Shaista Asif, Co-founder and Group COO, PureHealth Geoff Martha, Chairman and CEO, Medtronic In conversation with: Alyson Shontell, FORTUNE
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00:00 Moving to a very different topic, the integration of AI into global healthcare holds a potential
00:04 to revolutionize the industry while addressing and overcoming the challenges that arise along
00:08 the way.
00:09 While there are clear benefits, there are also concerns.
00:12 In fact, the World Health Organization recently outlined what are called key areas of regulatory
00:15 consideration with regard to the utilization of AI in health.
00:20 The idea is to offer countries guidance to help regulate AI in the health space while
00:24 harnessing its potential.
00:25 They include the importance of transparency documentation, risk management, data validation,
00:30 privacy and data protection, and collaboration between stakeholders.
00:33 Today, we want to talk about the innovations, challenges, and benefits of digital tools
00:37 in health.
00:38 To help us lead this, I'm going to have Fortune Editor-in-Chief Alison Chantel is going to
00:43 join us on stage along with Shaista Asif, who's a co-founder and group COO of PureHealth,
00:49 the largest integrated healthcare network in the UAE.
00:52 The cross-category ecosystem that covers hospitals, clinics, diagnostics, insurance, pharmacies,
00:57 health tech, procurement, and more.
00:59 And then we have Jeff Martha, the Chairman and CEO of Medtronic, a global leader in healthcare
01:03 technology with a team of more than 90,000 people in 150 countries.
01:08 Please welcome them to the Fortune Global Forum.
01:10 Good afternoon, everyone.
01:23 Great to see all of you.
01:24 And thank you for being here with us today.
01:25 And we're actually working with the Linux Foundation to set up a non-profit.
01:28 And that's something we wanted to talk about.
01:30 That would be really interesting.
01:32 We can do that.
01:33 And now my mic is working.
01:34 Now you can really hear me.
01:35 Great.
01:36 Yeah.
01:37 So, hey guys backstage.
01:38 Mics are on.
01:40 Okay.
01:41 Here we go.
01:42 Okay.
01:43 So, I don't know where to start.
01:44 Yeah.
01:45 One thing I really want to start with is like the state of healthcare today.
01:49 I think we're in this transition from it being a really reactive industry where you go to
01:53 the doctor when you're sick, you're not feeling good, you go get a test done or something.
01:58 But it's really not that helpful for preventing things and being proactive with things.
02:03 So where are we in making that transition as healthcare as an industry from being really
02:06 reactive to proactive?
02:08 All right.
02:09 You want me to start?
02:10 Well, first of all, good job navigating the interesting start there.
02:15 And thanks for having me.
02:16 Yeah.
02:17 Look, so Medtronic, we deal generally with pretty sick people.
02:21 Right?
02:22 We're a global leader in medical devices and cardiology, neuroscience, surgery, and diabetes.
02:29 And like I said, we're dealing with people that have been diagnosed generally with the
02:32 problem.
02:33 We do some diagnosis, but mainly therapy.
02:36 And they're fairly sick people generally.
02:38 And so what we try to do at this point is be more proactive at preventing an escalation.
02:43 Right?
02:44 So that's really what we're doing.
02:45 We're not really at the wellness stage.
02:47 I will say, though, that with the advent of AI and the explosion of data, we're using
02:55 that to move upstream.
02:57 So today we treat two patients every second.
02:59 That sounds like a lot.
03:00 But when you do the math, it's 80 million people a year.
03:04 The world has over 8 billion people.
03:06 So for us to move upstream, to be more proactive, it is around data and AI, I believe, is the
03:12 key.
03:13 So just in our world today, as we move up, we are using data and AI to be more proactive
03:22 and to identify problems earlier and prevent that escalation.
03:26 So like one example, and I can give you a bunch, one would be like diabetes management.
03:29 So we provide for insulin-dependent diabetics a closed-loop system here of an insulin delivery
03:36 device like a pump that they wear, tethered to a continuous glucose monitoring system,
03:43 all tied together with an algorithm.
03:44 And we're testing their blood sugars every five minutes and using AI to predict, based
03:50 on their past behavior, what's going to happen and try to microdose insulin to avoid a sugar
03:57 high or low.
03:59 And so we are preventing escalations using.
04:01 So that's kind of more like what we're doing.
04:03 And over time, want to move from these sick people to less sick to high risk to more preventative.
04:10 But we've got a ways to go on that.
04:12 And Shaista, I want to hear your thoughts on this as well.
04:16 But I know an important initiative for you is longevity.
