Open Prosthetic Fulfillment Initiative
Innovation is usually profit-motivated. Altruism often comes in money or labor. We seek to decouple the first, and amplify the effects of the second. Our organization is based on the principle of shared design. We believe that sharing designs lowers entry barriers by providing a platform for low-cost experimentation, allows collaboration across boundaries, accelerates technical evolution, increases societal wealth, and coordinates efforts to benefit underserved communities.
Good ideas, free or not, can't help anyone unless they are implemented. Unfortunately, the cost of implementation for many products, particularly niche market medical devices, can be prohibitively high. As result, many useful and needed innovations are left unused by or unavailable to the community they intend to serve. Our Open Fulfillment initiative, which we hope to realize through Changemakers, is an effort to reduce barriers to the implementation of good ideas, specifically cost. We will develop this innovation in order to pursue a modest specific goal: bring a sought-after prosthetic device back to market. However, the innovation is applicable to many other areas, and we intend to share this idea as well.
Through sharing the details of Open Fulfillment, we will enable many others to get products to market to help the consumers who need them, despite the lack of commercial incentive to do so.
About You
Location
Project Street Address
Project City
Project Province/State
Project Postal/Zip Code
Project Country
Your idea
Focus of activity
Product/procedure
Year the initiative began (yyyy)
2007
Positioning of your initiative on the mosaic diagram
Which of these barriers is the primary focus of your work?
Patients not empowered
Which of the principles is the primary focus of your work?
Center consumers in business model
If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic:
Underserved patient community
There are fewer than 100,000 people missing arms in the US. This is too few to spur innovation, despite the high cost of prosthetic appliances. People without arms are “orphaned” like users of “orphan drugs.” Many prosthetic developments have languished in the patent and academic literature, while the most used commercially available devices represent marginal improvements to devices first developed in the early 1900s. Because of the quality of these solutions, half of potential users of these devices chose to use nothing at all. Underserved populations include those with a variety of physical disabilities and diseases, each with unique needs and market limitations. These populations stand to significantly benefit from a model for servicing their needs.
Open Design
Circumvent business obstacles by reducing the cost of intellectual property through open design. This lowers barriers to participation and multiplies the impact of contributions of any significance. Openness focuses incremental efforts motivated by non-financial goals, and connects with users. As with linux, developers who are user-innovators “scratching their own itch” can plant seeds that grow solutions greater than those pursued in isolation, assembling a critical mass of effort where it is needed.
Another obstacle is presented by the open solution: once proposed, how can these products be provided to the patients? Open design spreads the cost of research and developments across user-innovators, volunteers, and government-funded projects. By democratizing access, the “activation energy” required to bring a product to market is now the marginal cost of manufacture. By removing the fixed costs of R&D, products can be made that would never have been. Rapid manufacturing can further reduce the cost of small numbers of products.
Name Your Project
Open Prosthetic Fulfillment Initiative
Describe Your Idea
Innovation is usually profit-motivated. Altruism often comes in money or labor. We seek to decouple the first, and amplify the effects of the second. Our organization is based on the principle of shared design. We believe that sharing designs lowers entry barriers by providing a platform for low-cost experimentation, allows collaboration across boundaries, accelerates technical evolution, increases societal wealth, and coordinates efforts to benefit underserved communities.
Good ideas, free or not, can't help anyone unless they are implemented. Unfortunately, the cost of implementation for many products, particularly niche market medical devices, can be prohibitively high. As result, many useful and needed innovations are left unused by or unavailable to the community they intend to serve. Our Open Fulfillment initiative, which we hope to realize through Changemakers, is an effort to reduce barriers to the implementation of good ideas, specifically cost. We will develop this innovation in order to pursue a modest specific goal: bring a sought-after prosthetic device back to market. However, the innovation is applicable to many other areas, and we intend to share this idea as well.
Through sharing the details of Open Fulfillment, we will enable many others to get products to market to help the consumers who need them, despite the lack of commercial incentive to do so.
Innovation
Define the innovation
Innovation is usually profit-motivated. Altruism often comes in money or labor. We seek to decouple the first, and amplify the effects of the second. Our organization is based on the principle of shared design. We believe that sharing designs lowers entry barriers by providing a platform for low-cost experimentation, allows collaboration across boundaries, accelerates technical evolution, increases societal wealth, and coordinates efforts to benefit underserved communities.
Good ideas, free or not, can't help anyone unless they are implemented. Unfortunately, the cost of implementation for many products, particularly niche market medical devices, can be prohibitively high. As result, many useful and needed innovations are left unused by or unavailable to the community they intend to serve. Our Open Fulfillment initiative, which we hope to realize through Changemakers, is an effort to reduce barriers to the implementation of good ideas, specifically cost. We will develop this innovation in order to pursue a modest specific goal: bring a sought-after prosthetic device back to market. However, the innovation is applicable to many other areas, and we intend to share this idea as well.
