Fast Company just announced its Innovation by Design Awards to honor members of the design and entrepreneurship communities.

We can’t believe it, but Krista Donaldson, our CEO, was honored as part of the Co.Design 50, its list of 50 people who are shaping the future of design, with others from companies like Google, Facebook, Apple, and Pinterest.

Thank you for your continued support; without our community of supporters we would not merit this honor!

As you read the print article (on stands September 18th) and become inspired, as we were, by the amazing designers, we want to set the record straight about one common misconception about D-Rev.  We are primarily a product development company – albeit a non-profit one – and we design and deliver products that improve the health and incomes of people living on less than $4 per day.

While we have incubated and absorbed one product – the ReMotion JaipurKnee – that started as a course project at Stanford with the Jaipur Foot Organization in India, our business model is not around commercializing student projects.  All of D-Rev’s other projects start at D-Rev – or more accurately, they start with partners and do-ers on the ground and in the field, like doctors and nurses, telling us what they need.  Brilliance, for example, started when an Indian doctor told our staff member, Ben Cline, about the dire need for affordable phototherapy in his clinic – adding that kernicterus (death or disability resulting from severe jaundice) was not seen as a priority by the global health community.

And as a last sidenote, a shout-out to George Kembel – head of the Stanford d.school who was also deemed an influential designer; he was “loftmates” with Krista in the Stanford Product Design program.  And apologies to Embrace (the incubator mentioned in the print article is theirs); we occasionally get credit for your and the Extreme Affordability class’s hard work. Kudos to all!

Last week, D-Rev kicked off its 1,000 Knees Campaign to support field trials for the third version of the ReMotion prosthesis, which includes a host of new features.  As with any field trial, the central objective is to study the product’s performance.

D-Rev's 1,000 Knees Campaign is raising money to fund a field test of its ReMotion knee. Next step: mass production and distribution through the market. Photo Credit: Joel Sadler

Our primary goals are to verify that the product is working as intended and to provide amputees with a high-quality knee prosthesis designed specifically for the environment and activities typical of those living on less than $4 per day.

Although fitting the knee to 1,000 patients will make a significant impact, the benefits of the trial will not end there. D-Rev’s trial is the first step towards a self-sustaining program. Consider some of the activities that will be part of the trial:

• Partnering with multiple clinics, chosen for their ability to supply trained staff capable of providing a quality fit (without this, even the best components would be rendered useless).
• Developing a distribution method capable of delivering units to multiple geographies.
• Supporting multiple teams of prosthetists, by developing standardized guides and troubleshooting manuals to efficiently train prosthetists on how to properly fit the knee joint.

By accomplishing these goals, we will conclude the field trial with a system in place to continue scaling the ReMotion knee to clinics across the globe. Scaling will then be done through the market, without requiring donors to sponsor knees or support trials (for more on why D-Rev does not donate products to end users, see Krista’s post from yesterday).

Ultimately, our goal is to fit far more than 1,000 amputees. We believe the best way to do this is to make the knee available on the market by creating a sustainable system that can scale to meet the global need, and successful completion of our field trial is what is needed to put that system in place.  So in reality, this isn’t a campaign for one thousand knees that you’re supporting; it’s a campaign for the first one thousand knees.

At D-Rev, we have a few core tenets. First, we design world-class products that perform on par or better than the best devices available. Second, we’re user-obsessed, which means that we relentlessly integrate user feedback into the design process, always expecting to iterate and improve our designs. Third, we are market-driven. That’s a phrase that gets thrown around a lot, but what does it mean in practice?

It means that we use the marketplace to tell us whether our products are meeting the needs of customers (in this case, clinics) and users. It means that we want our products to be self-sustaining on the market, and that our products must be purchased – not donated or heavily subsidized.

We sell our products because we believe that our target purchasers and users need to see value in products, and invest in using them. Valued products are used (and repaired and used); products that are used have impact.

This isn’t to say that donated products don’t have social impact; they can, and some products, like vaccines, do. But they aren’t economically sustainable once donors go away. It’s difficult to know whether a donated product is something that users would choose if they are getting it for free. If a well-designed donated product can have impact, a well-designed purchased product can have sustainable impact. This is a key distinction. Our goal at D-Rev is to design – and, with partners, to deliver – products that leverage the market and require no or very little further financial support.

While we are still in the design process, iterating and collecting feedback from our users (and iterating some more), we provide our knees to select clinics for free. In return, they help us by collecting rigorous data to better inform the knee development – and D-Rev’s approach. Once we move to full production, we will sell our knees to clinics. When you donate $80 (the cost of what we think the knee will ultimately cost our clinics), you are paying not for a one-time knee. You are supporting the design process itself and paying for an indefinite supply of knees, as long as clinics and amputees see value in them.

Please support the 1,000 Knees Campaign. By doing so, you become part of a movement to make mobility possible, and empower people to readily and sustainably access products that improve their lives.

The 1,000 Knees Campaign is raising money to fund final testing of the ReMotion knee before it goes into mass production

I serve on the board at D-Rev and recently, I helped initiate the 1,000 Knees Campaign to help fund the commercialization of ReMotion. This is why in a nutshell.

ReMotion will significantly improve the quality life for millions of amputees worldwide.

The ReMotion knee, priced at $80, is a low-cost device, specifically designed for amputees who live on less than $4 a day. These amputees cannot afford the alternatives that cost into the thousands of dollars, but like anyone else, they deserve mobility. There is a significant need for ReMotion knees.

