We keep this wall as up-to-date as our online dashboards, often updating them on the same day. This wall isn’t just for visitors; D-Rev is driven by impact so these numbers serve to inspire and energize our staff daily. There is certainly a rewarding feeling when tearing down the old numbers to replace them with larger digits.

Yesterday Sara, D-Rev’s Director of Impact, and Nicole, Impact Lead for ReMotion, updated the impact wall. We received new numbers from our partners in India this week—Phoenix reported Q1 2015 was tied for the highest number of Brilliance installations, and BMVSS sent in updated numbers for fittings of the JaipurKnee.

You can see up-to-date dashboards online at http://d-rev.org/impact.

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We expect to see impact really take off in 2015 with the public launch of the ReMotion Knee and scaling of Brilliance Pro.

The post D-Rev’s Impact in 2014 appeared first on D-Rev.

D-Rev is lucky to be the first nonprofit beneficiary of Mitera’s new Mother To Mother program. Yoko Shimada, a mother of two and an alumna of The World Bank and the Clinton Foundation, recently started Mitera, a new clothing brand for modern breastfeeding mothers and pregnant mothers-to-be.

Aligning her new venture with her passion for global public health, Yoko is committed to partnering with innovative organizations to improve maternal and newborn health around the world. D-Rev is honored to be the inaugural member of the Mother to Mother program.

Yoko’s own daughter was diagnosed with severe jaundice; her pediatrician notified Yoko as they drove home from the maternity ward, asking her to turn around immediately and return to the hospital. They spent three more days in the NICU for phototherapy treatment and Yoko left feeling fortunate to have been surrounded by the technology and diagnostics needed to quickly and efficiently treat her daughter.

Mitera’s support will directly benefit D-Rev’s Newborn Health program, helping to ensure access to world-class phototherapy for infants in developing countries. With Mitera’s support, the Newborn Health program will expand the reach of Brilliance into sub-Saharan and East Africa, key priority markets for D-Rev to research and reach in 2015.

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D-Rev is a non-profit focused on closing health inequities, and we are frequently asked if the designs for our products are “open,” that is, do we publicly share detailed designs, CAD drawings, and other product information that would allow others to make the product royalty-free. The short answer is no; we protect our intellectual property (IP) because we believe that doing so is a prerequisite to having the broadest possible impact.

This may seem counter-intuitive—we do believe in sharing knowledge—and we do so strategically where it serves our customers, or supports the social sector to achieve higher standards and greater impact. For example, we are very transparent in how we calculate impact and report on learnings from field work—even when it leads to corrections and updates that may not be the best for our numbers.

Product development, however, is another story. In an ideal world, we would make the design of our products publicly available, high quality manufacturers would make and distribute them, and impact would result. However, experience has taught us that this approach to broad impact is high-risk for three reasons:

1. At any level of scale, the quality of products made using open data is variable. While many of those who might download an open design and use it in production are technical medical device experts, most are closer to well-intentioned hobbyists. This is a critical distinction. A product, particularly a medical device, cannot fail the user, particularly a user in a vulnerable population. The quality of multiple producers, inevitably with varying skills and equipment, will differ no matter how tightly you constrain the tolerances and specify materials, tools, and quality checks. We have seen parents living in extreme poverty in remote places of the world opt to travel additional (sometimes significant) distance to a referral hospital with marginally better equipment rather than use a “homemade” device in a local clinic. We in the social sector need to move past thinking that a “good enough product” is good enough for poor populations who might otherwise have nothing.

2. Too many versions of a product increase distrust among users. Consumer trust is already poor in low-income markets. Put yourself in the shoes of your customer. You don’t think much of locally offered products: those that are affordable are usually poor quality, and many donor-funded products over-promise and under-deliver. Multiple versions of seemingly similar product sold from different entities at different prices or with slightly different features can exacerbate existing customer distrust. Consumer distrust limits the impact of the product or any solution.

3. The weakest link is not a product’s design. We’ve seen the biggest challenges to real impact to be consistent high-quality manufacturing, sustainable and effective delivery to users, and maintenance support. The product’s design is one piece of the puzzle; we believe that organizations need to take a holistic-approach the problem, as compared to being solely focused on the product.

A great example of this is in regards to prosthetics for amputees: 3D printing of limbs. While 3D printing is great for prototyping and the technology is promising for components, like the leg socket that interface with the human body, it won’t eliminate the need for skilled prosthetists, functioning supply chains, and well-run clinics. Remobilizing a patient with a leg system means ensuring that the patient is not just walking in a clinic, but can return to work, school, and social activities. And most importantly, six months later and beyond she is still doing these things with her prosthetic system.

