In response to the 2013-2015 Ebola outbreak in West Africa, USAID’s Center for Accelerating Innovation and Impact (CII) partnered with the White House Office of Science and Technology Policy, the Centers for Disease Control and Prevention, and the U.S. Department of Defense to launch Fighting Ebola: A Grand Challenge for Development in late 2014. The Challenge called on the global community to share new solutions to help healthcare workers provide better care to their patients. After a rigorous review process of over 1,500 applications, fourteen potentially game-changing solutions were selected that address a range of gaps in the global response capacity including personal protective equipment, care settings, decontamination, healthcare worker tools, changing behavior, and information communication technology.
This Challenge provided human centered design support to seven promising solutions from the Fighting Ebola Grand Challenge portfolio. Each innovator was at a different stage of product development and faced a wide range of challenges as they sought to bring their innovations to market. The innovators worked to identify their unique set of needs and develop individualized design support along the HCD process. A few examples of supporting activities provided to innovators included: gathering user feedback, product iteration and refinement, systems mapping, product introduction and market assessment strategies, pilot strategy and stakeholder alignment workshops. The design support spanned across five months, taking teams to seven different countries (Belgium, Guinea, Kenya, Liberia, Sierra Leone, Uganda, and the United States) to work directly with innovator teams and affected communities.
Below are the seven product innovations that received HCD support:
Systems Design: Mapping how products were procured during Ebola
The emergency crisis response market is a highly complex system that includes many different actors -- each with a different set of product requirements and specifications. A procurement map was created that illustrates the complex set of actors and market forces that went into selecting, stockpiling, approving, purchasing, and shipping products for the Ebola crisis. This map was used to untangle the relationships, regulations, funding, and approval processes related to procurement during an Ebola outbreak. It helped innovators design products that not only addressed the needs of providers delivering urgent medical treatment, but also addressed buyers' purchasing decisions, regulators’ specifications requirements, and donors' objectives in providing aid money.
During the Ebola emergency, procurement agencies and implementing organizations drove most purchasing decisions, relying on suppliers with whom they had existing relationships. While donors funded product purchases, they ultimately left purchasing decisions to buyers with more insight into the on-the-ground requirements of emergency responders. With implementing organizations such as the MSF, ICF and IMC, on-the-ground product needs were highly unpredictable, often requiring suppliers to quickly ramp up and scale down manufacturing capacity. To add complexity to production, suppliers had to to make adjustments to their products in real-time as product guidelines evolved quickly over the course of the crisis. These extreme circumstances for production cycles and product changes made it extremely hard during a crisis for a new innovator to enter the market. The“business-as-usual” market offers a more standardized path to market entry, but a fairly small market as they do not invest heavily in building up a stockpile of emergency preparedness reserves.
This procurement map was developed using a collaborative and participatory process. It provides a broad view of the purchasing ecosystem highlighting a set of pre-defined feedback loops. This information can be used to define a better strategy for market entry by understanding how demand is impacted in a time of crisis. It can also be used to inform design by seeking out feedback from the right users and opinion leaders, and effectively build partnerships for pilots to increase credibility with leading relief agencies like MSF.
At the conclusion of a product review, it was recommended that the EpiTent undergo value engineering, which includes new design configurations and material selection to improve temperature performance and cost reduction, as well as manufacturing recommendations. The Makerere University team was also supported in the development of a near-term product strategy, a funding strategy, and an organizational structure, which can lead to pilots for market validation and initial sales.
IPP partnered with Kappler to redesign personal protective equipment for healthcare workers that is easier to don and doff, improves visibility during use, and is a better integrated protective gear system. In addition to providing increased protection and comfort for healthcare workers, the design improvements also enable workers to form better connections with and take better care of their patients. While the product was undergoing performance testing with an established third party validation company, it had not been tested with healthcare workers in West Africa. Product usability feedback on the suit was gathered in Sierra Leone with hospital officials, Ebola survivors, burial attendants, doctors, and nurses. This user feedback, focusing on unique suit features, was used in conjunction with cost drivers to guide the next iteration of and improved product.
3. mHero is a two-way mobile phone-based communication system that connects Ministries of Health to health workers.
This open-source communications platform is a technology that has the ability to give a direct line of visibility to central decision makers in the Ministry of Health to the frontlines, enabling rapid response to health workers’ needs. mHero has been adopted by several Ministries of Health, and with the support of USAID through IntraHealth International, these Ministries of Health have integrated mHero into their health information system architecture. mHero has been scaled furthest in Liberia where the Ministry of Health has implemented mHero since the Ebola Outbreak in 2014. Through a research activity in Liberia, a design guide was developed to help the Ministry of Health in Liberia and IntraHealth chart mHero’s current process and describe key use cases for information flows so that the Ministry can improve the effectiveness and expand the use of mHero in their health system.
Full mHero case study (COMING SOON)
4. The Emergency Smart Pod (Baylor College of Medicine) is a fully-disinfectable emergency care unit that can be rapidly deployed in a state of crisis.
Since the Emergency Smart Pod started as a concept, Baylor College of Medicine spent much of their award prototyping a physical structure with a contract manufacturer. This project worked with Baylor to look at the Global Health Security Agenda as an opportunity for new use cases for semi-permanent structures, estimate market potential, and conduct a competitive product scan. We supported the team in defining the value proposition and core feature set. With interest from Guinea’s Ministry of Health to use the pod in Guinea for border control; a roadmap was developed during a workshop with key stakeholders in Guinea to begin to understand roles and responsibilities of each group once the pod arrives in country.
5. Highlight (Kinnos): is a patent-pending, powdered color additive for disinfectants that fades over time to help human error in sterilization processes.
As a newly formed venture with a great core technology, Kinnos looked to find a way to define use cases and market opportunity for the technology application to build their business. This project worked with Kinnos to evaluate and prioritize markets in terms of customers and geographies which would have implications for new product development, and on how to strategically develop their product portfolio. Once we supported them in choosing a pathway, a 1-year implementation roadmap and supporting financial model was developed.
6. DripAssist (Shift Labs) is an infusion rate monitor that continuously tracks gravity IV flow rate and volume.
The DripAssist Infusion Rate Monitor has the ability to monitor patient hydration and medication dosing, which is particularly useful for pediatric and elderly patients. Shift Labs had achieved initial sales, and was looking to develop a scaling strategy. To begin, high potential markets were prioritized based on potential market size, need, assumed willingness to pay, and enabling environment, and then a go-to-market strategy was developed for a single priority market. The go-to-market strategy identified high potential buyers and key opinion leaders and the project supported outreach to these stakeholders and mapping the regulatory landscape.
7. SteraMist (TOMI Environmental Solutions) is an activated ionized hydrogen peroxide decontaminant.
The technology, which was developed by DARPA and registered approved by the EPA is an aerosol consisting of converted 7.8% Hydrogen Peroxide into a Reactive Oxygen Species (ROS). Registered as a hospital-healthcare technology and successfully deployed throughout the world in many high-end industries; such as biosafety, pharmaceutical, educational research labs and hospitals including field hospitals. TOMI was looking to explore opportunities for SteraMist in epidemic crisis settings and low-income countries. Opportunities were assessed for SteraMist in these markets, a pilot strategy for the target high potential buyer was developed, and concrete next steps were mapped for TOMI to further test product-market fit and generate awareness and demand for their effective solution.