Luc Boronat, head of the digital division at the Eqwal Group and CEO of Qwadra, discusses his journey and insights on the meticulous balance between clinician responsibility and design automation in the prosthetic and orthotic industry.
Join us as we explore the story of a visionary who has reshaped the Orthotics and Prosthetics industry through innovative CAD/CAM solutions. From humble beginnings with a ZX80 computer to creating digital tools that replaced outdated plaster models, this journey showcases the power of blending engineering with clinical expertise. Discover how these tools evolved from internal innovations to marketable solutions, addressing real-world clinician challenges and ultimately shaping a company that supports Certified Prosthetist-Orthotists globally.
In the realm of advanced 3D printing in orthotics, we delve into the use of foaming TPU material for custom insoles. Learn about the clever solutions developed to maintain printer functionality in continuous operations and the strategic positioning of soft insoles in the European market versus global preferences.
Special thanks to Advanced 3D for sponsoring this episode.
00:00:00.681 --> 00:00:03.630 Welcome to Season 9 of the Prosthetics and Orthotics Podcast.
00:00:03.630 --> 00:00:11.446 This is where we chat with experts in the field, patients who use these devices, physical therapists and the vendors who make it all happen.
00:00:11.446 --> 00:00:19.646 Our goal To share stories, tips and insights that ultimately help our patients get the best possible outcomes.
00:00:19.646 --> 00:00:22.548 Tune in and join the conversation.
00:00:22.548 --> 00:00:27.751 We are thrilled you are here and hope it is the highlight of your day.
00:00:27.751 --> 00:00:31.266 This is the Prosthetics and Orthotics Podcast.
00:00:31.266 --> 00:00:33.031 With Yoris Pils and Brent Wright.
00:00:33.031 --> 00:00:41.615 We are super excited to share with you some of the recordings and interviews of people that we met at AOPA 2024.
00:00:41.615 --> 00:00:50.820 So our first guest is Paul Godonis, the CEO of Myomo, so let's lean in and listen to what he has to say.
00:01:15.037 --> 00:01:21.126 Hello everyone, my name is Joris Peebles and this is another episode of the Prosthetics and Orthotics Podcast with Brent Wright.
00:01:21.126 --> 00:01:21.808 How are you doing, Brent?
00:01:22.129 --> 00:01:31.730 Hey Joris, I'm doing well Doing a little traveling to the gloomy metropolis of Cleveland, ohio, okay.
00:01:33.052 --> 00:01:34.155 What brings you to Cleveland Ohio?
00:01:35.480 --> 00:01:38.768 So I'm actually hanging out a little bit with John Naft.
00:01:38.768 --> 00:01:40.090 He's from.
00:01:40.090 --> 00:01:41.033 Combscan.
00:01:41.033 --> 00:02:11.491 I tried that and I actually managed to get that so, uh, yeah, so doing that, and we're just talking a little bit of 3d printing, and then he's doing a lot of stuff with um myomo, which is the kind of the exoskeleton for people that have had a stroke or, you know, a loss of a function of a limb, and so it's been really interesting to learn about that.
00:02:11.631 --> 00:02:14.348 you know, and I love coming and seeing other people's practices.
00:02:14.348 --> 00:02:20.193 Then we talk shop, and, yeah, so it's been really great.
00:02:21.360 --> 00:02:29.742 I love the cone scanner product because it is something that could really democratize this and make this super easy with, like your phone and everything and and I really like those kind of enabling products.
00:02:29.742 --> 00:02:38.098 And, yeah, we should do an episode about this exoskeleton thing because, um, you know the the same thing that makes robocop can also make people walk again.
00:02:38.098 --> 00:02:44.705 You know, it's very interesting if, if this will actually happen, and and when it will happen, and, uh, and then to what extent?
00:02:44.867 --> 00:02:47.286 yeah, no, no, 100%, and it's super cool.
00:02:47.286 --> 00:02:55.948 He actually had a couple fittings yesterday and to see what the people so what's really neat is they really concentrate on outcomes or outcome measures.
