preventative care work into that? So I'll try and, and club both your questions with one answer. So the entire ethos are based on which your health vision is based and our vision personally is based is the ability to give people more time, which is longevity, which is preventive care. Unfortunately, the health care system of today is is sick care. It's not preventive health care. It's when you like you mentioned when you get sick, you walk into a hospital, you get treated and how hospitals are structured is more like hotels, come and enjoy our stay, enjoy the minibar, enjoy the pool, enjoy, you know, so this is how the entire business of health care is being delivered right now. And we want to deviate away from this, which is why longevity is, is just, it's, it's a natural margin to what you know, we want to do. Now, when we talk about longevity, longevity is let's uh slice in into longevity is having the ability to have a larger health span, a longer health span and thus pushing your lifespan more and more sorry. And when we talk about it, we have an individual who is 25% 25% of his longevity is dependent on his 20 to 25% on his genetics. And the rest of the 75 to 80% is dependent on epigenetics. Now, I think we'll need a separate panel on data and A I and gene sequencing. That's, that's a whole different conversation, but we're delving into that and we're being able to identify now what our code consists of and what we can do to prevent something which would naturally happen, you know, otherwise. But the rest of the 80% which is your epigenetics, that is your environment, your conditions, your access to health care, the choices that you make, which determine how long and how healthy you would live and how we're enabling that through technology. And A I is imagine if every single individual here in this room had a personal physician, a personal trainer, a nutritionist, a mental health coach, a pharmacist and whatnot. All of them available with you. 24 7. Guiding you every step of your journey of your life. Would you for sure, have a healthier life for sure. I mean, don't eat this, eat that you need to exercise more. Your BM I is now going towards an healthy level. You need to bring it back down, you need to visit a doctor. Your heart rate is abnormal stress levels are getting high. That's what we're hoping to deliver through the use of technology and A I through the application that we've built Pura that integrates all your health records, data from your wearables, your skins from, from your smart mirrors, your smart bathrooms and it guides you on the best possible journey for a longer health span. So it sounds like also tech will bring down the cost quite significantly because I too would love a dietitian and a nutritious and all these things, a personal trainer with me all the time. And you're saying tech can be that solution and it can be for everybody. Yes, absolutely. Tech is the only way to democratize health care. There is an estimated 15 mi shortage of 15 million uh clinicians in the world right now as we speak, there is no way to have to plug this hole through just normal. I mean, uh when we say just physicians, human physicians, if there's no way, the only way to bridge that gap is through technology. And A I. So, um e every health expert says like this is the golden age right now. What we're seeing the pace of innovation in health tech is astronomical. It's not like anything we've seen in the last 100 years. I'm curious both of your perspectives. Um What do you think is coming like, what are, what is A I gonna enable us to really do that? You're really excited about whether it's a device that you all are working on. And I think your diabetes, one is a great example. But like what's something where in 10 years it will just be sort of the mind blown. Do you think of what we can achieve? Well, look, I I think um in the medical device space, we're at an inflection point. There's, there's a lot of great innovation and traditional biomedical engineering. You know, I think mechanical engineering, electrical engineering, chemical engineering, you know, miniaturization of technology, you combine that with what we're learning about the human body. Uh And you combine it with digital technologies as digital comes into med tech. So think uh you know A I edge computing cloud computing, quantum computing, you know, five G uh all of this is is and then I put robotics in that bucket, uh you know, a game changer and what it's allowing us to do is, is personalized care at scale. Uh, you know, it, it for and, and, and I totally concur with what you're saying about physicians, tech is the only path forward. You can't, you know, if you're not personalizing, you're gonna get, you know, you're not gonna get the outcomes that you're looking for and you don't have the human capital to do this. It has to be uh technology. So in our world, things like we treat Parkinson's disease, we, we have a implantable device that stimulates certain parts of your brain that mitigates the um the effects of Parkinson's the uh the movement issues. Uh And it's an amazing therapy called uh you know, brain stimulation, brain modulation. And, you know, you see the, the, the, the the symptoms of that you turn this on and the patient is calm and smooth. It's, it's an amazing and it, and it slows down the progression of Parkinson's. The problem with it is is that patients need to keep coming back into the neurologist and with the Metronic um person there as well uh to reprogram the device as the disease progresses with A I and, and, and, and cloud computing, we can do this automatically and personalize it to that person. Uh their, their needs. So that's an example of another one that I'll give you one more example of surgery surgery today. Uh is becoming more and more robotically driven uh with uh all kinds of enabling technologies, imaging and navigation and visualization and tools. A I now we're collecting enough data that