Choosing the Right Problems to Solve and Aligning Your Core Technologies
Stephen Mariano is Vice President of Global Endosurgical R&D at FUJIFILM Healthcare Americas Corporation. Stephen has a long history of success in research and development for the medical device industry and has helped bring numerous innovative technologies to market. In this episode Stephen shares how a company chooses the types of problems to solve, how to choose a specific problem, leveraging capabilities and core technologies, strategic direction and planning, what to do when a technology you own doesn’t fit in your portfolio, and an overview of FUJIFILM and how they’ve grown their helathcare segment.
Links from this episode:
Mastering Medical Device:
Episode Transcript
This transcript was generated using an automated transcription service and is minimally edited. Please forgive the mistakes contained within it.
Patrick Kothe 00:31
Welcome! There are a lot of problems within healthcare. But how do you decide if the problem is worth solving? And if you're actually the best one to solve it, then if you do decide it's a worthy problem, and it's yours to solve, how do you develop or acquire the capabilities and the resources to build a solution? These questions are important for startup companies as well as large multinationals. To help us answer these questions. Stephen Mariano, who is Vice President of Global endo surgical r&d at FUJIFILM Healthcare Americas Corporation is joining us. Stephen has a long history of success in research and development for the medical device industry, and is helped bring numerous innovative technologies to market. Before joining Fujifilm, Stephenen worked for more than a decade at Lake Region medical, which was then the largest medical device or outsource manufacturer in the world serving cardiac neuromodulation, or the PDX, vascular and advanced surgical and Power Solutions markets. In our conversation, we discuss how a company chooses the types of problems to solve, how to choose a specific problem, leveraging capabilities and core technologies, strategic direction and planning what to do when a technology you own doesn't fit in your portfolio, and an overview of Fujifilm and how they've grown their medical segment. Here's our conversation. Steven, you spent the majority of your career developing new technologies and and new products for the medical device space. Why did you choose the medical device industry?
Stephen Mariano 02:45
Well, Pat, I appreciate them having me on here and to talk about the medical device industry. I'll be honest, that's not where I started. I was, you know, graduated at a degree in engineering was interested in materials research. And so I ended up starting off working for the US government, the army, developing new materials. And so I was truly a researcher, right. And that's kind of where my, my life was. And then in all of the time, I sort of ended up working with some great people, I'd say I followed people rather than maybe an industry, I actually ended up going into consulting for a little bit. technology consulting, worked with some terrific people started there with med device. And we were doing some development of some medical devices with it with the team in this consulting company. It was Arthur D, little long history of technology consulting with that company, and then followed a few folks that I knew over to med device contract manufacturer. And that's really how I ended up getting into medical device. And, you know, once I was there, and had a little taste of it in the consulting industry, I really, really enjoyed it. Obviously, I'm able to leverage my skills and experiences and do good work. But also then you really start to relate to the contribution I think that you can make in the industry and into society. And it was really, I'd say reinforced when I started to tell my kids who are pretty young at the time what I did. And they were like, That's pretty cool, Dad, that's pretty cool. And so at that point, you're like this is this is a good place to be. And obviously I've really enjoyed it for past couple of decades. So it's been great. I
Patrick Kothe 04:20
can't agree with you more when your children look up at you and you've got their admiration and their respect and type of work that you do. It means everything to you. So I want to go back to something you mentioned. Right off the start was you follow people, what was it about the people that you were associated with that made you want to stay with them?
Stephen Mariano 04:43
Well, you know, certainly having an opportunity to work with folks who you know, clearly respected the value that you could bring to a team was a big part of it. you pride yourself on your technical skills, your capabilities, your experience, right. And somebody who appreciates that values it as part of a team was certainly a big part of it. And also the folks that I worked with, were very committed to excellence in doing doing their work and developing the products. And so as part of that, you felt like, hey, I want to be a part of this team, you these folks in this person, really, we're committed to it. And then I'd say the last piece was the folks that I stuck with, were committed to improving their their skills, their knowledge, you know, practicing their trade, these folks were were leaders in product development, I got a lot of that, or Arthur D little and that's where I ended up following the folks when they left, they were truly practicing and improving their craft. And I had an opportunity to do a lot of Six Sigma, lean and those types of things. So I got to experience with a lot of different tools. And that's why I wanted to continue to work with those people, because I felt like I was still growing constantly growing still do today,
Patrick Kothe 05:55
that lifelong learner is something that I'm also a very big fan of, as well. Do you find that in in your teams that you're managing right now that you can pick out the people who are committed to that lifelong learning? And people who aren't? Oh,
Stephen Mariano 06:10
yeah, I mean, I think one of the things that I always I always look for, and I see with with those lifelong learners is that they're sort of always challenging the status quo. They're always looking at how can we do something better, because then you know that they're going to want to learn the new technique, or a better technique, or an a more efficient technique, or a new skill or a trade. So I think that's really what I look for is is in see that and people, those lifelong learners are ones who are challenging how they're doing it today. And they, they look for better ways.
Patrick Kothe 06:39
It's interesting, challenging is an interesting word there, because they're challenging, but they're also challenging to manage, because they're always questioning as well.