00:02:55.948 --> 00:03:00.151 So what can you do without the brace on and what can you do with it on?
00:03:00.151 --> 00:03:04.479 And it's a night and day difference.
00:03:04.479 --> 00:03:06.664 It's incredible.
00:03:06.664 --> 00:03:08.389 Um yeah, uh.
00:03:08.389 --> 00:03:10.442 Well, I'd love to do an episode on that.
00:03:10.442 --> 00:03:13.610 We can definitely get somebody from my mo in there, for sure.
00:03:14.312 --> 00:03:15.521 Cool man, we should, okay.
00:03:15.521 --> 00:03:16.945 So, um, do we have a sponsor?
00:03:16.945 --> 00:03:21.746 I think we have a sponsor from this, this kind of like 3d printing design service kind of thing.
00:03:22.367 --> 00:03:25.276 Yeah, advanced 3d yeah, have you ever heard of yours?
00:03:25.497 --> 00:03:36.950 it's crazy I have not, I'm not familiar, I think with so, uh, yeah, so advanced 3d is a is a contract manufacturer, but we also try to meet you wherever you are on your journey.
00:03:36.950 --> 00:03:49.383 Uh, whether you're just learning to scan, you're wanting to 3d print or you move to definitive sockets to do that, and then we also, if you have a product that you want to bring to market, we can also help you with that.
00:03:49.383 --> 00:03:52.659 And so we're in North Carolina.
00:03:52.659 --> 00:04:01.573 You get to work with myself, tyler and Paul, and then we met Katie on the couple episodes ago.
00:04:01.573 --> 00:04:07.743 She's amazing and try to help you wherever you are on your digital journey that's super cool, man.
00:04:07.824 --> 00:04:09.729 And and you guys, what do you guys print in?
00:04:09.729 --> 00:04:14.356 Actually, because you've got well, hp, obviously, but what kind of materials can I order parts from from you guys?
00:04:14.538 --> 00:04:18.004 yeah, so, um, we do the multi-jet fusion.
00:04:18.004 --> 00:04:28.375 Uh, color five, so the 580, we can do pa 11, 12, tpu, and then we've recently brought on PK 5000 from Jabil.
00:04:28.819 --> 00:04:31.848 Really, you can talk to people about this, because I'm super excited about that.
00:04:31.848 --> 00:04:39.103 We should do a PK 5000 thing, because that is really exciting that you managed to get that to work, and then you're going to use this for prosthetics.
00:04:41.819 --> 00:04:50.233 It really is an amazing material and, believe it or not, we're going to have the guy that invented it on our podcast very soon, so that should be very fun.
00:04:50.913 --> 00:04:51.454 Super cool.
00:04:51.454 --> 00:04:52.985 All right, then we'll leave a lot more on that.
00:04:52.985 --> 00:04:55.749 Okay, so who do we have on the show today?
00:04:55.819 --> 00:05:00.600 Well, I'm super excited to have Luke Bruna on today.
00:05:00.600 --> 00:05:18.382 He is the head of the digital division at the Equal Group and he's also the CEO of Quadra, and so Luke and I have known each other for a while and I'm really looking forward to just hearing his journey.
00:05:18.382 --> 00:05:29.490 You know where he's found himself now, as part of, essentially, the conglomerate of equal, but he was his company that had been around for a while.
00:05:29.490 --> 00:05:37.456 Rodin was acquired a couple of years ago, and so it's been a.
00:05:37.456 --> 00:05:41.249 I just am really looking forward to that.
00:05:41.249 --> 00:05:55.048 And he's been doing some amazing stuff, not only in the prosthetic and orthotic space, but also in this idea of clinician personal responsibility, design, automation, and so there's just a lot to unpack in this episode.
00:05:55.350 --> 00:05:55.790 Awesome dude.
00:05:55.790 --> 00:05:57.663 Welcome Luke to the show.
00:05:58.706 --> 00:06:04.963 Thank you, thank you, brent, thank you, joris, for inviting me to share my journey in the O&P.
