duPont Hospital for Children and the University of Delaware
Vol. 2, No. 3 -- Summer/Fall 1997

Designing Assistive Technology

When Dreams Meet Reality: From Concept to Market

Jan Little, Project Director, Resource Unit for Information and Education Northwestern University Prosthetics Research Laboratory & Rehabilitation Engineering Research Center, is a RESNA fellow and an inductee in the National Wheelchair Hall of Fame. She has served as the Project Director, Infinitec Assistive Technology Project in Chicago, as Director of Marketing of Rehab Products for Invacare Corporation, and as CEO of Medical Equipment Distributors, Inc. She is also the author of "If It Weren't for the Honor, I'd Rather Have Walked." She holds a B.S. in Journalism and an M.S. in Communications Science.

Jim Fee's article in the first issue of The Innovator made an important point about assistive technology. The intent of an assistive device is to solve a specific need of a specific person. But the progression of the device from concept to market... that's a different story. For most of my adult life, I've been involved in some phase of bringing assistive devices to market.

In my experience, I like to compare the progression of an assistive device from concept to market to a game of golf. There are many hazards, roughs and sand traps along the course, and, if you take too many strokes to reach the 18th hole, you lose. Even though I am a person with a disability (PWD), I've dropped more products in the water holes and sand traps than I've gotten out to PWDs.

#1--Water hole

Is there a large enough number of people who need this device to make production of the device practical?

Jim's article illustrated the first water hole on the course. He solved his need to write complex differential equations in limited spaces, using large letters and numerals, patented the concept-- then found he was possibly the only engineer who needed this solution.

#2--Hazard: Landing in the rough

You have to use components designed for consumer products.

golf Perhaps the next hazard an assistive device encounters is "landing in the rough" when finding components to make the device. Power wheelchairs must use batteries to power the motors. The number of power wheelchairs manufactured has never been a quantity sufficient to warrant development of special batteries. Batteries designed to provide adequate power, yet be extremely compact in size, have been so expensive that incorporating them into power wheelchair design would drive cost of the product out of range. Therefore, design has been compromised by the need to allow space for relatively large batteries, which are economical, but demand high levels of maintenance and frequent replacement.

#3--Sand trap

Who is going to manufacture the device?

sportchair It would seem logical that existing manufacturers would welcome innovation. If they don't welcome it, there must be many who would want to form a company to make the device. Innovation in wheelchairs illustrates obstacles presented when it comes to who is going to manufacture the device. Some crazy folks-- who used wheelchairs and thought they knew more about what wheelchair users wanted than engineers in design labs did-- developed designs using aircraft aluminum and bright painted colors construction of frames that adjusted to the user's body and activities. Established manufacturers responded with many reasons why they could not manufacture these devices: Factories were equipped to build chairs using welded, chrome-plated steel. They would need new welders, new assembly lines, new engineering departments, new sales staff training-- too many "news" to make it attractive for manufacturers to venture into this area. Besides, at that time, the majority of wheelchairs were prescribed by therapists and paid for by third party agents. Therapists weren't eager to prescribe "sports" chairs, for heaven's sake. And, funding agencies weren't ready to pay extra to provide paraplegics with the luxury of playing basketball. In this instance, the Motion Design company was started against all odds and made "Quickie" a generic term for wheelchairs. But, for every company such as Motion Design, there are about a hundred others which started and died. Causes of the death were the costs of product introduction and distribution; such as liability insurance, sales forces, manufacturing equipment, meeting competitive prices and discount structures, and waiting for distributors to pay for products delivered to them.

#4--Really belting the ball into the woods

The funding structure.

I have many friends who have worked to bring communication devices to PWDs. These fellows would sacrifice their first-born to have product introduction as easy as it is in the cut-throat world of consumer electronics. For example, folks who develop a software program or laptop may put all they have into development, gambling that people will love the device and make the designers millionaires. Unlike communication devices, if consumers like an electronic product, they dig into their pockets and buy it. They don't have to justify why they like it or whether they need it.

The communication device market is a different world. First, trade shows to reach PWDs who will like and want the product are few. Second, with the prospective number of sales on the order of 500 per year for the communication device compared to 500 a day for some electronic toys, advertising on TV is not an option. Third, the guy or gal who's going to use the device most likely doesn't even get to choose the device. It's probably prescribed by a health care professional, who labors to write a lengthy rationale telling the funding agency why Johnnie or Susie should be able to communicate his or her thoughts. After many contacts between the funding agency and the prescriber, the device may be funded. Or it may not.

Despite these hazards, many assistive devices have been introduced to make our lives more productive and enjoyable. People who develop assistive technology are a peculiar breed. They don't know what "can't be done" until they've already done it.

The moral of this tale? Golf courses are made better by bigger, tougher hazards. Life with a disability isn't. Users and designers of assistive technology would do well to be aware of the hazards and maybe even chop away at some.

-Jan Little, Northwestern University Prosthetics Research Lab