Page 19 - Mobility Management, March 2020

users were used to being treated as “study participants” rather than feeling shared ownership in the process of developing a product.
“The participants often don’t get a sense that their input is really valued, and they don’t often see where that input is going,” Viswanathan said. “We really flipped that model around ... and said: ‘We are the experts in the technology, we can execute, but we have no idea what it is that you need, so you’re really the experts in telling us what the challenge is. You’re the expert in the pain point, and we can execute.’”
Ding, the University of Pittsburgh professor and researcher, has also sought to ensure that engineers consider the experience of end users when developing technology for mobility applications. While working with some “hardcore” engineers on a robotic arm project, Ding noticed that the engineers were more focused on developing a newer algorithm than how the patient would react to it.
“Some of the newer algorithms will have a random component in it, and there is unpre- dictability because of how this random feed is given, so the user will feel overwhelmed,” Ding said. “They have no idea how this robotic arm is going to move around them, and they don’t like it at all. Even though it eventually helps them achieve the goal, they don’t feel comfortable.”
It’s really hard to have one model fits all, and on the other hand, [products] are expensive and we have all these policy issues. It makes it really hard to make this technology mainstream — Dan Ding
Once she pointed this out to the other engineers, they were sympathetic and said they had not thought about how this would affect the final application.
“They care about the final performance, but not the whole process, the user involve- ment, their acceptance or adoption,” Ding said. “Over the years I’ve learned, no matter how well the technology works, people may not use it, and there’s a lot of problems that come with that.”
OVERCOMING
INDUSTRY OBSTACLES
Beyond working with end users to develop their products, both Viswanathan and Beavers said they have had to overcome several regulatory and business challenges to enter the CRT industry, whether that meant putting their product on the market without a Medicare code or convincing clinicians and distributors that their inno- vation brings value to patients.
“One of the things that makes this industry challenging is that it’s not customer acceptance, it’s acceptance of the whole CRT process,” Beavers said. “I’ve known from very early on that there is a high degree of customer desire for Independence Drive, but that does not necessarily mean that
it’s going to be a success when it comes to coverage and regulation.”
But the startup founders also said that there are benefits of the system as it is currently laid out.
“A lot of times, it’s pretty easy for another company that’s bigger than
you and better capitalized than you to copy your product if you come up with something innovative,” Beavers said. “Here, there are fewer people who are going to do that because you have to develop the knowledge of how to deal with Medicare and the FDA [U.S. Food & Drug Administration], and so it gives you a little more space to develop your product without just anybody copying you.”
As an academic researcher, Viswanathan heard comments about resistance from ATPs and the stereotypes that “clinicians are averse to new technol- ogies.” But after working with clinicians to get them on board with the potential uses of the sensor systems, she came to a different conclusion.
“We found that it was completely false,” she said. “If anything, clinicians were our
biggest advocates right from the beginning in terms of giving us critical feedback
that was really important. It wasn’t just criticism, it was very constructive, telling us areas we needed to work on.”
Viswanathan noted that it’s easy to
I’ve intentionally tried
to make sure we don’t over-promise and under- deliver, because there’s still a lot of thinking that has to go into these platforms to make sure we can execute it right — Doug Moore
criticize the industry by saying that the high number of stakeholders involved stifles technological innovation. But the complexity in the field and the level of customization needed for each individual wheelchair makes innovation difficult in the first place, she said.
Rather than being bothered by the number of gatekeepers in the industry, her main concerns come from the lack of communication between stakeholders.
“I think we’re a very siloed industry where there’s not a whole lot of commu- nication between the healthcare providers and the end users and the manufacturers,” Viswanathan said. “I do think that if we had more open sort of venues and forums for us to talk about these things, I think we could actually, as a community, move things forward a lot better and try to find a better use of resources.”
LIMITATIONS & OPPORTUNITIES FOR THE FUTURE
There is no question that there have been major developments in the use of robotic elements in complex rehab, ranging from the Obi robotic dining companion to
the ReWalk exoskeleton systems to the wheelchair products designed by Braze and Evergreen.
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