00:06:05.764 --> 00:06:07.250 So how did you get started with the O&P?
00:06:08.279 --> 00:06:10.869 Well, are you sure that you want to go in this?
00:06:12.761 --> 00:06:14.947 You're not even probably going to be the furthest back.
00:06:14.947 --> 00:06:15.971 We're going to go lately.
00:06:15.971 --> 00:06:22.687 So we've been getting back to the 40s and 50s, so don't worry, don't worry, yes, we do the very beginning.
00:06:22.767 --> 00:06:43.168 I started at the very beginning my journey in 1983 ah, a kid, just a child, I was yes, yes, I was just 15 years old and uh, my mother said me that uh omp company just nearby us was looking for an apprentice.
00:06:43.168 --> 00:06:51.132 Then you know, at 15, it was two words that I don't know ONP, no idea, what is it, and apprentice.
00:06:51.132 --> 00:06:53.447 Then I say yes, why not?
00:06:53.447 --> 00:07:06.350 And then I started my apprentice in a very small ONP company located in Bordeaux in France, who was specialized in only orthotics.
00:07:06.350 --> 00:07:09.187 I don't learn at the beginning the prosthetics.
00:07:09.829 --> 00:07:15.528 Okay, and one thing that's really interesting, because I know that France, to a certain extent also Germany, they have these apprenticeship programs.
00:07:15.528 --> 00:07:16.985 In America, they don't really have this.
00:07:16.985 --> 00:07:20.850 Yes, and so do you think it's a really good thing because you started as an apprentice?
00:07:20.850 --> 00:07:27.680 Do you think that's something that France, for example, example, should totally continue doing, because it really teaches people a craft and and a very hands-on way of learning things?
00:07:28.101 --> 00:07:33.411 at this time it was quite only the, the only way to um, to, to, to learn the NP field.
00:07:33.411 --> 00:07:35.223 Now it's completely different.
00:07:35.223 --> 00:08:00.512 Uh, it's a different study, but at this time you need to work seven years in a workshop, only starting to see patient under the responsibility of the other cpos, and after seven years I was able to be certified by the ministry of the veterans equivalent of the euro veterans in in us, who was taking care mainly about the, the, the onp device.
00:08:00.512 --> 00:08:04.245 At this time it was quite the only way.
00:08:04.245 --> 00:08:18.564 I think the first school was created in 1982, quite in the same time to learn how to be a CPU in France in a different way than to the apprentice.
00:08:18.564 --> 00:08:29.033 Now it's different and it's impossible to start at 15 years to learn this type of works.
00:08:30.641 --> 00:08:33.791 And when you got started making orthotics, what would you do?
00:08:33.791 --> 00:08:36.614 Was it a lot of leather wood, carbon fiber?
00:08:36.614 --> 00:08:37.639 What were the materials you worked with?
00:08:38.140 --> 00:08:54.192 I entered in the workshop for the first time and I discovered a forge and a machining lathe, because in this company at this time, we build everything from scratch, from aluminum, iron, leather, everything.
00:08:54.192 --> 00:08:58.589 We have a machining lathe, as I said, to also produce the screw.
00:08:58.589 --> 00:09:06.570 Everything that is probably at the beginning shaped my sense of independence.
00:09:06.570 --> 00:09:16.794 I learned to use all this old machining and how to be independent and produce everything.
00:09:16.794 --> 00:09:23.113 Yes, something that has followed me throughout my career all along the way.
00:09:23.133 --> 00:09:25.647 Yes, and what has changed?
00:09:25.647 --> 00:09:29.668 If you look at the materials, what are like the big things that you think are really like?
00:09:29.668 --> 00:09:35.090 You know that when you started with the lane and stuff like that, you know what has really gotten people.
00:09:35.289 --> 00:09:49.530 Uh, you know a lot, a lot further than they used to be as I said you in 1983, it was just the beginning of the arrival of the polyethylene, who was a game changer for the body jacket, for example.