04:20 And there's a lot of progress working around health spans so that you're not just living
04:23 a longer life, but you're actually enjoying more years of your life and able to do more
04:28 with the longer years of your life.
04:29 And you have a 101 by 2071 initiative.
04:34 Hopefully that's the time for me to make it.
04:35 That would be great.
04:37 But I'm curious, where are we in that path?
04:39 And how does preventative care work into that?
04:43 So I'll try and club both your questions with one answer.
04:46 So the entire ethos based on which Pure Health's vision is based and our vision personal is
04:51 based is the ability to give people more time, which is longevity, which is preventive care.
04:56 Unfortunately, the health care system of today is sick care.
05:02 It's not preventive health care.
05:04 It's when you, like you mentioned, when you get sick, you walk into a hospital, you get
05:08 treated.
05:09 And how hospitals are structured is more like hotels.
05:12 Come and enjoy our stay.
05:14 Enjoy the mini bar.
05:15 Enjoy the pool.
05:16 Enjoy, you know, so this is how the entire business of health care is being delivered
05:20 right now.
05:21 We can't deviate away from this, which is why longevity is just, it's a natural marriage
05:27 into what we want to do.
05:30 Now when we talk about longevity, longevity is, let's slice it into, longevity is having
05:37 the ability to have a larger health span, a longer health span, and thus pushing your
05:42 lifespan more and more.
05:44 Sorry.
05:45 And when we talk about it, we have an individual who's 25% of his longevity is dependent on
05:52 his 20 to 25% on his genetics and the rest of the 75 to 80% is dependent on epigenetics.
05:58 Now I think we'll need a separate panel on data and AI and gene sequencing.
06:04 That's a whole different conversation, but we're delving into that and we're being able
06:08 to identify now what our code consists of and what we can do to prevent something which
06:14 would naturally happen, you know, otherwise.
06:17 But the rest of the 80%, which is your epigenetics, that is your environment, your conditions,
06:23 your access to health care, the choices that you make, which determine how long and how
06:28 healthy you would live and how we're enabling that through technology and AI is.
06:34 Imagine if every single individual here in this room had a personal physician, a personal
06:41 trainer, a nutritionist, a mental health coach, a pharmacist, and whatnot, all of them available
06:48 with you 24/7, guiding you every step of your journey of your life.
06:54 Would you for sure have a healthier life?
06:56 For sure.
06:57 I mean, don't eat this, eat that.
06:58 You need to exercise more.
07:00 Your BMI is now going towards an unhealthy level.
07:03 You need to bring it back down.
07:04 You need to visit a doctor.
07:05 Your heart rate is abnormal.
07:07 Your stress levels are getting high.
07:09 That's what we're hoping to deliver through the use of technology and AI, through the
07:13 application that we've built, Pura, that integrates all your health records, data from your wearables,
07:19 your skinnables, from your smart mirrors, your smart bathrooms, and it guides you on
07:24 the best possible journey for a longer health span.
07:28 So it sounds like also tech will bring down the cost quite significantly because I too
07:31 would love a dietician and a nutritionist and all these things, a personal trainer with
07:35 me all the time, and you're saying tech can be that solution and it can be for everybody.
07:39 Yes, absolutely.
07:41 Tech is the only way to democratize healthcare.
07:44 There is an estimated shortage of 15 million clinicians in the world right now as we speak.
07:52 There is no way to have to plug this hole through just normal, I mean, when we say just
07:59 physicians, human physicians, there's no way.
08:02 The only way to bridge that gap is through technology and AI.
08:06 So every health expert says this is the golden age.
08:10 Right now what we're seeing, the pace of innovation in health tech is astronomical.
08:14 It's not like anything we've seen in the last 100 years.
08:17 I'm curious from both of your perspectives, what do you think is coming?
08:22 What is AI going to enable us to really do that you're really excited about, whether
08:25 it's a device that you all are working on, and I think your diabetes one was a great
08:28 example, but what's something where in 10 years we'll just be sort of mind blown, do
08:32 you think, at what we can achieve?
08:34 Well, look, I think in the medical device space we're at an inflection point.
08:40 There's a lot of great innovation in traditional biomedical engineering, you know, mechanical
08:45 engineering, electrical engineering, chemical engineering, miniaturization of technology.
08:51 You combine that with what we're learning about the human body, and you combine it with
08:56 digital technologies, as digital comes into med tech.
08:59 So think AI, edge computing, cloud computing, quantum computing, 5G, all of this is, and
09:09 then I put robotics in that bucket, a game changer.
09:13 And what it's allowing us to do is personalize care at scale.
09:21 And I totally concur with what you're saying about physicians.
09:24 Tech is the only path forward.