Through sharing the details of Open Fulfillment, we will enable many others to get products to market to help the consumers who need them, despite the lack of commercial incentive to do so.
Context for Disruption:
Open Fulfillment
The Open Prosthetics Project is devoted to increasing the diversity and capability of prosthetic components. We will return a discontinued device called the Trautman Hook to production, proving the principle, and allowing its extension to any health care product in an underserved market.
We have reverse-engineered this device, and have a manufacturing route for the device that appears sustainable. Through an Open Fulfillment model, we will create infrastructure supporting shipment of the product direct from the manufacturer. While this is routinely done for profit, we will assemble products in this way to ensure their availability.
The Open Design model will reduce fixed costs and multiply the impact of R&D by volunteers or government agencies. The Open Fulfillment model will deliver it to the consumer, using a published supply chain. With existing tools, a product will be assembled and delivered to the consumer (the prosthetist) with each input paid and no overhead. Regulatory approval can be a shared asset like the design itself. Warranty and support could be another paid input.
Again, we are undertaking this project to carry our first design through to delivery, and intend for the impact to extend beyond the delivery of the test product, the hook. Many initiatives face similar obstacles, and could benefit from the solution. As an example, Engineering World Health's Bililight (http://www.newsobserver.com/150/story/566739.html), a low-cost appropriate technology design for a jaundice phototherapy light to which we contributed, has potential customers (NGOs), and an implementable design, but needs a pathway through manufacture of the device. It in this larger context that Open Fulfillment can join Open Design to deliver real solutions to those in need.
Delivery Model
We communicate using the Open Prosthetics Project website. Through the site, we have reached a broad audience of others who share our vision. As a measure of our success in this area, we are, the second-ranked site on a Google search for the word "prosthetics." We have had over 31,000 visitors, and have received over 500 emails expressing interest in the project. Acknowledging the variety and imperfection of factors that influence these results, it suggests success in identifying interests that affect the community of prosthetic users. While we have to date succeeded mainly in documenting early efforts at problem identification and design, we have been striving to complete the fulfillment process for a single device, the Trautman Hook. So far, we have succeeded in using the website to identify a need (an out-of-production device), come up with a prototype of the solution (a reverse-engineered product), and delivered second-generation prototypes of four devices to users.
Key Operational Partnerships
TRS, a prosthetic manufacturer, has provided feedback from a current industry player on the design of prototypes and on providing the devices to consumers. Whirlwind Wheelchair has published open wheelchair designs for the developing world for over 30 years. providing inspiration for the efficacy of the open design model. Alibre, a software company, shares our desire to democratize access to design tools, and has provided us software licenses to aid our efforts. Wyrick-Robbins has provided us pro-bono legal services, and has helped us navigate some uncharted legal territory in our efforts to create an open design community. We have worked with Anvil Prototype, Biomodal, and Rapid Tool to create prototypes of our designs, and we are looking to these firms and others to participate in manufacturing the devices. WebslingerZ and Axtion, web publishing companies, have helped with web development and identity design. We hope to expand on all of these relationships as we proceed.
Impact
Financial Model
Our project depends on volunteers. Through the website, our ranks have grown. Volunteers and user-innovators will continue to be an integral part of our project. As the project grows, we will seek funding from foundations and government agencies to further specific initiatives, for realizing designs created by volunteers, and to cover administrative costs.
We do not seek to be in the prosthetic business, but seek to ensure the availability of good solutions. While it might be possible to use revenue from the sale of devices to fund further research, we acknowledge the fact that the requirement for such revenue is one of the very obstacles we hope to overcome. We intend initially to make the products available without royalty or profit, a goal that we will retreat from only if it is otherwise impossible to fund research and development efforts through other means.
What is your annual operating budget?
5000
What are your current sources of revenue? (please list any sources that are foundation grants)
We have funded our first year based on small cash donations from individuals and businesses, along with the donation of thousands of hours of volunteer help.
Effectiveness
At this early stage of the project, we have succeeded in creating a usable design of a single prosthetic device, one out of production for many years. We have funded the manufacture and testing of four of these devices, donated to patients who were long time users of the old device, and are moving forward to sustainable production of this device.
Which element of the program proved itself most effective?
As we have discussed, the impact of these small successes extends beyond the four patients who have actually received prosthetic devices. The Open Prosthetics Project website led to the identification of the need for the hook, brought to our attention by Ken Heide, a prosthetist, and the development has been published through the site. More volunteers have found us as a result of these efforts.
The beginnings of a virtual marketplace for ideas and a focus for effort to help a group with specific needs has been successful so far, although there is lots of work to do. True success will be measured by success in extending the prototype of this virtual forum and tools like the Open Fulfillment model to other communities.
Number of clients in the last year?