00:09:49.530 --> 00:09:58.852 At this time we produced a lot of body jackets in plexiglass, you know, and the arrival of the polyethylene was a kind of revolution.
00:09:59.820 --> 00:10:03.650 Okay, and then how long did it take for you then to get more into prosthetics and stuff like that?
00:10:03.650 --> 00:10:06.690 Was it a long time, or did you focus really on orthotics for a really long time?
00:10:07.461 --> 00:10:11.812 No, I mainly focused only on orthotics all along my career.
00:10:11.812 --> 00:10:17.580 As I said, after seven years of apprentice I was certified.
00:10:17.580 --> 00:10:19.754 It was 1990.
00:10:19.754 --> 00:10:32.869 And I worked at this time mainly on idiopathic scoliosis patients and cerebral palsy scoliosis, yes, mainly during 10 years.
00:10:33.871 --> 00:10:37.269 Okay, and we know that some of these braces and things have been 3D printed.
00:10:37.269 --> 00:10:42.331 Did you end up using 3D printing back then as well, or soon for this application, or not really?
00:10:46.519 --> 00:10:47.341 soon for this application, or not really.
00:10:47.341 --> 00:11:01.816 Well, my first experience with 3d printing was during the in 2006, probably where we tried to produce our first ak bk sorry um sockets in fdm okay, okay, and.
00:11:01.916 --> 00:11:04.422 And did you think, oh, my god, this is the future, this is going to be everything?
00:11:04.422 --> 00:11:06.548 Or was it like, oh no, this is never going to work?
00:11:09.234 --> 00:11:09.916 probably both.
00:11:09.916 --> 00:11:14.889 If you have a good imagination, you can think that it's, uh, it can be a revolution one day.
00:11:14.889 --> 00:11:20.062 Uh, at this time, it's the, the, the materials that we use.
00:11:20.062 --> 00:11:23.889 It was probably abs, I don't remember so well, but yes, it was abs.
00:11:23.889 --> 00:11:36.293 Then with a very long process to um, to to produce it, but, yes, for sure that we, we, at this time, imagine that, uh, it will.
00:11:36.293 --> 00:11:40.793 It will be a big game changer in in the profession and how is it?
00:11:41.014 --> 00:11:42.679 is it taking a lot longer than you expected?
00:11:42.679 --> 00:11:48.327 Did you expect everyone to have 3D printers already, or you know how do you think it's going?
00:11:48.849 --> 00:11:49.529 For me, for us.
00:11:49.529 --> 00:12:06.629 I don't want to minimize the 3D printing, but I want to say it's only a tool and today there is no one answer to all the only I mean one printer, one answer to all the needs of the CPUs, as they have a workshop with many machineries.
00:12:06.629 --> 00:12:31.366 Probably in a few years they will have different 3D printers, you know, to produce different aspects to the temporary sockets, to the definitive sockets, with carbon fiber inside, or for body jacket with polypropylene, or also with the HP technology body jacket with polypropylene, also with HP technology, with the TPU, with very, very good material for the ONP.
00:12:31.366 --> 00:12:35.751 The answer today is diversity, from my point of view.
00:12:36.032 --> 00:12:37.013 Okay, I like that approach.
00:12:37.013 --> 00:12:38.073 You're seeing it as a machine.
00:12:38.073 --> 00:12:39.115 It's not a revolution.
00:12:39.115 --> 00:12:40.376 It's just another tool we use.
00:12:40.376 --> 00:12:44.933 It's like a mouse or a lathe or whatever.
00:12:44.933 --> 00:12:48.481 I think that's a very kind of hype-free way of looking at the technology.
00:12:48.481 --> 00:12:52.523 And how about for insoles, specifically and stuff like that?
00:12:52.523 --> 00:13:03.326 We've seen a lot of uptake in insole production with primarily TP or polypropylene with desktop printers or relatively inexpensive.
00:13:03.326 --> 00:13:04.591 Do you think that's going to get much bigger?