Stephen Mariano 06:49
It's a good, it's a good thing, because it let's face it, we all we all have opportunity for improvement. So I liked that debate, I guess you got to be comfortable with a little criticism or a little uncertainty. And that's product development is a lot of uncertainty. So you got to be comfortable in that environment, for sure.
Patrick Kothe 07:05
Absolutely. So let's get into product development. One of the things that we wanted to discuss today was assuring that you are solving the right problems, from the company standpoint, from a product development standpoint. So I want to kind of divide that out into two things. The first part is, what kinds of problems do you want to solve? Because if you say you were going to solve problems, well, there's a whole bunch of problems that may not be related to the market that you serve. So let's let's kind of start with your How do you or how does a company decide what's in the box? What's out of the box for problems?
Stephen Mariano 07:46
It's a great question. And I know a lot of companies have different strategies, some sort of focus in a particular procedure or clinical space. But from my perspective, one of the things that I think is really critical or important, too, is, you know, I want to solve problems. What am I good at? I want to look at what are my skill sets? What am I my capabilities? What do I know really well, because then that helps you come up with solutions. You don't want to necessarily be looking for problems that fit your technology, your products, but you want to actually be saying, Okay, well, what can we solve? And so I think it's a combination of looking at the market, as well as what your capabilities are, what your technology is. And so I always look at it as there's a there's a balance between the market poll and technology push, you've got to find a problem and a solution. And it's really matching those. So maybe in the end, what problems do I look to solve is ones that I think I can solve? I have some solutions? Well, I
Patrick Kothe 08:47
think if you look at it from an r&d person's standpoint, and you can say, I can solve the I'm working in cardiothoracic surgery right now, but I can solve something and bowel resection or I can solve something. And it's something that's completely non related to that roof. From a company standpoint, all the resources are devoted to cardiothoracic surgery. That's where the Salesforce is, that's where the, the mark comm is. That's where the regulatory everything is focused in on that. But as an r&d person, you can say, I can go outside of that. So so that big, big question of how does the company decide what's inside? And what's outside the box? What's what's kind of been your experience?
Stephen Mariano 09:31
Yeah, I mean, I think, you know, what's important is really doing that us you know, it's in it is an r&d sort of area, right? I mean, you can't go and ask your sales and marketing people to go look in a new market, right? Because it's, it's really alien to them. It's something totally different. That may be a whole total different channel to the market. So I think in the end, r&d has to sort of assess the technologies and has to look at their capabilities and say, Okay, think outside the box. So as you say, how do I go outside it think outside? What other problems could we solve? And then begin to apply those. There's, you know, lots of examples from Fuji films past and even things like artificial intelligence, which is a hot new topic. You know, I've seen fuji film apply their artificial intelligence technologies to the clinical space, but they also applied it to light, inspecting construction, you know, like, well, it's similar types of algorithms and analysis, and you're basically saying, Look, I need to find something, and I'm looking at a lot of information visually, right? We're an imaging visual company, I'm looking at images, how do I take my AI technology and apply it to image analysis, and then you can start to say, well, the I can analyze pictures, I can analyze scanning of concrete structures, I can analyze the mucosal over a colon, right? You saying I can look at images and then do analysis. So I think it's an r&d responsibility to think broadly about where the applications are, and then ultimately have to do a little bit of work with maybe its partners, maybe it's with to Advanced Business development folks to find some potential applications.
Patrick Kothe 11:13
And then it's feeding it up through the management structure of the company, and making some decisions. And it's, it's a matter of saying, This is what we can potentially do. This is an outsourcing opportunity, this is something we're going to look at in the mid term. These are some technologies that we we may want to further develop to get them to a certain point. But we're not ready to take that. But it's with that management group, to say this is inside our box today. This is how we want to stay today. Maybe in the future, we might apply that in a different way.
Stephen Mariano 11:49
And you know, I'll give you an example of I think how Fujifilm does that we have, we have these things called the Open Innovation Hubs. It's one in Tokyo, which I've had the opportunity to visit, which was really a terrific experience. And we have them in one in the US and one in Europe. And it's really a display of all of our technologies and how they're being applied. And what we do is invite partners. So other companies and say, here's our technologies, here are how we're applying them, here's maybe how we think it could be applied in your industry, come in, sit with us, we'll explain some things will brainstorm some possible solutions. And it's literally like, then we're, we don't necessarily have going to become a company that's going to be doing something in a whole different market. But we can license technologies, we can work with someone else who may be in that market. And as you said, Pat, then you've got maybe the sales, marketing management people focused in that market, all of a sudden, they can bring a new technology from someone else. And so it's it's sort of not only gathering all the potential technologies under our roof that we can leverage, but also sharing things that we might have with others. And we think that's really a great way for us to advance our goals and goals of society.