we're not too far away from. I'll call it a driver assist technology in the or for surgeons. So we're, you know, A I is not gonna replace the surgeon anytime soon, but surgeons using A I will be replacing those that don't. Uh because this, this technology is, is just democratizing good health care uh where you're not so reliant on training, it's taking average docs and making them really good docs and that's not out in the future that is today. So these things I can give you more, those are two different types of examples. Um And to this point, I mean, like taking an electrophysiologist that treats cardiac rhythm and and atrial fibrillation in the United States, you know, there may be a ratio of 100 to 11 of those electrophysiologists for 100 people, you get into the developing world, it's a million to one. I mean, you can't, you can't train enough. So the technology is the only path forward and it, and it is exciting, it is a golden era as you all are thinking about keeping up how as CEO S and executives, you think about keeping up with the pace of innovation. Um There's a few avenues to explore obviously your own R and D budgets, um acquisitions partnerships. Um Sha I know that you guys made a big investment in the US and health care system here or uh there, I'm from the US um recently. Uh and uh Jeff, I know you've done partnerships with all sorts of companies including spacex and Apple. How do you think about when to do what and what can accelerate fast enough for your businesses? So, um health care, when we know technologically has always been behind the other industries, you know, while the rest of the industries are racing towards the four ir health care in most parts of the world isn't stuck in the tail end of the second or the beginning of the third. And that gives us immense opportunity to go in into these areas and to leapfrog them towards the four ir so I think so, first of all, a just to add on to the previous question, COVID was the Chief Transformation Officer for Health Care Technology, the way that it was adapted and the way that it was absorbed by not just medical professionals but patients, it accelerated it. And that's why we're in that golden era of technology. Now we're growing obviously at an exponential speed. But the way that we want to grow is to be able to reach the areas where there is a shortage of health care where there is that ratio of one is 200,000. You know, you know, uh pa patients, one physician for 100,000 patients or where there is that dirt. So we're wanting to go into those areas. We're wanting to take them into the fold and to bring our technological investments from Abu Dhabi to the rest of the world to take them with us on this journey, you know, for us in the, in the med tech space, there's a lot of different technologies and it's, it's hard to invent everything yourself. Uh And the barriers to get in are, are relatively, have been relatively low. So we're very proud of our organic R and D. We, we spend, we invest, not spend, invest, you know, over $3 billion a year in, in, in R and D clinical trials plus technology development into products. But we do have a venture arm that's investing in start ups and a and a healthy mergers and acquisitions team because sometimes somebody, uh you know, often times, you know, innovators from around the world, it's, it's global now, you know, you're seeing that this happened all over the world, come up with something uh very unique. And so we'll invest and, and, and maybe by that company. Uh so the answer is when somebody comes up with something that's truly innovative, uh and they're, they're ahead of us that that's when we really, it's something that we're interested in is, is where we'll, we'll do m and A uh in terms of buying technology, but we also do um COVID, it was a transformational time and that's when we started to do it. We realize that maybe we should look beyond the medical technology industry for R and D innovations. That's where we partner with spacex as we uh open sourced our ventilator. During COVID, we, we had some real challenges scaling it. There's a particular part called a proportional solenoid valve. Never heard of it. But it turns out if you think about a ventilator as a life support system, guess what they need on spacecraft life support systems. And it turns out that SpaceX had a, had a, had a real, a good product there, a good component. And they, you know, Elon helped us there quite a bit. So, you know, we've, we've done more open sourcing since then. It was a real lesson learned uh is to not just think about other medical technology companies, but the broader tech industry. And uh so we've got a lot of more big tech partnerships these days. And the, the last type of partnership we're doing is with health care providers because the key for us is to make sure this technology is fully integrated into the care pathways of the different health systems and health systems operate differently around the world. So it's not a one size fits all. So we find ourselves inventing the technology and then having deep partnerships with uh different health delivery uh organizations, big hospitals, small clinics, what have you to make sure our technology we know how to integrate it into their work flow so that they use it. Uh I just want to give people a little bit of context here. Uh Jeff is being modest. I think he had the hardest job in COVID. Maybe of anyone on the planet, he became CEO of Metronic 23 weeks, maybe before COVID hits. Uh, and Metronic supplies a third of the world's ventilators. And if you remember at the beginning of the crisis, I mean, there was such a short and you made a bold move to open source. Um So others can make this like spacex. Um So I'm curious actually from both of you, if this was such a transformation agent, um not just for your company but for your leadership, like what do you take forward from the COVID era to further accelerate your companies now? Um How are they