09:26 You can't, if you're not personalizing, you're not going to get the outcomes that you're
09:32 looking for, and you don't have the human capital to do this.
09:36 It has to be technology.
09:38 So in our world, things like, we treat Parkinson's disease.
09:42 We have an implantable device that stimulates certain parts of your brain that mitigates
09:50 the effects of Parkinson's, the movement issues.
09:53 And it's an amazing therapy called brain stimulation, brain modulation.
09:58 And you see the symptoms of that.
10:01 You turn this on, and the patient is calm and smooth.
10:04 It's an amazing, and it slows down the progression of Parkinson's.
10:07 The problem with it is, is that patients need to keep coming back into the neurologist,
10:11 and with the Medtronic person there as well, to reprogram the device as the disease progresses.
10:18 With AI and cloud computing, we can do this automatically and personalize it to that person,
10:25 their needs.
10:26 So that's an example of, another one that, I'll give you one more example of surgery.
10:31 Surgery today is becoming more and more robotically driven with all kinds of enabling technologies,
10:38 imaging and navigation and visualization and tools.
10:41 AI now, we're collecting enough data that we're not too far away from, I'll call it
10:47 a driver assist technology in the OR for surgeons.
10:51 So we're, AI is not going to replace the surgeon anytime soon, but surgeons using AI will be
10:57 replacing those that don't.
10:59 Because this technology is just democratizing good healthcare, where you're not so reliant
11:05 on training.
11:06 It's taking average docs and making them really good docs.
11:09 And that's not out in the future, that is today.
11:11 So these things, I can give you more, those are two different types of examples.
11:16 And to Shai's point, I mean, like take an electrophysiologist that treats cardiac rhythm
11:20 divide and atrial fibrillation.
11:23 In the United States, there may be a ratio of 100 to one.
11:26 One of those electrophysiologists for 100 people, you get into the developing world,
11:31 it's a million to one.
11:32 I mean, you can't train enough.
11:35 So the technology is the only path forward and it is exciting, it is a golden era.
11:40 - As you all are thinking about keeping up, how as CEOs and executives, do you think about
11:45 keeping up with the pace of innovation?
11:47 There's a few avenues to explore, obviously your own R&D budgets, acquisitions, partnerships.
11:53 Shai said, I know that you guys made a big investment in the US and healthcare system
11:57 here, or there, I'm from the US, recently.
12:02 And Jeff, I know you've done partnerships with all sorts of companies, including SpaceX
12:06 and Apple.
12:07 How do you think about when to do what and what can accelerate fast enough for your businesses?
12:13 - So healthcare, when we know technologically, has always been behind the other industries.
12:19 While the rest of the industries are racing towards the 4IR healthcare, in most parts
12:24 of the world, it's stuck in the tail end of the second or the beginning of the third.
12:28 And that gives us immense opportunity to go in into these areas and to leapfrog them towards
12:33 the 4IR.
12:35 So I think, so first of all, just to add on to the previous question, COVID was the chief
12:40 transformation officer for healthcare technology.
12:44 The way that it was adapted and the way that it was absorbed by not just medical professionals,
12:50 but patients, it accelerated it and that's why we're in that golden era of technology.
12:56 Now we're growing, obviously, at an exponential speed, but the way that we want to grow is
13:01 to be able to reach the areas where there is a shortage of healthcare, where there is
13:08 that ratio of one is to 100,000 patients, one physician per 100,000 patients, or where
13:15 there is that dearth.
13:17 So we're wanting to go into those areas, we're wanting to take them into the fold, and to
13:21 bring our technological investments from Abu Dhabi to the rest of the world to take them
13:26 with us on this journey.
13:28 - Look for us in the med tech space, there's a lot of different technologies, and it's
13:34 hard to invent everything yourself, and the barriers to get in have been relatively low.
13:40 So we're very proud of our organic R&D, we invest over $3 billion a year in R&D, clinical
13:48 trials plus technology development into products, but we do have a venture arm that's investing
13:54 in startups and a healthy mergers and acquisitions team, because sometimes somebody, oftentimes,
14:03 leaders from around the world, it's global now, you're seeing this happen all over the
14:07 world, come up with something very unique, and so we'll invest and maybe buy that company.
14:13 So the answer is, when somebody comes up with something that's truly innovative, and they're
14:18 ahead of us, that's when we really, it's something that we're interested in, is where we'll do
14:23 M&A in terms of buying technology, but we also do, COVID, it was a transformational
14:31 time, and that's when we started to do it, we realized that maybe we should look beyond
14:35 the medical technology industry for R&D innovations, that's where we partnered with SpaceX, as
14:40 we open sourced our ventilator during COVID, we had some real challenges to scaling it,
14:46 there's a particular part, called a proportional solenoid valve, never heard of it, but turns
14:50 out, if you think about a ventilator as a life support system, guess what they need
14:53 on spacecraft?