Patrick Kothe 13:03
So Steven, let's say that there's an idea for a product or technology and you say, Okay, there's a problem out there, it's, it's now it's in our wheelhouse. It's in our defined market. And now we want to make sure that we're solving the right problem. So there's a couple of things in there who's going to be putting a process in place? And what does that process look
Stephen Mariano 13:29
like? That's great. That's a really good point. So so now we're sort of getting into the nitty gritty of okay, how do we develop an actual product, right, that solves that problem, right. And, and I know you've had a lot of folks on your, on your podcast, talking about product development, and project management and regulatory strategy, there's all of those elements have to factor in. But ultimately, it is a cross functional group, I worked very closely our r&d team with our with our marketing team, and our product management folks. And ultimately, what that means is the connection to the customer. So we've got to get the customer involved. It's a key element, but you kind of have to listen carefully. Ultimately, they're gonna tell us what they want. But we also have to show them what can be. We've heard many stories about, you know, we don't know we needed an iPhone or a smartphone till we had one today, right? We didn't know we needed that. I always go back to the Henry Ford's quote of if I asked my customers what they wanted, what they would have told me a faster horse, right? So we've got to show them the possibilities of what the technology can do. But then clearly, we have to listen a lot as we refine that solution, that product solution. So there's a lot of interaction between customers and and I'll add to that, that those customers, you really need a good selection. I mean, you can't ask everybody but you have to sort of have KOLs or key opinion leaders who can work with you. And you want those that are a little forward thinking and innovative, willing to adopt new techniques. Always willing to listen. And you need also need folks who are a little critical, right? They got to tell you now this isn't working, that's not going to work. And here's why, unfortunately had many experiences in my career where I failed miserably with the product development. Maybe that's why I've sort of learned along the along the years, many years ago, I'll give you a story, I worked on a saphenous vein harvesting device. And we developed it did a lot of cadaver models. But the imaging aspect of it when we started to get into validations, and actual animal labs, and we realized that we couldn't keep a clear image. And so really had a significant impact on the tools that we were developing, because you couldn't see. And so that was a big issue. So there's where you really got to get those Kol is involved in the right validation activities, the right development, clinical work to really prove out the concept and the design. And I can certainly give you a positive one as well. Don't want to stick to just the negative Oh, no, that gives me a positive, please. But so most recently, Fujifilm, we just introduced our track motion device, I'd love to tell you a little story about it is how that came about. It's targeted towards endoscopic submucosal, dissection, or ESD. And it's really to remove lesions, cancerous lesions on the mucosal right below the mucosal surface right? Technology for ESD tools techniques have really advanced in Japan, that's where they started gastric cancers for the stomach, right? We saw an application in the US for that for more colon cancers, because that's really more predominant in the West, and Japan, gastric cancers are much more stomach cancers are much more significant than there and in the West. So how do we apply those tools techniques to that type of a procedure? What we learned was, there was a lot of challenges in time and training, etc. And so that was the problem. We said, well, how can we help physicians train? How can we help them be more efficient, effective and doing these procedures that could take hours, right, so unique techniques, and we developed a device that sort of mirrored how surgeries done with traction, you're usually lifting tissue. And so the Track Motion device allows the clinician to lift tissue and cut away underneath. And ultimately, what it leads to ESDs, lead to better patient outcome. And we're giving tools that allow the physicians to be more effective and efficient. It's definitely a win win for everybody. So there's an example of okay, how do I apply that working with those Kol to develop that product, we can have some wins as well. So it's been a it's been a big success and well received, we're excited about where it's headed.
Patrick Kothe 17:46
What you mentioned earlier about not only getting the KOLs involved, but also it's the community surgeons as well, a community for physicians as well, because there's numerous examples of people who've developed products specifically to KOLs. And and then your average physician out there says, Well, maybe that guy can do it, or that woman can do it, but the mass majority of the market is not going to be able to do this. But if the company has gone in to develop strictly on Kol opinions, they're gonna get their their lunch eat.
Stephen Mariano 18:20
Yeah, you're very right there. That's that's a really good point is you really DO have to sample a lot of different I mean, not all and, and Oscar pista are created equal, right? You've got advanced practicing folks, you've got folks who are really sort of day to day, a lot of screening. And one of the things I think is when you are working with those advances Kol is you sort of need to work with those who want to promote that in the industry, right? They're doing training of their fellows, right, that's part of their focus and career. So they help develop tools that they know they're going to be able to apply and train others to use. And so I think that's an important thing to consider when you're working with with your customers, for sure.
Patrick Kothe 19:03
So, Stephen, going back to the main question here, the question isn't, you know, we're not talking about how do you develop a product, but how do you identify that the problem that you're biting off is the right problem. So let's, let's spend a little bit of time on the problem, not the solution side. But the problem. How do you identify those problems?
Stephen Mariano 19:24
Well, I mean, I think there's a few techniques. One thing I would say is r&d has to listen a lot. They need to listen to their sales and marketing people they need to listen to Kol is they need to go to conferences and listen to what the challenges, right. I mean, many, many times at least in the surgical space, you hear the conference sessions on what went wrong and what the challenges they're facing. Right. I think another technique that's important the term gamba for a MA from the Japanese of going to the place where it really happened. Clearly in COVID. That's been a lot harder than it used to be. But certainly Spending time with your Kol is observing their cases. I don't know how many times my r&d team have come back and have explained to me, oh, though, that was a difficult case. Here's what went wrong. And I think that often leads to potential solutions, right potential ideas, while they're struggling with this aspect of it, maybe we can come up and again, matching some of what we can do to hey, I think we can solve that problem or at least alleviate some of their issues.
Patrick Kothe 20:29
Most of the organizations I've been in, have not had a direct pipeline from sales rep to r&d, many times its product management r&d, its top sales, leaders to r&d, but the majority of the customer interaction is with sales reps. So how do we train our sales reps to be better communicators of what they're seeing when they're in that case? directly into r&d?