00:13:13.863 --> 00:13:15.668 We have 3d printers who print a foaming tpu and the.
00:13:15.668 --> 00:13:19.340 The market is a probably a little bit different here in europe than in us, uh, where we have a lot.
00:13:19.340 --> 00:13:42.524 We produce a lot of soft insoles, I mean with cat cam, uh CAM, by carving like a TP form or something like this, and now with 3D printing with TPU, with FDM, that it's already something that we have on market since some years.
00:13:43.888 --> 00:13:45.412 So I want to hear a little bit about.
00:13:45.412 --> 00:14:02.279 So I find it interesting, I didn't realize how involved you were on the scoliosis side of things, and I want to hear about how that also helped you to create the rodent you know back in 2003,.
00:14:02.279 --> 00:14:04.366 Like, what was the journey to be?
00:14:04.366 --> 00:14:04.587 Like?
00:14:04.708 --> 00:14:19.850 Hey, I need a digital tool so I don't have to, uh, have mess with these massive plaster models yeah, I need to come back in 1980 when I was I bought, I was 12 and I bought my first personal computer.
00:14:19.850 --> 00:14:21.232 At this time it was a zx80.
00:14:21.232 --> 00:14:24.692 I don't know if you know that it's from a company, uh, sinclair, in a english company, and at this time it was a ZX80.
00:14:24.692 --> 00:14:33.532 I don't know if you know that it's from a company, sinclair, an English company and at this time you know you receive the computer, you have to weld all the components before to plug it on the family TV and start programming.
00:14:33.532 --> 00:14:40.486 That is my first experience and my first journey in the I want to say IT.
00:14:40.486 --> 00:14:44.894 And all along my career I started to.
00:14:44.894 --> 00:14:57.746 I developed some softwares, mainly for the, for managing the production in the workshops, and one day I was very interested by 3D.
00:14:57.746 --> 00:15:17.087 And then I continued developing some softwares and in 1997, in the group where I'm working in France, we decided to invest in the Swedish system, at this time named K-PodCAD.
00:15:17.087 --> 00:15:18.784 It was bought by Osu.
00:15:18.784 --> 00:15:25.530 After it was a CAD-CAM software working only by scanning.
00:15:25.530 --> 00:15:43.408 And, yes, we started our experiences with this type of tools and we reached rapidly the limit of the tools because we wanted at this time to invest in the system, always to scale up the use of the CAD CAM but also to scale up the central fabrication.
00:15:45.363 --> 00:16:06.234 At this time we was taking a plaster cast, as you know, and sending plaster cast, and there is no sense for that, and we wanted to really have a tool not only to show that we are using CAD CAM, but really a tool to scale up the company at another level.
00:16:06.234 --> 00:16:17.768 Then I developed the first software for only designing body jackets and scoliosis body jackets and at the same time we developed our first carver.
00:16:17.768 --> 00:16:33.091 It's with a partner nearby us in the area or nearby us in the area, and that's the first experience that I had and that we had in the company with the CAD CAM.
00:16:33.091 --> 00:16:46.620 In the same time we need to also develop a complete workshop of how to produce polyurethane blocks to carve in the carver.
00:16:46.620 --> 00:16:49.888 Then we we developed all the tools.
00:16:49.888 --> 00:16:57.673 I developed all the tools the Pro8n blocks, the software and the cover.
00:16:58.799 --> 00:17:20.107 At this time, for sure, the 3D scan was very expensive and then it's why we were concentrated at the beginning on the body jacket and we developed some 3d libraries working by measurement only that we don't need to uh to take a full 3d scan.
00:17:20.107 --> 00:17:26.983 And progressively, when the the price of the scan decreased during the 2000.
00:17:26.983 --> 00:17:29.587 It started in 2008, 2010.
00:17:29.587 --> 00:17:35.056 Then we can scale up more about device.
00:17:35.056 --> 00:17:40.132 We need more accuracy, like A4s, ak, bk.
00:17:40.132 --> 00:17:44.328 But yes, mainly that.