Lastly, we protect our IP because we believe the most economically sustainable and scalable way of reaching our customers is through the market. By selling our products, we must meet the quality requirements of our purchasers and users, which are often consistent with international standards. Tactically, we rely on partnerships with market leaders like Phoenix Medical Systems to manufacture, distribute, market, and scale products like Brilliance. To succeed, serious partners (for-profit or non-profit) must also make an investment, and none are willing to do that with the threat of knock-offs.

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A commonality of almost all the world’s hospitals is the waiting room, where families and children are waiting for other family members or for care. Those waiting are worried, bored, tired, and above all, forced to have patience. When we visit hospitals and clinics, we are struck by the how people pass their time. This clip is from the waiting room of a large public hospital in Nairobi, Kenya in July 2012. The lingala music is from a television in the corner of the room.

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I’m so happy to have joined forces with the D-Rev team. At Draper Richards Kaplan, we believe in supporting organizations that have the capacity and leadership to truly solve problems. D-Rev’s potential to disrupt the way medical technology is designed and delivered in under-served markets could unleash market forces that will make a huge difference in the poor’s access world-class care.

Advanced medical technology is so embedded in our health care system in the U.S. so it is easy to take it for granted. The absence or shortage of medical technology is a reality in many countries, which can create enormous disparities in healthcare, resulting in unnecessary suffering and deaths. But it doesn’t work to just throw equipment out into the marketplace. D-Rev understands that products must be affordable, beautiful, and perform in challenging circumstances.

What I love about D-Rev:

• In the funding world we hear constantly about impact. I have never met anyone as committed to measuring and sharing real results as Krista Donaldson, D-Rev’s CEO.

• D-Rev’s design process truly is user-based. Its process of listening to people and designing to their needs is a model for any medical device company.

• The team is committed to making sure its products are used. This requires real persistence and commitment. They understand that it is not enough to merely design beautiful products. Dozens of challenges in the field must be addressed to make sure the products are manufactured, distributed and used.

I know how hard this work is through my own experience as co-founder of Project Healthy Children, where we partner with developing countries to save lives through sustainable and measurable methods of food fortification and supplementation. I also co-founded Strategic Grant Partners, a venture capital model of consulting and philanthropic investing working to create positive futures for children and families in Massachusetts and nationally, and a girls’ middle school in Rwanda, The Maranyundo School. I’ve been involved for many years as an advisor, board member, funder, and cheerleader for a host of social venture organizations.

I love my hometown Boston, but it’s great to be able to come see D-Rev—great food, sunshine, many friends from my Stanford Business School days, and one of my three daughters nearby. I play the piano, ski, bike, climb, hike—I never let lack of ability ruin my fun!

It’s such an honor to support the D-Rev team.

The post Introducing D-Rev’s New Board Member: Stephanie Dodson of the Draper Richards Kaplan Foundation appeared first on D-Rev.

We’re excited to announce the release of Brilliance Pro—we’ve updated the website, the materials have been revised, first-looks have been given, we’ve won an award—and we’re ready to start taking orders!

Brilliance Pro, the next product from D-Rev’s Newborn Health project, is for sale through our partner Phoenix Medical Systems. The original Brilliance, launched in November 2012, will now affectionately be known as Brilliance Classic.

Based on feedback from our users—everyone from doctors and patients to the service engineers, sales team, and manufacturing leads at Phoenix—we started from scratch to design phototherapy unit just after the launch of Brilliance Classic. This version includes critically-important, patent-pending features like SmartTilt™ and the Brilliance Pro Light Meter that raise the standard of care, and a refined aesthetic that bypasses the expectation that medical devices aren’t, or don’t need to be, beautiful.

During our annual holiday party in December Jesse got a late-night call from the marketing director at Phoenix to tell us that Brilliance Pro had won “Best in Show” at the largest neonatal conference in India—as much of a surprise to her as it was to us. (Note: it was the overall Best in Show, not in any special category like “NGO” or “affordable” devices. Brilliance Pro was competing against all neonatal product categories and prices.) AJ immediately stood up on a chair in the middle of the small remaining crowd to share the news, and as he talked there were some folks asking if we had planned the timing, if it was a stunt of sorts, but I assure you, the excitement and pride was authentic.

Brilliance Pro is a device that we believe exemplifies the core of who we are at D-Rev. Here’s how:

• Its inception was based on the potential for incredible impact. Brilliance Pro cuts the manufacturing time in half and uses processes that enable Phoenix to make more units, faster, so we can treat more babies in more hospitals.

• Its design modifications originate from user feedback. Brilliance Pro is a step forward in device usability. It includes a backlit LCD screen, a tilt mechanism that requires only one hand, an option for white observation lights, and buttons for high and low intensity settings, all in response to feedback on Brilliance Classic. These features don’t directly affect the efficacy of treatment, but alleviate important pain points for doctors, nurses, and purchasing officers.