Stephen Mariano 20:56
Yeah, that's a great point. And I think that is training, right? It is a bit of training, right? There are a couple of things that come to mind. One, I like to put the r&d folks with the sales people with the reps with our clinical specialists, almost as just a tagalong. Just to go and listen, because then, you know, the dialogue between the r&d engineer and the clinical specialist over lunch is really where a lot of thought process and questions and trying to understand what's going on are valuable, right. So that's one aspect of it. Clearly, you know, formal training is something we need to do a lot more have to obviously, that's always good. But that sort of informal area where r&d is talking with the with the salespeople. And I think obviously, the sales organization itself has to see that as I mean, obviously, they've got a lot on their plate, and then they're trying to drive growth in the company, etc. But they're critical for solving those problems. And conveying that, and they need to know that that's an important role for them is to help us develop again, as we talked earlier, they'll write products. And so if they know that that's an important aspect of their job, and of the company's success, is understanding what those problems are, and conveying them to the organization. I think that's another good practice.
Patrick Kothe 22:12
So you're getting these ideas in, and you're identifying what these problems are, then the next step really is what process are you going to follow, to vet those ideas to vet those problems to see if there's something something there? You mentioned earlier about saphenous, vein harvesting, I was part of a company and we had a product that could replace saphenous vein for bypass surgery wouldn't need of saphenous vein to be something that was harvested through an ostrich actually, ostrich carotids, we were using to do it, and treating the tissue, but the clinical pathway to get a product like that out there was going to be so it was going to take decades to get to get the clinical data to support something. So even though technically, hey, it could work, we could get something to work. There's no practical way of getting it. So we had to follow a process and going through there. How do you what's the best best way to manage process to take an idea or a problem and decide whether it's something that you want to kick up kick off a project, but
Stephen Mariano 23:22
it's, you know, sort of the engineering me always goes back to those selection criterias and pew matrices and say, you know, we have to rank priority, what we can do, you know, comparing what our capabilities are, what's possible, versus the market need, right? And there are many factors that play into that, right? You know, I always look at the impact we can have. So the potential impact to the market, is this something that is going to make a significant contribution to the industry, it's going to improve patient outcome, reduce costs, that's a big aspect nowadays, too, and comparing that to the level of effort to implement. And as you said, that could be a regulatory issue, right? That's just regulatory wise, that path is too challenging. Or it could be a you know, technical hurdle you have to overcome, right? We can't make this thing small enough, we can't make the resolution good enough, right? Or out or cost issues, right? I just can't make it inexpensive enough that it that it really amplifies the market. So I think you have to look at all of those aspects, when you're doing prioritization and ranking of those r&d ideas or those projects. And, you know, ultimately, there are a lot of good ideas. I, you know, in my career, I have seen lots of great ideas, but being able to implement those that's, that's innovation. And ultimately, it's being able to prioritize and sift those, which is a critical, critical aspect to saying this one's going to have an impact, right.
Patrick Kothe 24:47
Is that a multidisciplinary team that's doing that as well?
Stephen Mariano 24:50
Yeah. But yeah, most definitely. I mean, you've definitely got to get the business folks involved. The market. salespeople who understand the market well, the technical folks tax and regulatory and manufacturing, right. So it's clearly a multidisciplinary group. And I know that can be challenging sometimes. But it's important that organizations have that level of interaction when you know, whether that's annually, quarterly monthly, there's sort of a review of those projects. I feel that r&d being out of r&d, I'm constantly engaging my partners across the organization to make sure that we're aligned from a goals and objective standpoint, and the projects of supporting what can be done right. So there's a lot of interaction at that level, it has to be,
Patrick Kothe 25:38
there's a lot of several different product development frameworks you use, it could be led by marketing could be led by r&d could be joint ownership and or a separate division of project management, to lead projects. But that's when a project has been defined and said, Okay, now we're going forward with this. What we're talking about here is do you go forward with a project is that set outside of the project management system as a separate group that makes those decisions?
Stephen Mariano 26:08
From my, my perspective, in my experience, that that happens at a, I would say, a pretty senior level in an organization, because it has to be really linked to the organization's strategy, not only like what we can do, what do we have resources to tackle? What do we have experience with? But also what makes sense from a company? Where are we trying to be as a company, and making sure that we align those projects with that? So you know, that's the conversation at a very high level, from a business perspective and senior leadership perspective.
Patrick Kothe 26:42
Let's talk about planning for a second, many companies will go through a strategic plan, and it could have a time horizon, a five year time horizon, and then they revisit annual operating plans with the annual annual budgets. And sometimes this the strategic plan is done on an annual basis. Sometimes it's done every two years, it depends kind of depends on the company, I'm assuming that your experience, those big decisions with the senior managers kind of lead through that strategic planning process.
Stephen Mariano 27:15
Yeah, that's, that's critical. I mean, you know, obviously, like a company like Fujifilm a very big organization, right, you know, 75,000 employees globally, right. from a strategic perspective, at the very top, I would consider it sort of aspirational, where do we want to be, you know, from a society perspective, right. And then that sort of begins to filter down into the business units, right, which are getting more and more sort of industry specific, and even, you know, sort of down to the product specific sort of areas, or, you know, whether that's some clinical specialty we're trying to tackle or something like that. So it's definitely multi layered, right? That it has to be aligned. And to the organization, Fujifilm has made considerable investments in health care being an area that we're focused heavily in. But again, the business units are focused in specific areas and capabilities and, and products, and those align with that overall strategy.