00:17:45.000 --> 00:17:50.528 And I'm interested that you guys have always kind of like you notice, well, okay, you make the whole solution right.
00:17:51.070 --> 00:17:51.250 Yeah.
00:17:51.319 --> 00:17:54.025 Was that because you had to do it, or because you wanted to control it?
00:17:54.025 --> 00:17:58.644 Or you think that was a good product for people to just have the material, the software, the machine, everything together?
00:17:59.346 --> 00:18:09.190 yeah, as I said, you the, the, the, the way to be independent and to um, to, probably because we are our dna and my dna is from the ONP field.
00:18:09.190 --> 00:18:16.167 I never feel comfortable with, I mean standards tool from the industry.
00:18:16.167 --> 00:18:43.548 And then we decided to develop it for our internal use and, as we were a company a little bit well-known ONP company, a little bit well-known in France, that we have many visitors at this time and each time they saw our tools to produce, they wanted to buy and that's why we decided to put it on the market and to sell the full solution.
00:18:45.464 --> 00:18:46.808 And was it difficult for you to get into.
00:18:46.808 --> 00:18:53.123 So you're trained to do all this podiatry stuff and all of a sudden it's software, it's machine, it g code.
00:18:53.123 --> 00:18:54.246 How did you do that?
00:18:54.246 --> 00:18:56.269 You just learn everything yourself, or did you?
00:18:56.269 --> 00:18:58.500 Yeah, how did you kind of do that?
00:18:59.001 --> 00:19:13.718 at the beginning I want to say yes, but now, now we hopefully I don't, I still don't develop and we have a lot of engineers and, uh, very clever people who are ended up better than me at this time.
00:19:13.718 --> 00:19:24.545 But yes, yes, it was a way to learn all these type of things to, to connect all these tools to make a full solution for the, the np market.
00:19:24.545 --> 00:19:25.528 Yes, so.
00:19:25.728 --> 00:19:35.364 so one thing that I find fascinating luke about this journey, what it sounds like, is they you created the tools essentially for yourself because you needed it.
00:19:35.364 --> 00:19:40.123 And then you have these guests that come in and they look around and they say, where can I buy that?
00:19:40.123 --> 00:19:45.642 And you're like, well, uh, where I think I need to start a business and to be able to sell it.
00:19:45.642 --> 00:20:05.608 So I think that's fascinating to me because I think that there's there's so many people that look at the O and P market and they're like, hey, we can build tools for them, but they don't actually have an understanding of the pain that we go through as clinicians, or even the evolution of how we've gotten to where we are.
00:20:05.608 --> 00:20:33.508 Secret sauce, I guess, if you would say, is you have all this experience from not only making your own aluminum and iron stuff now to programming and all that, but you have this vast experience of being very focused on solutions from real problems that you have.
00:20:34.329 --> 00:20:34.730 That's true.
00:20:34.730 --> 00:20:40.180 That's what drives me at the beginning, but still driving the company.
00:20:40.180 --> 00:20:44.050 We are lucky to have this digital division.
00:20:44.050 --> 00:21:16.371 Now we're connected to this big group of equal with more than 250 clinics worldwide, and we are still connected to the patients, and all the engineers who are working now with us have the ability to see the patients, to understand the needs of the clinicians, and that's still driving the opportunity to support the CPOs worldwide.
00:21:17.133 --> 00:21:33.537 Yeah, well, before we get into that side of things, I just wonder, like, how do you decide as a person, especially on the software side, what solutions you need or what problems you need a solution to right?
00:21:33.537 --> 00:21:35.748 So how do you filter that?
00:21:35.748 --> 00:21:56.011 So definitely at Rodin, when you had your client base, essentially, or your customer base, and now, with a bigger customer base, with maybe some people that are experienced, some people that aren't experienced, how do you filter those things of, hey, these are features that we want, which one?
00:21:56.011 --> 00:21:56.653 How do you choose?
00:21:57.073 --> 00:21:58.134 A good question, thank you.
