shaping the future of health care, and i'm very glad we're now joined by one of the authors, john roundtreertner at nova -- sectal we're seeing so much disruption whether it's in the automotive or financial services, but also in health care how is that being documented how is that -- how does it manifest itself? >> the interesting thing about these 100 companies is that they're all dealing with that in very different ways. in the u.s. you find that companies are looking to these disruptions for massive growth and companies investing. a lot of it a lot of capital going behind it in terms of deals and m&a. in europe and the says rest of the world people are playing a slightly different game. they're trying to hook to that with the capital markets, but they've also got this, if you like, burden of legacy from their old products and their old businesses and their old sales forces that they've got to deal with as they actually wrestle with the same innovation challenges as their u.s. counterparts >> so there are essentially a couple of ways to pursue this growth through m&a or organic growth bot