Patrick Kothe 28:10
And that strategic plan, you may have major projects, that are multimillion dollar projects, that would be decided at that level, if you're talking about a line extension, then that stays within a business unit. It's
Stephen Mariano 28:23
definitely definitely there's, I see it as this, this sort of all levels of projects, you know, at the, at the r&d sort of team level, you've got many, many projects, maybe you're you're participating in some larger, big initiatives. But there's also lots of like you said, line extensions, or even just, you know, addressing improvements within an existing product line to say, you know, we really need to better understand how this is being used, what some of the issues might be, and that all feeds into improvements, and, and maybe even some disruptive innovations, right. So so it's really a multi level down to the specific product lines.
Patrick Kothe 29:04
So big picture, it's in the box. Next level, we've identified that this, this is a real problem that needs to needs to be solved, you kick off a project, but things change. Some of these projects are multi year projects. And the need may be different. Two years into the project than it was originally it could be competitive forces could be a new technique that came came out could be that you couldn't solve something or couldn't solve it well enough. So what is that? What is that mechanism that you have in place? Once the project is kicked off to make sure that you're on target? Yeah,
Stephen Mariano 29:45
part of that alignment at a senior leadership level was it within the business unit is you have to constantly be reviewing the status of projects and I know it can be hard being an r&d guy and my little baby, you know, I don't want to give that up. But you do have to have at strategic level the decision process to say, this one's not really going to pan out, we need to shift gears and maintain that level of flexibility. You know, fortunately, in my career, I've been involved in companies that it isn't, we don't need that anymore. So we're gonna get rid of all the r&d people. It's like, no, we've got tremendous talent here, let's refocus it in a new area, or a new product, or we have to shift our resources to other things that are higher priorities. I always tell my r&d team that when the sales and marketing folks are saying that they need a new product, they need it today. The need is out there right now. They're not telling us what they need four or five years from now. So we have to sort of obviously work fast and effective, and hopefully continue to be flexible and navigate those those changes in the market as they come about.
Patrick Kothe 30:46
Well, it's it's difficult every time because typically, I come from sales and marketing, that's my background in the past, or always after the next shiny object. Okay, you know, somebody told me this, and we needed it today. And you know, we told you, we need to something else three years ago, and you're almost to the point of doing it, but not now let's shift gears and you know, put that one away. And now this is the new, new hottest one. So it's always this kind of push pull on finishing a project. And because there's a lot of inertia, anytime you put a project out there, there's a tremendous amount of inertia just to finish it. But it may not be the best product strategically to come out at that at that point in time. But there's got to be a process to really understand whether you're truly are just going on to the next shiny object, or you should be finishing this project that you've got going. So in my estimation, it's process that needs to be in place throughout the project, to be able to assure that that happens. Is that your experience to that it has to be formalized.
Stephen Mariano 31:56
Yeah. I think in the end, you've got your, the, as we discussed earlier, the process of deciding what to work on also as a process that you need to use on existing projects and say, do we continue to work on this? Do we need to make changes to this from a strategic standpoint based on what we're understanding in the market? And they can ebb and flow? Right? I mean, I'll be honest with you, my experience, projects are hard to kill. They have an inertia, as you said, and they want to get done and the team wants to finish them. Usually, it's not necessarily a dead stop, as it is a course correction. Usually, that's sort of what we're seeing. And we might say, Well, what we think now that's going to be needed, we need to modify our direction on this product, say, we need to explore something a little different. And sometimes you do have to start saying, okay, look, it's good enough, we need to launch it, right, we trying to improve certain aspects of it. But this is something we can put into the market. I've had experiences on products that I've launched that we need to get this in the market, because we're going to learn a lot more when it is in the market. And let's move to gen two. And so I think that's also part of that process of saying, Alright, this is good enough. Let's get some market feedback on it. And then we'll modify once we learn more about it from the market.
Patrick Kothe 33:18
Let's talk about fuji film I love to fuji film just makes film right?
Stephen Mariano 33:23
At one time. So what did you film? It's certainly seen a great transformation we've been I'd say we've been very fortunate to have leadership Komori sound So Ken Osan, who, who sort of saw back in 2000, the peak of the film, when I think the market was about almost a billion rolls of film a year. analog cameras, I think, you know, Patrick, you and I might be of an age where we remember those. Oh, yeah. Get it developed, right. But the leadership really saw that the market was changing, Fujifilm decided we really need to change direction. You read a lot about Clayton Christensen and disruptive innovations. There was disruption coming to that industry in that market. And fortunately, our leadership said we're gonna we're gonna pivot, we're gonna move towards new markets. And you know, what's really interesting is, not only did we say okay, we're gonna go from film to digital photography. But literally, that was like 2000 to 2010 10 years film disappeared, from about 2010 to today. Digital cameras have mostly disappeared, because they're all in our phone now. So just saying, Well, we're going to go from digital, we're going to go from film to digital cameras would have been not a very clear insight. So ultimately, the leadership and Fujifilm said, Well, you know, what, are we really good at? What are our core technologies and capabilities and where could they be applied? We talked about this earlier. And a lot of those core technologies really had terrific opportunity and application In the healthcare industry, clearly at that point we knew healthcare was something that's going to continue. We need to there's tremendous growth in that space. There's a lot of unmet need in healthcare. And so that was the idea is to apply those those those core technologies to new markets and healthcare being one that I'm sort of very dear to me and been involved with my whole career. So it was it was really fortunate to make that change. So I wouldn't say we don't make film we still do, we have a little bit of film. And we're an imaging company. So we have a lot of products, photos, and pictures are still a very important part of our life and our world. But clearly, we've made some changes to adjust to that disruption.
