the conventional thinking is is that the advancement of products and services into Health Care um and I think there’s some truth to this just adds layers of additional products Services protocols Etc in and nothing ever goes away and there’s some truth to that because when you bring something new to the marketplace before it really gets fully embedded in the marketplace and the and whatever it’s uh predecessor protocols were or products are really pulled back from the marketplace is almost a generational change so you get basically two layers the change Dynamic takes way too long in healthcare to occur and you can measure that and it does add costs um but at the same time I would say there has been an observation uh too much incremental uh change products and services that have come into the marketplace that really don’t drive that much difference and so what we’re learning uh as a company I would offer as a learning to you if you don’t drive about a 20% so that is a change that can really be felt in terms of a an outcome economic kind of Delta if it’s not kind of in the 20% range then I would question how much I’m spending developing that new thing because if it is not bringing that kind of impact to the marketplace then I think the consumer is going to be um uh very slow to uh recognize it and value it and I do think what’s what I’m learning about the consumer is is that they’re going to ultimately make the decision at the end of the day um they’re going to take their input from a variety of places but it is not going to be one of these small incremental changes that my product provides a slightly incremental advantage and it has perhaps a meaningful uh uh cost difference or even just a when I really take a look at what consumers choose when they get the opportunity it is really sobering to realize um what the standard for performance is going to be

传统观点认为，医疗领域中新产品和服务的引入会层层叠加更多产品、服务、流程等，而原有的方案很难完全被替代，需要经历几乎世代更替的漫长过程，因而在落地前便已产生显著成本。然而，我们也观察到，市场上涌现了过多增量式的产品和服务，它们往往无法带来实质差异。作为企业，我们的经验是：只有当变革的效果达到约20%时，才会对结果产生明显的经济影响；如果没有那么大的变化，就值得质疑我们为此投入的资源是否划算。消费者不会为稍微改进的功能买单；他们的决策会基于多方面信息，真正会影响他们的是具有实质差距的产品。因此，在设计新方案时，要瞄准能让消费者“真切感受”到的变革标准。

and then I’ll take you to international travels and you take a look at uh in countries where they are um getting very respectable Health outcomes and they using products and services at much lower levels than we are um you’re seeing what I’ll call an high performance clinics so in our in our neck of the woods when we begin to engage with the clinical Community we are obviously very much Discerning um who performs better than others and who’s consistent at it and when we look at what I’ll call high performance kinds of clinics the products the services they bring together the kinds of techn Technologies they use the kind of responsibility they take for performance and the kind of consistent performance they get and using much lower levels of products services and Technology than others or using um lower cost um Technologies to accomplish those things it’s uh it is pretty impressive and those are cost differences up between um let’s say 25 and 35% so all I’m really saying is is that that the to to my way of thinking the market has changed the expectation of something having an impact is pretty high I don’t know if that answers your question but

再来看国际视野：在一些国家，他们以远低于我们的资源投入获得了相当可观的健康结果，这些我称之为“高绩效诊所”。在与临床社区合作时，我们会仔细甄别哪些机构的表现更出色且更稳定，然后研究它们所采用的产品、服务、技术及其绩效责任承诺，往往能以更少的资源或更低成本的技术，实现同样甚至更好的结果——成本可低25%到35%。这印证了我所说：市场已对效能提升抱有更高预期。当然，不知这是否回答了您的问题。

so I can appreciate uh your comments about around streamlining healthcare costs with existing tools some and products some of the Technologies devices and Diagnostics you reference and that are developed by people in this room are breakthrough technologies that don’t have pre-existing payment structures although could benefit patients and potentially reduce costs we hope do you have initiatives internally to encourage those new technologies to get paid or you know you have ways that you’re going to you know you envision your organization looking at those Technologies and welcoming them uh in a constructive way that would you know allow small companies to actually get to the point where they can prove the data and show you the data

我能理解您所说的：利用现有工具、产品、技术设备和诊断手段来压缩医疗成本固然重要，但在座许多团队研发的那些突破性技术尚无既定付费模式，尽管它们可为患者带来效益并有潜力降低成本。请问，贵公司内部是否有举措来推动这些新技术获得付费？或者您设想组织将如何以建设性方式接纳这些技术，以便让小型企业有机会获取、验证并展示数据？

I think we do you know particularly given the fact that we serve a lot in that in that Community around Expediting the process to get regulatory approvals and and so forth we’re held to the same kinds of um we share an an issue about how quickly good products and so forth get to the marketplace because of the very rigorous um um regulatory hurdles that they have to get through in this country um so uh we’re very much aligned interest along along those and if we can actually be helpful uh in any way um in terms of moving those kinds of processes along but when we see something that has gotten approval that we think is um a distinctively um better approach I think we’re one of the companies that is uh most aggressive in terms of putting it forward but then you have to get to the point of well how do I get that done so the way we do that is to really focus in the marketplace again to the same notion of where are the best places and who is most likely going to be adopters of this so that we can design products and programs to get those people to those places so that that technology is driven and then we’ll pay for that and we’ll pay for those kinds of outcomes

我认为我们确实在这方面有所作为——特别是考虑到我们在该社区中积极推动加速监管审批流程。我们与研发方都面临同样的挑战：由于美国严格的审批门槛，优秀产品难以及时进入市场。如果我们能在推动流程上提供任何帮助，我们都会这么做。一旦有新技术获得批准，我们通常是市场上最积极将其推向前沿的公司之一。我们的方法，是再次回到市场：寻找最优应用场景与最可能的早期采用者，进而设计相应产品与项目，将这些人聚集到指定场所，让技术得以落地、应用；随后，我们会为实际产生的成果买单，并对相关绩效进行付费。