00:21:58.134 --> 00:22:08.462 Probably at the beginning it was more easier because the choice of diversity, of the Sorry, I want to mean.
00:22:08.462 --> 00:22:14.907 Now there is more diversity of technology and the choice is more difficult to choose the good direction.
00:22:14.907 --> 00:22:23.381 At this time the problem was clear and there is not so many solutions, but, as you said, rapidly.
00:22:23.381 --> 00:22:32.644 We build a community of users internally, but also we build progressively.
00:22:32.644 --> 00:22:59.634 We have many customers worldwide and when we gather them we work on that and we analyze the needs and then the best idea wins each time and we were very reactive and developed fast the new tools to give access to and answer the needs of our customers.
00:23:00.394 --> 00:23:07.518 Let's talk a little bit about Carvers, because you guys make a number of Carvers, right.
00:23:07.518 --> 00:23:10.098 So what's the latest and greatest in the world of Carvers?
00:23:10.098 --> 00:23:15.525 Are these things getting cheaper, more convenient, faster?
00:23:15.525 --> 00:23:16.580 What's happening in this carver development?
00:23:16.925 --> 00:23:22.561 Yeah, we started with a 3D axis carver and it's not really 3D.
00:23:22.561 --> 00:23:28.863 It was not really 3D axis carver, it was 2.5 axis because we obtained the 3D by the rotation of the mold.
00:23:28.863 --> 00:23:35.326 Then it allowed us to make all the positive shapes that we need.
00:23:35.326 --> 00:23:41.609 It was a little bit different when we wanted to carve.
00:23:41.609 --> 00:24:33.651 As you know, in Europe we are making a lot of custom-made seats with negative shapes that we need really to have five axes of freedom to do that and it's why we developed a branch who integrated the robot solutions but for, I think I mean for the, the daily things akbk, body jackets, uh, helmets and so on, made by carving Two and a half carvers was well enough at this time Again in 1997, it doesn't exist really and we needed to develop everything and still we have more than something like 160 machines worldwide working and still working on that.
00:24:34.560 --> 00:24:49.053 Of course, with the arrival of the 7-axis robot, it was also a game changer in terms of time To carve now a body jacket in 12 minutes.
00:24:49.053 --> 00:24:54.969 It was not possible at this time with a carver but it's possible now with the robots.
00:24:55.740 --> 00:24:57.267 And these kind of robot-driven machines.
00:24:57.267 --> 00:25:02.308 Right, is it going to be much more expensive to buy one of those or is it just a no-brainer because of the speed?
00:25:02.308 --> 00:25:03.884 Is it just going to?
00:25:03.884 --> 00:25:08.631 Maybe the investment's a little bit more, but then the speed is going to win it back for everyone really quickly.
00:25:12.194 --> 00:25:12.758 It's still we have a.
00:25:12.758 --> 00:25:16.410 It's why, sorry, we still have an offer with Carver's.
00:25:16.410 --> 00:25:25.645 But in terms of productivity, yes, it's more expensive, but in terms of productivity, it's more interesting to have this type of robot.
00:25:25.645 --> 00:25:35.240 Of course, you need to reach a certain level of production to be able to make the amortization of this type of investment okay, and what are you seeing?
00:25:35.260 --> 00:25:37.586 of course, you guys have got more a global perspective here.
00:25:37.586 --> 00:25:41.006 The podcast we end up talking a lot more about the us often.
00:25:41.006 --> 00:25:42.431 Yes, uh, you know.
00:25:42.431 --> 00:25:46.804 Are you seeing a shift towards kind of more central fabrication, c-fab type of stuff?
00:25:46.804 --> 00:25:51.080 Are you seeing mom and pop shops do a lot more fabrication in house?
00:25:51.080 --> 00:25:54.451 What are some of the trends you're spotting on the machinery side of things outside?
00:25:55.141 --> 00:26:13.128 What we always wish is to give the tools for the CPOs can be as much as they can be independent I mean control their own orthopedic correction, control their own way to produce.