Patrick Kothe 35:43
What's interesting is at that point in time, there were two boxes that you you could buy, when you when you went to buy film, there was one that was green, and there's one that was black and yellow. And the one that was black and yellow, didn't quite do as well didn't didn't quite pivot business, as well as Fujifilm that,
Stephen Mariano 36:01
yeah, we were very proud and happy that our leadership saw that direction. That's true, it was a difficult challenge in the market. And not everybody survives right out. Everybody survives in the in the same way. So.
Patrick Kothe 36:14
So at this point, let's talk about the different business areas that different market segments that Fujifilm serves.
Stephen Mariano 36:23
So as I said, a lot of it, you know, is based on imaging, there is still cameras, right? You know, we've had some great success with things like the Instax camera and bringing that instant picture back to society, people value that we still make cameras, we have some very high end cameras that we do. But in addition to that we've expanded into healthcare, as I mentioned in really broadly in the sense of healthcare being radiology, digital, radiology, mammography, MRI, CT, ultrasound, made a significant investments in ultrasound, both internally and through acquisition Sonosite, Li world leader and point of care ultrasound, most recently Hitachi, and adding their capabilities that was an acquisition Fujifilm made last year. So building our portfolio and healthcare is pretty broadly based, I am sort of more focused in the endoscopy and surgical space. We've been in that since the 1970s. So it's not like these are all like brand new things we've done. But it's really an investment and refocusing of the organization around industries and opportunities and then leveraging our core technologies. And I should mention business innovation, which is a group now that's that sort of came out of the Fuji Xerox, and in that type of business, again, imaging oriented, and then materials, industrial materials, we do a lot of work in that area, again, leveraging our core technologies for things like a lot of the films on led cameras and LED screens, things like that. And again, you can kind of start to see the analogies of the technologies and film, while it's a different kind of film, but important technologies relative to manufacture those is relevant to those other new products. So definitely pretty proudly based in those markets.
Patrick Kothe 38:06
How large is a company how many employees
Stephen Mariano 38:07
about 75,000 employee employees globally, about a $21 billion US health care's close to 7 billion. So it's a big chunk of our business today. But it's a very large company, very global company. You know, as I've had an experience working across the globe, with customers and with partners, it's interesting to see the knowledge and experience with Fujifilm can vary quite a bit from one country to another. But it is very global, and so pretty well known across the globe, and I think a lot of people have had some experiences with Fujifilm.
Patrick Kothe 38:39
So Steven, you're you're managing the r&d part of endoscopy. So tell us a little bit about the types of products the type of customers type of patients that you're serving in endoscopy?
Stephen Mariano 38:53
No, it's a it's a great question. And I guess I'd like to start Patrick with talking about sort of what's going on in the industry. Right? What are the challenges we talk really about? What are the problems, right, what are the problems that the industry is facing? And that's where we need to begin? One One is treatment, right, interventional treatment, you know, basically, if you can treat a patient, we you know, you hear a lot of terms around see it treat it right, if I can do more for the patient. That's a trend in the industry. And so things like the ESD what I talked about, rather than sending that patient back for surgery, can I solve this issue with that patient today? Or maybe with the with a less invasive procedure? So that's a big trend in the industry. There's a term called third space endoscopy, sort of working in this space between the lumen bed mucosal of the of the say, the colon, and the abdominal cavity. Is that space in the wall? Can I do things in there to solve problems? Cancer is typically one of those where it's not fully invasive. So if they don't need the full surgery, can we cure them this cancer, treat that lesion, remove that without having them have to have a call mastectomy and have their whole colon replaced? Right? So those are things that I think are definitely a trend. And so that's what we've been focusing on quite a bit is how do we provide those tools, and those techniques, the scopes, the equipment, the devices, to help expand interventional endoscopy, and help those those those physicians practicing. And you know, we talked earlier about making it easier for them, training becomes easier, those tools make it easier to track motion device, if we can promote and help them do that, that's going to lead to better patient outcomes, lower costs. So that's one area that I think is a big focus in endoscopy. And other areas. I think as you're, as you're well aware, and I think, you know, the audience is aware that imaging technologies have improved considerably, right? We all have 4k TVs at home, they're talking about 8k TVs. Image quality is terrific, right? Everybody's advancing that. So what's next for those endoscopist? How do we give them more information? How do we interrogate the tissue? How do we look for functional imaging? How do we see how the tissues behaving? So we've recently launched a new technology Alexey of vision that basically allows you to visually see oxygen saturation in the tissue. That gives them a lot more information about ischemia, about ulcers about things like IBD, and inflammation, we can interrogate the tissue more, learn more and make better decisions, both procedure wise, and also from a diagnostics perspective. So that's another area more information, not just a better image, but more information for the physicians. And then I think ultimately, the last area that we're seeing a lot of challenges, I think, clearly COVID accelerated all of these issues is capacity, right? Health care organizations are struggling with burnout with staffing issues, just read recently, and the local Boston newspaper that, you know, they're searching for 500 nurses, these particular health care facility just don't have enough staff. So that's putting limitations on care. Just read recently, I think it was in health system in North Dakota, was scheduling colonoscopy, so to a year wait, that's not a good thing, right? So how do we help the healthcare industry those those endoscopy tests, and the practices be more efficient and effective? There, you have things like we recently introduced a product called Gi, with a partner that ultimately helps them see, you know, sort of in the folds of the tissue, right, that's an important thing, I don't miss anything and make them more efficient in their visualization. And then, of course, artificial intelligence, we're hearing a lot about that. Fujifilm has launched cat AI in Europe, it's available in Europe right now. And we're hearing some terrific things. And we're really excited about where that technology is going. I know that the American gastroenterological associations journal just published recently, that artificial intelligence improve the detection rates by 50%. So they're gonna more likely catch things become more efficient. So in the end, those are the things that we're tackling. Those are the problems we see the products we're trying to bring to market that can help address those problems.