better future proofed because of what you had to go through in those times? So I think what um we underwent a transformation ourselves as healthcare entity, you know, during COVID COVID was a wake up call to everyone who was taking it just as, as like we said, you know, business as usual COVID accelerated the need for change. COVID accelerated the need for preventive care even more. So, uh it accelerated the need for a physician for you to have health care at your fingertips, in the comfort of your home, in the palm of your hand and it, it provided everyone the tools to access it out of necessity. So the learning that I think we took from COVID was that while technology may be a luxury, still in certain parts of the world, for hospital providers, for health care providers, it is an absolute necessity for all of us. If you're wanting to take this towards the future and towards that preventive care, it is an absolute necessity. Uh We invested a lot in the R and D. We, we again, you know, like you mentioned, it was absolutely necessary to go into clinical trials into seeing what we needed to do when it came to stem cell regeneration. When it came to uh you know, tackling sick care when it came to taking the population, population health management say, for example, so all of these things came in as a part of learning of COVID and when we applied them, it was how aptly and uh and, and, and agile we were, you know, in, in this application that gained us the momentum to move forward. Now, I think for me, you mentioned, you know, becoming CEO right at the beginning of COVID. And um you can look at that as a challenge and, and I look back at it as a as AAA great learning experience and opportunity. And you re one of the, the, the things I, you know, COVID struck me as, you know, we're in health care and it is a privilege and, and just how important health is, is to, you know, humanity and society and to the global economy and, and that we need to kind of think a little bigger and the partnerships, open sourcing. Um you know, a company like ours with a lot of technology, but we have gaps and making yourself vulnerable, taking the risk and, and, and, and, and having these partnerships, the partnerships has been real accelerator for us and in our innovation and how we think about it. So that's one, the second is less um uh sexy uh uh but supply chain. Uh how, when we as, as the world is globalized, uh how long supply chains have gotten and how we've lost sight of where our components are coming from and, and how geopolitics or climate, you know, issues can affect our supply chain. We saw that during COVID and, and it caused us to really revamp uh one have a, a deeper understanding of our supply chain, 345 layers deep um and building that resiliency as well. Uh So those two things uh are, are big ones, partnerships and supply chain. Well, thank you both so much uh for your efforts to make the world healthier to help us all live longer. Um And thank you for joining me on stage, Jeff. Thank you.

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Leadership

Jeff, thank you so much for joining us. You know, you became Ceo of Medtronic just a year ago and it was right at the beginning of the pandemic. And one of the first things you did was to find a way that you could ramp up the production quickly of Medtronic ventilators. And it's a remarkable story, tell our viewers about it. It really starts with first of all, a commitment from our manufacturing employees to to work 24 7 through Covid cases and and putting really their own safety at times on the line for patients around the world. Um, the second part of this story is really of a commitment from our management team to put patients before profits, uh, and make the bold decision to put all of our ventilator designs online. Open source as they call it. And the reason we did this is because just working harder wasn't enough. The demand was orders of magnitude greater than our capability to supply. So we put these plans online and ask for help. We asked for engineering support of key constraints. We asked for manufacturing support to augment our own manufacturing And what we got was over 250,000 downloads of these plans. And these are thousands of documents and whether the individuals just trying to help out individual engineers downloading these things on their own time and reading them or large multinational corporations like Intel or, or like SpaceX and Intel ended up being a great partner for us and help us improve our processing power. That opened up new capabilities. And SpaceX uh, was really an unexpected partner who helped us with a particular component that we were very much supply constraint. It turns out this, this component called a proportional solenoid valve is something that they used in spacecraft, uh, and, and in ventilators and not much else. Uh, you know, this type of valve especially and uh, they became partners. Elon musk personally got involved in and provided support and leadership and commitment and uh, there there are partners to this day. Well, I think you're amazing. Part of that whole story is how many people did partner with you to make these ventilators. And one of those volunteers, as you mentioned was SpaceX, which is the company owned by Elon musk. What did he bring to this project? Was there something special? I was surprised how much the level of detail that he knew about this part and not only about this, this this particular component, but the history of it, how it's made the challenges and the whole history of why SpaceX gotten into it. So the level of granularity that he had on this uh, was was quite astounding. And the other thing, he was very just down to earth, you know, so you know, you read and you you hear you read his tweets, you read about him and there's a lot lot to read out there and you hear him speak. But he was very down to earth. Uh and and very into the details and very, you know, sign, you know, I'd