ReMotion has been through design and early field testing, with over 3,500 patients fitted with knees during the past three years. It’s time to finish beta-testing and reach the next level of scale.

During our next phase in the commercialization of ReMotion, the product and its supporting systems (e.g., sales, delivery, monitoring, impact assessment, service) will be tested, and further optimized, before ReMotion goes into full-scale production. Stay tuned to this blog for updates from Krista and Vin about why D-Rev uses a market-driven model and what the next steps are if we raise the funds.

I hope you’ll join me by helping to move this important solution forward, and by ultimately helping to provide renewed mobility to millions of people worldwide.

Krista at TEDxStanford. Photo Credit: Stanford University

Despite D-Rev colleagues’ advice to not razz Bill Gates in my TEDxStanford talk Saturday, I started with his Annual Letter for the Gates Foundation from January.  He uses the word “innovation” a lot − 23 times if you include innovate, innovator, and innovative.  He says innovation is key to changing the world.  I agree with him if we define innovation broadly – but in international development, it seems like the focus is too often on coming up with a technological innovation.  What gets left out is the context for these innovations. How exactly will an innovative product thought up in a Western lab work in a rural hospital in Malawi or a small maternity center in India? What replacement parts does it need?  How will it be maintained without skilled technicians? Will it work when the power goes out?  What happens when the battery dies?

In addition to a user-centric design approach – at D-Rev, we think it is critical to integrate delivery and scaling into the design process from the earliest stages.  If you want to have impact, that is.  We don’t just want a good idea that turns into a cool technical proof-of-concept – the product needs to be made affordably, distributed, sold, installed, used properly (in the places that need it) – and maintained.

I’m describing a market-driven process because we believe it is the best way to ensure that your users value and use the product.  Read on »

April is World Autism Awareness Month.  On April 2^nd, Niagara Falls, Christ the Redeemer in Brazil, and The Great Buddha in Japan were among over 4,000 recognizable international landmarks to be lit blue in support of Autism Speaks and the UN’s World Autism Awareness Day.

Researchers estimate that 70 million people worldwide land on the autism spectrum¹.  Lately, autism has been in the news more frequently with the American Psychiatric Association reassessing how to define Autism Spectrum Disorder (ASD) – and experts expecting a much narrower definition.  While fewer official diagnoses may save public health costs, it could hinder future research on what causes autism. For instance, autism rates are higher among adults who were underweight as babies; low-birth-weight children are 5x more likely to have autism than the 1% in the general population². At D-Rev we’ve been particularly interested in autism research because Read on »

Originally from Anhui province, this shoe cobbler lost his $180/month factory job after a work injury two years ago.

With fireworks lighted across East Asia, January 23 rung in the Year of the Dragon for many Asian communities. But perhaps less obvious, it also marked the culmination of the largest annual human migration on the planet. For the past few weeks, millions of people across China have been on the road, traveling by rail, bus, motorcycle, and any means possible to return to their hometowns for Lunar New Year, the most important holiday in Chinese culture. An estimated 3.1 billion passenger trips—more than two times China’s population—will be made via public transport around this time.

Beyond the cultural emphasis on family reunions during New Years, this phenomenon is largely driven by the 250 million (and growing) migrant workers “floating” around China’s urban centers. Over the last few decades, with coastal cities and industrial zones desperate for cheap labor, many of the rural poor have left their villages and towns in search of jobs and livelihoods. The men often find work in construction while the women join the assembly lines. Despite leaving, they maintain close ties with their hometowns, mostly due to elderly parents and young children who remain in the countryside.

Although migrant workers are the main labor force behind China’s urbanization, they are ineligible for urban hukous, a household registration system upon which access to public education, healthcare, and social benefits depends. Read on »

We are thrilled that the Lemelson Foundation is supporting the scale up of the JaipurKnee, as well as building a future pipeline of innovations and design services. So we thought we would interview them: Krista chats with Erin Tochen of Lemelson about her role there, how the Foundation is organized, what makes D-Rev projects a good fit for the Lemelson portfolio, and their favorite speakers at Pop!Tech.

Krista: First, thank you for chatting with me today! Could you start by giving us a background on Lemelson and what you do at the Foundation?

Read on »

Sketch: Hannah Lou, D-Rev

If you are starting a for-profit social enterprise, you face a unique challenge: where will you find the seed capital willing to bear the risks inherent in new ventures – things such as product-market fit, executive leadership, sales channels, etc. Unlike conventional early-stage start-ups, social enterprises cannot leverage venture capitalists who embrace risk knowing that a few successful investments can more than cover losses in dozens of other investments. Moreover, unlike non-profit social enterprises, for-profits retain a core fiduciary duty to ensure a financial return. This adds additional pressure to mitigate early-stage risk. The result? A disproportionate dearth of risk-tolerant seed capital. Read on »

Thank you to Meg Wirth, founder of Maternova, for this entry. To read more by Meg, visit Maternova Blog.

Randomized control trials have long been considered the “gold standard” of medical research. RCTs are typically large-scale studies that randomly assign individuals to an intervention or control group in order to measure the positive or negative effects of the intervention.Their results are often regarded as irrefutable proof, for they compare how one group responds to a treatment against how an identical group fares without it.

However, recent meta-research by Dr. John Ioannidis suggests otherwise. Read on »