Patrick Kothe 43:13
So Steve, the company has been working in an endoscopy since the 70s. And evolving the technology and based on different needs in the marketplace, different capabilities that you're able to deliver. So you've got a set of core technologies that you work with, and you're able to build off of those technologies? How do you identify what is your core technology? And how do you identify when you need to bring a new core technology and to be able to expand the types of things that you're doing? Yeah,
Stephen Mariano 43:47
core technologies for Fujifilm sort of start with almost basic research. And we have a significant effort in research and the company that starts with basic research, right, so So that is sort of at a level that can be applied, applied broadly. So clearly, we want to tap into those things. And that might help direct some of the more basic research that's being done.
Patrick Kothe 44:08
This is interesting, because when I think of core technologies as they go, it's imaging but what you're talking about is a core capability. And that core capability really is more important than the technology is do you have the expertise in house to be able to make these this Yeah,
Stephen Mariano 44:22
yeah, ultimately feed into that to that. That's a good way to put it into capability. Imaging is such a broad field and and how do we apply our capabilities within imaging to really make a difference? So you know, I think the point you said about how do you transition? Or how do you navigate sort of changes in the market and make sure that you continue to develop relevant capabilities, relevant technologies to support it? I think it's an ongoing assessment. You know, as we've talked before, about how do we look at the market and say, what are the core technologies that are going to be needed? And to me that's a responsibility for r&d. management to be looking at and saying, What technologies do we need? You know, and as you're well aware in the healthcare industry at a medical device industry, there's a lot of startup companies, right, lots of new technologies, assessing those looking at those working with those folks partnering, I think is a big area that is gonna continue to help everyone sort of stay focused on the on the needs in the market, it's sort of the classic, you know, sort of market driven, right? The funding goes where the problems are being solved, right. And so maintaining that level of focus to I think, helps to maintain those core technologies in the right in the right markets.
Patrick Kothe 45:38
Focus is is also an interesting word. And if you've got somebody who's devoted to a project, you've defined it out, and that person is devoted that project and you want them doing nothing but developing that project. But a good rd person, in my estimation, also is looking for the next thing. So some companies have said, you know, devote 90% of your time, we'll give you 10% of your time for skunkworks. Do you do anything like that? Do you believe in that type of concept? What how do you how do you manage? How do you manage a department with that challenge? That's
Stephen Mariano 46:11
a great point. I know, there are a lot of companies and a lot of in, you know, case studies written about that, and how that's done. To me, I think one of the key things is you need to make sure that you've got curious people, because let's face it, in the end, if I said to somebody, I want you to take 20% of your time and devote it to something, if they're not curious, what are they going to devote that 20% of their time to write. So you can't dictate that. And I literally believe that you've got great technical folks, I know, that worked for me, I've had the opportunity to work with in my career, that are doing 100% of their time on their project, and then spending their own time being curious about something. Whether that's a hobby, or just hey, I ran across an article. And that's really interesting to me. I know, many folks have talked about having diverse interests. It's not just being very technical and engineering and science based. But you know, you're interested in, in literature, art, sports, anything that sort of continues to keep you engaged, right. And I think ideas can come from all kinds of places,
Patrick Kothe 47:15
as you're building this knowledge base of your core core capabilities, your core technologies, and you see, we don't have this right now, we always have a decision to make by decision. You say there's a lot of a lot of startups out there. There's also, you know, things that you can do capabilities that you've got insight, how do you assess that make by decision?