• Its performance is cutting-edge and world-class, while maintaining an affordable price point ($500). SmartTilt™ is a patent-pending technology that will ensure that light intensity from the Brilliance Pro LEDs is consistent across the treatment footprint at any angle of head-tilt, automatically adjusting the outputs of each LED as the head unit is tilted. This is the first technology of its kind in a phototherapy device. In addition, Brilliance Pro has the Brilliance Pro Light Meter, an optional accessory, that will allow doctors to measure the dose of light being delivered to an infant in real-time. Generally, these Light Meters cost upwards of $1,500 USD. Our Light Meter, usable with any Brilliance Pro unit, will retail for less than 1/10th the price (exact cost TBD).

• Its aesthetic demonstrates that we believe affordability doesn’t rule out an opportunity for dignified and beautiful design. Brilliance Pro is sleek, refined, and captures a modern aesthetic that is rarely, if ever, available for our target hospitals.

• Its technical design allows us to collect new types of impact data to verify effective use, enabling us to evaluate impact in new ways. We’ll be able to more accurately estimate the number of newborns treated with more thorough, time-stamped event data from each Brilliance Pro unit, and we’ll have the flexibility to collect the data over the phone, through text message, and by in-person download. Similar to how the usability features satisfy one set of users above, these additions make the D-Rev team, our funders, and especially Sara, happy! It’s so important that our customers have choices in high-quality, affordable phototherapy devices, and you—our partners, friends, and donors—have made it possible. Thanks for your continued support.

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This is our third annual end of year blog post wrapping up all of D-Rev’s activities for 2014—and we’ve had fun going back through our first few. We’ve accomplished a lot since 2012 and 2013.

The most important number on our minds right now is 2. We have 2 product launches in the next few months—Brilliance Pro & ReMotion Knee v3. That means that D-Rev is 2 for 2 on products scaling in multiple countries.

What did 2014 look like?

38,749 – Babies treated with Brilliance devices. (How do we know that? See here)

501 – Newborn deaths and disabilities averted by our installed Brilliance devices.

33 – Countries where D-Rev has devices installed, sold or in-use.

2 – Number of Impact Dashboard iterations since their launch in June. We view Impact as an equal project area at D-Rev.

288 – Cumulative hours spent listening to and debating Serial.

751,881 – Views of D-Rev’s TED talk on the ReMotion Knee.

1,000+ – Brilliance units sold to date by our partner, Phoenix Medical Systems.

7 – Field partners who provided critical support to reach our target customers.

1064 v1 JaipurKnees by D-Rev’s partner, the JaipurFoot Organization, and 52 v3 ReMotion Knees fit this year.

12 – Suggestions we received to come up with a D-Rev #IceBucketChallenge.

2 – Volunteer photographers and videographers who went into the field to capture impact stories for us (thank you, Scott and Tina!). See Scott’s amazing work here. One of Tina’s photos from early December 2014 is used above.

1:09 – Hyperlapsed time to assemble Brilliance Classic by our product manager Garrett.

4 – New hires at D-Rev. Stay tuned, we will be hiring more in 2015.

195,517 – Total air miles traveled by D-Rev staff to meet with partners, users and peers.

Unlimited thank yous due to our friends, fans, our boards of directors & advisors, and D-Rev supporters. We wouldn’t be where we are without you!

We wish everyone happy holidays and an exciting journey into 2015!

Krista, Garrett, Sara, Vin, Mike, Nicole, AJ, Kelly, Jesse, Rob & Dina

The post D-Rev’s 2014 By the Numbers appeared first on D-Rev.

You may be thinking “how does a for-profit medical device company come about to partner with D-Rev?” The two goals were quite simple:

1. provide philanthropic support to a highly influential non-profit, and

2. understand how D-Rev is able to create, manufacture, and implement products that impact the underserved.

While many of Medtronic’s current products are meeting the needs in developed markets, we realize the large business and social opportunity to develop and market products and solutions to serve unmet needs in the global healthcare landscape. There were several learnings gained in my six months, but in an effort to make it more digestible in a blog post I’ll share with you these three key insights:

Low-cost devices are not going to sell themselves

The equation is not that simple…a low cost/high quality device + a massive market need does not equal instant impact. There are much more complex variables in the mix. One of the largest unmet needs in the developing world is healthcare infrastructure: reimbursement systems, trained healthcare workers, and the availability of complementary products. This represents a major challenge when trying to develop new devices for developing markets and a current disconnect between product development and implementation. While there may be a market need, to create sustainable demand, significant attention must be paid to developing infrastructure to support your products. D-Rev can’t tackle the entire pie by itself, but it can work with partners actively involved with helping to develop the local infrastructure. For example, one of D-Rev’s partners in Southeast Asia is a full-fledged non-profit prosthetic school that is training future Category II and III prosthetists. Because there is such skilled work involved to fit a patient with a prosthetic knee, the work this school is doing is highly critical to provide and maintain devices like the ReMotion Knee for the users.