say very technical. Um Yeah, the other thing that uh I'd say my kids, I have, you know, two kids in college and they thought I was a lot cooler after after talking to Ellen. How did this whole experience shape your perspective when it comes to things like competition and collaboration? Well, first of all, look, we're in health care uh and even even if there is no pandemic and its business is normal, we're often talking to our competitors about safety issues because patient safety comes first. And even if you're our tribals, the, when it comes to patient safety, we share as much information as possible and try to help each other solve problems and, and that's important. Um look, it's important for employees to know that the patients come first because uh, if you lose your North star on that, you're going to be in trouble in healthcare. Well now that we're at the tail end of the pandemic, how's your business doing right now? It's coming back strong. We're seeing a strong rebound uh, in, in the United States. It's not even a snap back, I'll call it and we're starting to rebound in europe and china is pretty much back to normal, but there are parts of Southeast Asia, especially India. And there's parts of latin America that unfortunately the pandemics worse there now than anywhere in the world, You know, India, you hear a lot about. And so the pandemic is not, you know, we're not through this yet, Jeff, I know you talk regularly with the ceos who run hospitals, what are they telling you? How are they doing post covid they're very focused on getting back to serving their patients and they're preparing for uh working through this backlog of patients instead of been waiting in their homes and putting off certain health care needs. And so they're really focused on growth right now. I think over the next 12 months you're going to see procedures at above pre pandemic levels. So how how is their comeback impacting your comeback at medtronic? Well, they're very much linked. There's a high correlation there. Uh most of the products we sell our in our used in hospitals, in these procedures. And so as the hospitals are coming back, patients coming back into the hospitals, the hospitals ramping up their procedures. It's directly impacting our economics and we're really close to getting back fully to pre pandemic levels, both from a revenue perspective and a profit margin perspective. So it's it's good to be back seeing this kind of activity. So what's in the pipeline at Medtronic? Is there one new invention or one new technology that you're most excited about the pipeline right now is the best it's been in our company's history. And so it's hard to pick from. But if I had to pick one, I would pick our Micra. Leaderless pacemaker. This is something we launched this device. We launched the size of a roughly a paperclip. Uh it's uh implanted using a catheter versus a surgical procedure. And it is uh it's revolutionizing the cardiac rhythm space. Uh and what's particularly interesting about this story is that Medtronic invented the pacemaker back in the 19 fifties and then here we are now today, reinventing and revolutionizing this whole space. What we call cardiac rhythm um with a with a disruptive technology like micro that is so small yet gets uh unbelievably safe and gets great outcomes Jeff. Let's talk a little bit about leadership. You worked at General Electric Healthcare Business uh for nearly 20 years before you came to Medtronic and you held many senior leadership positions. But here at Medtronic, this is your first time as a Ceo and you're running a 30 billion giant enterprise and in the middle of a global pandemic, what would you say is the most important leadership lessons that you've learned so far in your first year as Ceo lead and move with speed. Uh So big company like us can be a little slow sometimes and over the pandemic. We led we led in health care issues like open sourcing the ventilator. And we also led in in these social issues, the social unrest that came about over the pandemic and to you know, kind of voice uh you know what's what we believe is right or versus wrong and to express that opinion and to take tangible actions even on some of these social issues. Uh it takes courage. That was wasn't something that I anticipated coming into the ceo but it's something that I learned is very important for employees and our stakeholders. Um the young employees in particular, but all employees, they want to work for a company these days that stand for something and Medtronic stands for something and I need to vocalize that beyond Medtronic, you're working with the White House. I understand an attack force of global business leaders to help developing countries deal with the covid pandemic. And you sent a huge shipment of ventilators to India. You've assigned people at Medtronic to train the healthcare workers there on on how to use them. How do you feel about the work that you're doing in India and why is it important to you in times of need um use our capabilities uh to solve these problems? And I think you saw over the course of the pandemic, whether it be the vaccine or the shortage of ventilators and now shortage of ventilators and oxygen in India. It's really the private sector working with governments who provide the oversight and coordination. But the private sector that's coming up with a lot of the innovation to solve these problems. And we're the leader leading company in MedTech and we need to not just be part of this, but the uh be a leader here and shape the response. And so I'm proud of what we're doing in India. Um, to be quite honest, I want to be able to do more. It's difficult, there are challenges. And so, um, I'm, I'm proud of what we're doing, but I'm not satisfied quite yet. There's way too many people are dying unnecessarily. And so we are really, really working around the clock to see what we can do to stop that.

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