Interview With CTO Dave Saunders

For the next interview in our series speaking to technical leaders from around the world, we’ve welcomed Dave Saunders, the CTO of Galen Robotics. Since 1991, Dave Saunders has taken over 40 Internet-based products from conception to market. Through his leadership of diverse product development programs, including computer-vision-guided surgical tools, desktop Internet software, cloud computing, medical devices, telco switching, and virtual machine clustering, he has driven innovation in a wide range of fields.

Tell us a bit more about the business you represent.

We've developed a new surgical robotic platform in conjunction with research coming out of Johns Hopkins University. We intend for it to fill a series of niches that are currently unmet in the surgical robotics field. This technology also lends itself as a development platform for future software and hardware accessories which we are developing internally and through collaborative research with multiple universities.

Being the CTO, what do your day-to-day responsibilities look like?

I look across all departments at the different pieces and technologies that come together to create a product for our customers. In parallel to that, I'm also looking forward to other technologies and advancements to see how our current technology platform can intersect with those to meet the clinical needs of our surgeons and their patients in the future.

With my background in Internet technology, I also look at a robot as a computing platform which has the ability to monitor or learn from a surgeon as they work it has the potential to bring information from other sensors and medical devices in the OR right to the fingertips of the surgeon where they need that information without distractions.

What frameworks do you use for managing technical debt?

Working with technology that was originally developed at a university leads you to almost immediate situations for managing technical debt. Much of the original code is often written to get a grade or provide a demonstration, and then it is very rarely maintained. As it is, that code is not useful for many finished products, it is unacceptable for using a medical device.

Upfront we had to work very rapidly to rearchitect our code base while at the same time continuing to push forward on new features and completing the requirements for our first release. In other industries, you might be able to kick the can down the road a little bit, but in my years of experience, I have found that the longer you wait to clean up code, the more expensive it will be to maintain it and eventually replace it. So it is a debt that we always seek to minimize in spite of product delivery pressures.

How do you decide whether something is so painful that it merits a full rewrite?

We take a holistic view of any discrete chunk of code and decide why it was written in the first place. With early code, you often find examples that were hacked instead of engineered. This code was written to demonstrate viability but was clearly never written for the long haul. Red flags include hard-coded constants, embedded strings, and no discernible modularity. 30 years ago, you might write code like that because you had limited resources and needed to be brutally efficient, but today those things are indications of sloppy and shortsighted work.

How does your technical organization work with the other operational components of the company?

I have a group in the company as part of its mission to work with everyone else. We do our very best to avoid silos. Everyone in the company is welcome to attend our regular engineering status meetings because we want everyone to know what's going on.

A product is far more than a piece of hardware or lines of code, and everyone in the company is in part responsible for how we, and our products, look to our customers as an experience of us. Who we are as a company is on display every time a customer uses our products, and that means everyone in the company needs to be aware of the part they play.

What do you see as the hottest trends within your industry today?

I think there's a lot of potential for machine learning and augmented reality when combined with human users. What I mean is, I like technology solutions that augment human beings instead of replacing them. Machine learning can be used to observe, adapt, and learn about the environment in real-time, while augmented reality can be used to bring that information to the user to help them make better decisions.

In Medtech I see this having a lot of value because there is an explosion of wearable devices, and embedded software technologies in the hospital and operating rooms. In order for a customer to make effective use of the technology, there needs to be a way of bridging the gap and collecting all of the information together and presenting it when it's needed, in a manner that is useful for the customer to take action.

Do your technical teams or do you use log analysis as part of your role? If you do, how do you find this helps day-to-day operations?

We do some log analysis today and that will expand over time as our products have a wider reach in the field. Today, it's most important for us to get target users using our prototypes and get their real-time feedback and watch them at the same time. We record demos, usability studies, cadaver studies, and basically any interaction with the system. We don't want to filter any of that input through somebody's memory or a bunch of checkboxes on a form.

We want to see how they experience what we are building so we know what to improve and what to leave alone. A lot of what we do has never been experienced by any of our potential customers before. There is no surgical robot providing solutions for the kinds of clinical applications we're targeting, so it’s important to see how they work with our technology to do what they've already been trained to do and make sure our technology is helping them improve things and not a hindrance.

What can we hope to see from your business in the future?

As I mentioned earlier our approach to surgical robotics is as an enhancement to surgeons. We're not in the business of making technology to replace a doctor, but to allow them to free up some of that cognitive load on the ergonomic mechanics of difficult and intricate minimally invasive and microsurgical procedures, and shift the focus to the most important thing in the OR, the patient. We are looking towards future technologies that will act as accessories for our core platform which will further enhance those surgeons' skills around specific procedures, but in a manner that is more economical than any robotic solution on the market today.

If you enjoyed this article then why not check out our previous guide to logs management tools or our Interview with Vaibhav Sinha, CTO of BlocPal next?