14:54 Life support systems.
14:56 And it turns out that SpaceX had a real, a good product there, a good component, and
15:04 Elon helped us there quite a bit.
15:07 So we've done more open sourcing since then, it was a real lesson learned, as to not just
15:12 think about other medical technology companies, but the broader tech industry, and so we've
15:17 got a lot of more big tech partnerships these days, and the last type of partnership we're
15:21 doing is with healthcare providers, because the key for us is to make sure this technology
15:25 is fully integrated into the care pathways of the different health systems, and health
15:29 systems operate differently around the world, and so it's not a one size fits all, so we
15:34 find ourselves inventing the technology, and then having deep partnerships with different
15:38 health delivery organizations, big hospitals, small clinics, what have you, to make sure
15:43 our technology, we know how to integrate it into their workflow, so that they use it.
15:47 I just want to give people a little bit of context here, Jeff is being modest, I think
15:52 he had the hardest job in COVID, maybe of anyone on the planet, he became CEO of Medtronic
15:57 two, three weeks, maybe, before COVID hit, and Medtronic supplies a third of the world's
16:04 ventilators, and if you remember at the beginning of the crisis, I mean, there was such a shortage,
16:08 and you made a bold move to open source, so others can make this, like SpaceX.
16:14 So I'm curious, actually, from both of you, if this was such a transformation agent, not
16:18 just for your companies, but for your leadership, like, what do you take forward from the COVID
16:22 era to further accelerate your companies now?
16:25 How are they better future-proofed because of what you had to go through in those times?
16:30 So I think what we underwent a transformation ourselves as healthcare entity, you know,
16:36 during COVID, COVID was a wake-up call to everyone who was taking it, just as, as like
16:42 we said, you know, business as usual.
16:44 COVID accelerated the need for change, COVID accelerated the need for preventive care even
16:49 more so, it accelerated the need for a physician, for you to have healthcare at your fingertips,
16:56 in the comfort of your home, in the palm of your hand, and it, it provided everyone the
17:03 tools to access it out of necessity.
17:07 So the learning that I think we took from COVID was that while technology may be a luxury
17:13 still in certain parts of the world for hospital providers, for healthcare providers, it is
17:18 an absolute necessity for all of us, if we're wanting to take this towards the future and
17:25 towards that preventive care, it is an absolute necessity.
17:29 We invested a lot in the R&D.
17:32 We again, you know, like you mentioned, it was absolutely necessary to go into clinical
17:37 trials into seeing what we needed to do when it came to stem cell regeneration, when it
17:42 came to, you know, tackling sick care, when it came to taking the population, population
17:48 health management, say for example.
17:51 So all of these things came in as a part of learning of COVID and when we applied them,
17:56 it was how aptly and, and, and agile we were, you know, in this application that gained
18:04 us the momentum to move forward.
18:06 >> I think for me, you mentioned, you know, becoming CEO right at the beginning of COVID
18:11 and you can look at that as a challenge and I look back at it as a, as a great learning
18:16 experience and opportunity.
18:18 And you, one of the, the things I, you know, COVID struck me of, you know, we're in healthcare
18:24 and it is a privilege and just how important health is, is to humanity and society and
18:31 to the global economy and, and that we need to kind of think a little bigger and the partnerships,
18:37 open sourcing, you know, a company like ours, we have a lot of technology, but we have gaps
18:41 and making yourself vulnerable, taking the risk and, and, and, and, and having these
18:46 partnerships, deep partnerships has been real accelerator for us and our innovation and
18:51 how we think about it.
18:52 So that's one.
18:53 The second is less sexy, but supply chain.
18:59 How, when we, as the world has globalized, how long supply chains have gotten and how
19:07 we've lost sight of where our components are coming from and, and how geopolitics or climate,
19:15 you know, issues can affect our supply chain.
19:18 We saw that during COVID and it caused us to really revamp, one, having a deeper understanding
19:24 of our supply chain, three, four, five layers deep and building that resiliency as well.
19:30 So those two things are big ones, partnerships and supply chain.
19:34 Well, thank you both so much for your efforts to make the world healthier, to help us all
19:38 live longer.
19:39 And thank you for joining me on stage.
19:40 Thank you.
19:41 Thank you.
19:41 Thank you.
19:42 Thank you.
19:43 Thank you.
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