Saving Newborns and Helping Amputees Walk: All in a Day’s Work at D-Rev

by Cindy Glass
Manufacturing - Nov 26 2014 - 5 min read
d_rev_construction
Courtesy D-Rev

D-Rev, a San Francisco–based design firm founded in 2007, organized itself around designing world-class medical devices with a focus on truly supporting end users.

Combine this with a mission statement that targets underdeveloped economies and customers who earn under $4 a day, and you have a company with a goal that’s both revolutionary and inspiring.

D-Rev is part of a wave of designers and entrepreneurs who are crafting new models for underserved markets they believe are entitled to world-class products suited to their needs and constraints.

Designing Innovative Treatment for At-Risk Newborns

Last year, D-Rev launched Brilliance, a phototherapy system that uses arrangements of blue lights to treat newborns suffering from severe jaundice, a potentially life-threatening condition if left untreated. While treatment is straightforward—place the infant under blue lights—access in under-resourced areas like India, D-Rev’s initial target market, is not.

Although many hospitals had phototherapy equipment donated, the equipment was designed for a developed economy with reliable power sources and easy access to replacement bulbs. The machines typically require six bulbs, with a replacement cost of $15 each and a life span of four months. Maintenance for the machines is simply out of reach, which means therapy for these at-risk newborns is also out of reach.

D-Rev_Brilliance_Jaundice_LED
Courtesy D-Rev

Sam Hamner, design engineer at D-Rev, says that once the obvious need for Brilliance was established, the team quickly decided that a technical solution could deliver an excellent product that this kind of resource-poor area could support and maintain. He says three things came together: “We established need on the ground, saw that technology could address that need, and realized that the cost curve on LED technology could be used to design an affordable device.”

Hamner describes being able to leverage optical simulations using software to minimize the number of parts going into the unit while still achieving the light intensity standards required for phototherapy. “That kind of simulation also helped us reduce cost by saying ‘Okay, here’s the minimum amount of LEDs and if we orient the lenses this way we can have a good footprint of light that’s meeting the standards.’”

This kind of thinking fuels D-Rev’s hybrid business model that uses donations to fund its internal operations, which primarily consists of R&D activities. Hamner says the design team starts with need. “So, is there really a need for this?” he says. “It can’t be solution first. It has to be need first.”

He says that engineers can fall in love with a technology and start looking for ways to make a solution. “We really want to make sure we understand what’s the need and who are all the stakeholders around that need?”

The team also focuses on making the idea sustainable. And, for this emerging business model that blends non-profit and for-profit principles, sustainability can take a variety of shapes.

Brilliance_production_D-Rev
Courtesy D-Rev

For Brilliance, the team found a partner based in India that is capable of arranging manufacturing and distribution. This partner is a for-profit entity that requires a certain profit margin to make the business viable and help D-Rev scale. D-Rev includes this stakeholder’s needs when evaluating a product’s viability. Hamner says that long-term sustainability for a project is crucial. “One of the things with Brilliance is, if D-Rev goes away tomorrow, that device will still be manufactured and distributed and sold through our for-profit partner.”

One of D-Rev’s key donors, Kevin Starr from the Mulago Foundation, discussed this emerging model with The New York Times earlier this year. “What D-Rev is doing hasn’t been done before,” he states. “They’re combining ways of designing equipment by focusing on the user and the user’s context, while also thinking about how to get it to people, about strategies for distribution and the market.”

The results are telling. According to D-Rev, more than 35,000 babies have been treated with Brilliance in nine countries. As of October data, the product has helped to avert 454 newborn deaths and provided effective treatment to 29,413 babies who would not have received it otherwise.

D-Rev Develops Low-Cost Knee Joint for Amputees

Next to launch, most likely sometime next year, is D-Rev’s ReMotion Knee. Stanford students developed the prosthetic knee join as part of a group project and licensed the product at no cost to Jaipur Foot, the largest provider of prosthetics in India. Since then, the clinic has fit more than 6,000 patients.

ReMotion_Knees_D-Rev
ReMotion Knees. Courtesy D-Rev.

While it has successfully helped many get on with their lives, problems with the original design made it difficult to scale globally. D-Rev stepped in to take lessons learned from the 6,000+ user experiences, iterate the design forward, and bring a low-cost, high-functioning prosthetic to international markets—all for about $80 a patient.

Hamner speaks with enthusiasm about what the D-Rev team has been able to do with the original concept, including enabling high-volume manufacturing, drawing from more standard connection mechanisms, and learning from patient experiences.

“We learned early on that there’s a plastic-on-plastic contact, so every time a patient takes a step, it makes a clicking sound…we realized we needed to add a noise bumper so that every time someone takes a step, it’s not making a loud, clicking sound,” he says. “The other thing we saw is that the first version had sharp corners. We’ve designed the newest version to have a much more natural knee shape when it’s under clothing, and when you sit down or kneel down, it looks much more like a natural knee.”

D-Rev_Amputee_ReMotion_Knee
Courtesy D-Rev

D-Rev has expanded the definition of success beyond whether it can survive in the marketplace to include assessments of impact on people’s lives—and has started publishing results. For the ReMotion Knee, Hamner sees the direct economic impact that remobilizing a person can have in terms of being able to find and hold a job.

Hamner describes one of the “super users,” an Indonesian construction worker who participated in field trials. Hamner’s team watched this worker with a ReMotion Knee carry large bags of concrete up a ladder. “We’re all over there like ‘Oh my gosh! He’s really putting that knee through its paces!’”

But that story underlies a core tenet for D-Rev.

“We want to make world-class products,” Hamner says. “It’s not about stripping away [a product’s] features so that it’s affordable. It’s about using those constraints around the required standards to develop something that people can afford.” And transform lives.

D-Rev is a member of the Autodesk Foundation, the first foundation to focus investment exclusively on the people and organizations using design for impact.

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