00:26:13.128 --> 00:26:32.492 But in the same time we see that concentration on market and concentration on market may create a big CFAB and the need of big tools of production like robots.
00:26:33.013 --> 00:26:39.568 Okay, and do you think this kind of centralization is going to continue across the world?
00:26:39.568 --> 00:26:54.819 Do you think there's going to be more bigger companies, or do you hope that the smaller shops are going to be really empowered by all these machines and they could maybe in the future, automate more and do more with automation and maybe have to spend more time with patients?
00:26:56.825 --> 00:27:08.334 It's what I wish to keep this diversity on the market, because diversity makes the offer for the patient at the end a variety of treatments.
00:27:08.334 --> 00:27:17.051 And that's what is important for me, for us, for the patient to have access to a variety of treatments.
00:27:17.051 --> 00:27:22.711 But, as we see today, there is a big concentration on the market.
00:27:24.667 --> 00:27:25.413 And how about software?
00:27:25.413 --> 00:27:30.112 I mean, you used to have a complete CAD-CAM package.
00:27:30.112 --> 00:27:33.327 Now you've got more automated of automated workflows.
00:27:33.327 --> 00:27:34.540 Where do you see this going?
00:27:34.540 --> 00:27:40.224 Do you see people wanting like really, you know, really powerful cad tools, or do you want, or do you think that people just want to?
00:27:40.224 --> 00:27:44.803 You know, press a button and then out pops uh, you know the device I.
00:27:44.942 --> 00:27:45.844 I see both needs.
00:27:45.844 --> 00:27:50.869 Uh, still a big central fabrication need I?
00:27:50.869 --> 00:28:00.367 I want I mean horizontal offer, that's a software we're able to correct a fo but also an insult, but also body jackets.
00:28:00.367 --> 00:28:12.631 But in the same time we see also some very specialized clinics, very vertical, who make only helmets, who make only 3D printing body jackets.
00:28:12.631 --> 00:28:26.568 Then the answer is not always the same and it's why we have kind of different offers for different approach depending on the needs of the clinic.
00:28:28.152 --> 00:28:31.249 Okay, and I understand that you're.
00:28:31.249 --> 00:28:36.710 One thing I really saw was really interesting is that you make a mobile unit as well, carver as well.
00:28:36.710 --> 00:28:38.242 And do you see?
00:28:38.242 --> 00:28:54.989 You know most of the orthotics and prosthetics market seems to be very focused on the rich kind of the OECD country people right, the billion richest people on the planet and we know there's like a much bigger market out there in also developing countries and also really poor countries and they have different needs.
00:28:54.989 --> 00:28:56.805 Do you think that that's?
00:28:56.805 --> 00:28:58.931 Are you guys making tools for those people as well?
00:28:58.931 --> 00:28:59.983 Do you think that is going to be?
00:28:59.983 --> 00:29:02.525 Because it seems like that could be where all the growth is right.
00:29:02.525 --> 00:29:07.707 If these guys get richer, they'll be able to afford more sophisticated devices and they'll power a whole new wave.
00:29:07.707 --> 00:29:09.344 Is that something on your radar as well?
00:29:10.165 --> 00:29:14.557 Yeah, yeah, is that something on your radar as well?
00:29:14.557 --> 00:29:32.023 Yeah, yeah, we are working with a lot of NGOs worldwide and then, when we analyze the needs, there are a lot of mainly different than what are the CPOs in the I want to say rich countries?
00:29:32.023 --> 00:29:33.509 Then the approach is a little bit different.
00:29:33.509 --> 00:29:35.237 What are the, the, the, the CPOs in the I want to say rich countries?
00:29:35.237 --> 00:29:45.288 Uh, then, uh, the approach is, uh is a little bit different and, um, we want to, uh, to have an answer to that also and we want to keep that on our radar.
00:29:46.604 --> 00:29:58.605 Um, because, uh, the, we, we, we have to serve all the the, the patient, uh, all the patients worldwide.