Stephen Mariano 47:38
Yeah, it's that's a that's a great question. And I think sometimes some of its strategic within a company. You know, Fujifilm invests a lot in our r&d. Recently, certain number, we spend $3.6 million a day in r&d. Wow, wow, big number. So fuji film is committed to developing technologies and value from innovation is our tagline. Right? So so we spend a lot of money doing that some companies not so much, that's not their core, right? They're not doing research, basic research, right? So they're looking more externally, right. And so I think you have to start with, what's the strategy of the company? Are we going to develop our own technologies? Or are we sort of looking, and then you've got to structure your company around that, right? You've got, you know, people who are looking or maybe partnering with universities or, or startups to try to identify new capabilities, new technologies and bring them in the fold, you hear a lot about fill in technologies that help support their overall mission and strategy, you know, or you're saying, well, I need to make sure that I'm managing my internal organization and funding to support the right initiatives within the company. So I think it's a mix, you have to basically look at the strategy as a company, and then build the process around what makes sense for it.
Patrick Kothe 48:52
So Steven, you're managing a large organization, but you started out as a single contributor, and you've moved up in the organization. Now you're managing not only the team, but you're managing managing the strategy of the department, you're managing, you know, what technologies and capabilities are coming in. So how do you develop your people? How do you keep them focused on what they're doing, but develop them so that they have a broader picture of the mission of research and development, to enable them to have a career to move up? So so somebody who's starting out or somebody that is in mid management, what advice would you give them?
Stephen Mariano 49:40
It's certainly from my perspective, what's very important is communicating in the organization, the strategies and what we're doing and what's important, right? And so that's a big part of it. So if you're in the mid level manager, you know, arena, right? And you're saying, Look, I want to advance my career in this discipline or this or this function. It's not Understanding the strategic direction and it may be if you feel I'm not getting a lot of information, go get it go seek it out many companies I know Fujifilm communicates a lot from formal perspective in the company, we publish a lot internally and communicate internally, I would always advise folks read that we have something quarterly called Fujifilm world. It's a global publication. It talks all about fuji film that tells you and gives you a lot better perspective about the company and the culture and what we're trying to do. And so I suggest people dive into that. And then of course, with your manager and your manager, making sure you're doing one on one time, you've got town meetings, things like that, that well, you're collecting information about where the company's headed, what we're trying to do, I think communication is really critical for folks to to move within an organization because you never know what you did, where the journey will take you, right? Building those relationships, you find yourselves I know, personally, I can't say I had a grand plan to be where I am today. I got here, and I'm happy I made it. You know, and I had a great time along the way. But it's sort of taking those opportunities and just continuing to be curious and exploring the world around you and your company.
Patrick Kothe 51:13
Do you remember any manager or any person that gave you great career advice,
Stephen Mariano 51:20
I had a manager who told me sometimes you have to leap before you look. There's a little bit about sometimes you got to take a little risk. So that was definitely a good piece of advice, I think. And then I think in general, I've had some some very good managers who were very supportive, you know, sort of went to bat for you, right, that they valued doing the organization, they felt you could make a lot of contributions. And they helped to make sure that you're in a position to do that. So they sort of put you into those good opportunities, in good experiences. So that would be something else that I think several managers of mine helped me do is give me that type of opportunity,
Patrick Kothe 51:59
kind of full circle. Now we started off talking about the people that you knew that you followed, and the reason why you follow them as they valued your contribution. And now you're back to the same thing, valuing the contribution that you're making, I'm assuming that's the type of culture that you'd like to work in, and that you foster.
Stephen Mariano 52:20
I mean, honestly, I enjoy working with my teams, I like being into the details of the projects. I'm curious about them, and I want to learn about it. But it also shows them that what they're doing is important and a value to the organization. If I'm spending time listening to them, and engaging with them, hopefully giving them some good guidance as well. Right. Hopefully, I can return the favor, pay back a little bit.
Patrick Kothe 52:46
Solving problems in health care is what we do. I enjoyed speaking with Stephen, and exploring how he thinks about problems and solutions to those problems. Everyone does it differently, depending on what our size is, what resources we have, and our the stage that our companies are in. But a systematic approach is required to make sure we do it correctly. Here's a few of my takeaways. Number one, when I asked him, How do you identify problems, he was very quick to say r&d needs to listen a lot. And he went on to explain about listening to to sales and marketing go into conferences, listening for challenges, he discussed gamba, where means going to the place where it actually happened. And then working with sales directly with the with the ride alongs. But clearly, listening is high on his priority list. The second thing that stuck out to me was understanding and embracing your role within a company. And he talked about r&d, taking the lead on some things, you know, things like you know, understanding the capabilities and understanding technologies. And then also taking the lead on developing use scenarios which may be inside or outside the current business. So that's that's r&d responsibility. But then he also said that there are other times when it's a multidisciplinary team that's going to look at things and make make those decisions and that would be things like a product opportunity analysis or strategic direction of the company as a whole. So really understanding what group you're in and what responsibilities you have to to help out the team in general. The third thing was the idea of a large company and what Fujifilm is doing with open innovation hubs, and this is their display of technology. And I thought that this was a really interesting way to, to get get technology out into the marketplace. And it could be through partnerships or licensing technology. And as Steven discussed, it was either to advance their own company goals, or to advance the goals of society. Thank you for listening. Make sure you get episodes downloaded to your device automatically by liking or subscribing to the mastering medical device podcast wherever you get your podcasts. Also, please spread the word and tell a friend or two to listen to the mastering medical device podcast as interviews like today's can help them become a more effective medical device leader. Work hard. Be Kind.