Quality, Quality, Quality

Developing devices that are affordable for underserved populations but still meet international quality standards is no easy task. The ReMotion Knee, for example, must be able to handle some of the toughest conditions that a users’ daily livelihood depends on: carrying heavy equipment on a construction site, driving a motorbike to make deliveries, or kicking around a soccer ball are some realistic examples of how this prostheses may be used. From a technical standpoint, the design must be able to withstand these conditions to provide customers with confidence that their device is not going to fail on them when they need it most. If users can’t come to trust the safety and reliability of a device that their livelihood depends on, cost and access may not even become factors in a decision.

Measuring impact isn’t only for non-profits

Finally, the notion of measureable impact in the non-profit world, of which D-Rev has certainly been a pioneer, has created a wave of honest and sustainable investment of donor funds. In many ways, for-profits can adopt a similar mindset of impact. While public companies like Medtronic are motivated by delivering financial returns to shareholders, they can also be motivated by social impact. At Medtronic, we have an obligation to work for all patients and to put the skills and resources we’ve developed as a for-profit company to work for patients around the world. Impact is ultimately created by demonstrating quantifiable value for each stakeholder in the value chain.

Let’s revisit the ReMotion Knee one last time for a practical example. The knee is a low-cost prosthetic joint intended to increase access to effective mobility devices. This increase in access to a more effective mobility device can, in theory, increase the number of patients treated in a market and possibly return an amputee to work, school or other pursuits to improve their life and income. For some, who are the primary breadwinners in their families, this means putting food on the table or getting their children to school. Demonstrating value on a social front complements business development effort to establish new accounts, to receive government tenders, or even to make the case for an increased investment in healthcare infrastructure. Of course, this all depends on finding patients and collaborating with business partners who value the social impact created by a product or solution. A focus on these types of business partnerships may then drive economic growth in the market through an increase in sales or service offerings.

Here’s a brief graphic to illustrate the point:

This may sound like Market Development 101, and while it is easy to describe this process in a blog post, correctly measuring and appropriately using the data to drive business and sales decisions is ultimately the secret sauce.

To wrap up, the way a business is structured (whether a for-profit or non-profit) has little to do with how we should think about these development challenges. The insights shared here have all been gathered from speaking with customers (patients, administrators, distributors, etc.) and come with an in-depth understanding of the challenges these stakeholders face every day. The purchaser/payer may ultimately be different depending on financial expectations, but the way we should approach stakeholders to truly understand their needs remains the same.

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Editor’s Note: D-Rev works with several interns throughout the year. Last summer we were lucky to have Leela Amladi, now a senior at Saint Francis High School. She worked with the ReMotion Knee team to understand where the most above-knee amputees were located. Her work on traffic accidents is outlined below.

Around the world, road traffic accidents account for the majority of traumatic amputations, especially in countries with unregulated traffic laws and higher population densities. In an effort to identify regions that would have the greatest need for the ReMotion Knee, our low-cost prosthetic knee joint, we pursued this connection between traffic accidents and amputations. The following is a geographical heat map reflecting the rate of traffic accident deaths per 100,000 population for each country.

After examining and plotting this data, we realized that this statistic—the rate of traffic deaths per 100,000 population—could be misleading. For countries with very small populations, the rate of deaths can spike easily. For example, we noticed that the small island of Niue, with a population of only 16,111, outranked all other countries in our chart with a death rate of 68.3 per 100,000 population. The next highest contender was the Dominican Republic at 41.7, with a population of around 9 million (at the time the study was conducted in 2010).

To take into account outliers like these, we mapped the total populations of countries as well.

Finally, to align this study with our mission of delivering products to those living on less than $4 per day, we mapped out the MPI index (Multi-Dimensional Poverty Index) of countries as well.

Overlaying all three of these data sets generated a heat map that highlighted regions with the greatest need for the ReMotion Knee based upon the rate of fatal traffic accidents, population size, and MPI. Based on these factors, the top eight countries with the greatest need were Nigeria, Ethiopia, Uganda, Burkina Faso, Niger, Mali, India, and Pakistan.

At D-Rev, we focus our efforts on countries with greatest need for our products in order to have the greatest impact. The first step in pinpointing these areas is a thorough understanding of the problem and its causes. This information lays a foundation that is coupled with other factors, such as the current prosthetics market, infrastructure to deliver the product, clinical availability, and the regulatory environment, to determine the countries where D-Rev’s ReMotion Knee has the most potential for the greatest impact.

The post From the Intern Desk at D-Rev: Traffic accidents and amputees, plotting data to derive countries of greatest need for prosthetic knees appeared first on D-Rev.