We have delivered four prosthetic devices to patients this year. That said, as an internet library dedicated to raising awareness and distributing information on a very small niche market (between 50,000 and 100,000 potential customers for prosthetic arms in the US), we have had over 31,000 visitors to the site, from clients of a different sort.
What is the potential demand?
While the demand for Trautman Hooks may be small, on the order of a few hundred a year, this is indeed why we are taking on the project: to ensure the delivery of devices to fill this small need. Further, niche markets like that for Trautman Hooks are part of the "long tail" (http://en.wikipedia.org/wiki/The_Long_Tail) that models such as ours seek to serve. While individually such markets are minuscule, collectively they are much larger, and their size does not diminish their need.
Scaling up Strategy
Our priorities over the next year include the initiative that is the subject of this application. Our longer term plan is to ensure that the tools provided on the website are effective for encouraging design collaboration and at sharing the results. We also want to make sure that it is easy to implement these tools for similar initiatives.
Within three years, we would like to have infrastructure in place to allow individuals with a design goal to find each other, begin a collaboration, and effectively share the results, simply by using the online tools available. Developing this infrastructure and making sure that it works is our number one priority. Beginning to demonstrate this with a manageable project is the first step.
Stage of the initiative:
0
Expansion plan:
The Open Prosthetics Project has a number of open initiatives. In order to succeed, we would like to demonstrate the possibilities by completing a single manageable project through manufacture and delivery to the consumer. The Open Fulfillment Initiative completes the missing piece of this puzzle. Throughout the process, we will continue to develop the online tools that will allow the project to grow. When these tools reach an appropriate level of finish, they can be used to expand the number and variety of projects supported. Given the freedom to do so, we hope our users show us the possibility of much we never dreamed possible.
Origin of the Initiative
In 2005, Jon Kuniholm lost part of his right arm in Iraq. He learned about prosthetic technology both as a user and a designer. Innovation in prosthetic arms had stagnated because of market size and traditional manufacturing.
After starting the project, we were contacted by prosthetist Ken Heide, who told us of his efforts to get the Trautman Hook back into production following his purchase of the company's assets. Frustrated, he agreed to release the results to the public domain in exchange for volunteer design work.
Later, we heard about some of the users who inspired Ken's quest, including a retired welder who repaired his own hook for 15 years until there was nothing left to repair. This patient was among the four. Hear more here: http://marketplace.publicradio.org/shows/2007/05/03/AM200705032.html
http://thestory.org/archive/the_story_59_Fish_Biting_Today.mp3/mediafile...
This Entry is about (Issues)
Sustainability
What are your two main challenges to finance the growth of your initiative
Challenges include generating a sustainable revenue stream to cover cost of operating the Open Fulfillment infrastructure. The revenue requirements differ significantly from traditional manufacturing operations, as Open Fulfillment only seeks to integrate existing manufacturing and fulfillment capacity--not recreate a new manufacturing operation. Once integrated, these collective resources will be connected directly to consumers to provide just-in-time fulfillment of orders. This eliminates the overhead for inventory management and investment in new capital. The overhead for the Open Fulfillment initiative is only in providing the communication and coordination – if successful much if not all of the process from our perspective will be automated.
While we acknowledge that R&D costs could be borne by profits or fees gathered as part of the Open Fulfillment process, because our desire is to create innovation where the market has been unable to provide such incentives, we think that it may be worth accepting that the project must seek funding or volunteers for R&D, while seeking sustainability and self-sufficiency only for the marginal costs of manufacture.
How did you hear about this contest and what is your main incentive to participate?
We heard about this contest from Anthony So.
The Story
Do you have an annual financial statement?
Available on request.
Do you currently have an annual financial statement that tracks profit/loss?
Available on request.
Please describe the amount (and/or type) of funding you need to implement your initiative, at year 1 and at year 5.
The seed funding of $5000 from Changemakers could be sufficient for year 1 of the initiative, enabling the creation of the set of infrastructure tools. By year 5 we intend to have several self-sufficient and sustainable products available through open fulfillment. While we remain open to the idea of funding research and development through the fulfillment process, as discussed we would prefer to find other means (research grants, e.g.) to fund initiatives without forcing users to bear the cost.
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Comments
Although there is a fair bit of focus on differently-abled people in the developed nations, the cost of replacing lost limbs with inovative, specifically designed components is either unavalible or very expesive (leading to unavalible again). The focus of this team to enable many people to work on refining designs used only by a small number of people is greatly needed. While it may not impact a large number of people, the people it does impact will see a large improvement over what they could have received in the past. I can also see this benefitting the lest developed nations in the trickle down effect, with better designs being offered sooner to those with less resources.
Brad
As a prosthetist working in the US and in Haiti I have seen the need for less expensive prosthetic componentry available for those not able to afford. Open sourcing design of prosthetic components might lead to more usage, better design and ultimately lower costs.
Al Ingersoll
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