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ReMotion Pro: a prosthetic knee specifically designed for young, active amputees in rural areas.

D-Rev aims to develop a better prosthetic knee to improve access to modern mobility for amputees in rural Africa and Asia.

Photo of Rob Weiss
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What problem does your idea solve?

A 2011 WHO reports suggest 30 million people in low-income regions require prosthetic and orthotic care, and more than 80% do not have access to modern devices. When low-income amputees in Asia and Africa are able to access to a prosthetic knee, the knee joint is usually a simplistic device that does not offer much functionality. Patients are frustrated by the lack of excellent prosthetic devices in their price range, and their clinicians are frustrated by the lack of options they can offer.

Explain your idea

In 2015, D-Rev released the ReMotion Knee, an $80 prosthetic knee designed to meet the basic requirements of low-income patients in an affordable package: simple maintenance, long-lasting build, adjustability, good cosmesis, and modern “polycentric” mobility. ReMotion is currently in 17 countries and we’re thrilled about continuing to expanding access to modern mobility and help clinicians remobilize patients. To scale impact even greater, the ReMotion project aims to design a knee specifically tailored to the needs of active, young rural patients: ReMotion "Pro." Without a great prosthetic limb, amputees are forced to use inappropriate, low-mobility devices such as crutches or staffs, leaving otherwise healthy persons disempowered and stigmatized. Lower-limb amputees living in rural areas need a prosthetic limb that can handle rugged, uneven terrain; they typically don’t have convenient access to transportation systems and are likely to be engaged in physical labor or agriculture. As a result, low-income amputees in fact require a higher level of functionality from their prosthetic limb. Our hypothesis a next generation knee called ReMotion Pro that integrates new features to increase patient confidence navigating rural terrain will fill an important gap and expanding access to mobility in an underserved population. With IDEO’s financial and design support we believe can efficiently design a ReMotion Knee Pro that serves these patients' unique needs.

Who benefits?

Our target user is a young (15-24 year old) transfemoral amputee: a patient who has lost their lower limb above the knee usually in a vehicle accident, but is otherwise healthy and active. These patients are typically of a critical age of entering the workforce, studying for higher education, or seeking a marriage partner. A great prosthetic knee can help reduce stigma by enabling normal-looking gait, make the prosthetic limb cosmetically appealing, and empower the patient to meet life goals.

How is your idea unique?

Currently, no other organization has succeeded in providing high-quality above-knee prostheses to low-income, rural amputees at scale. D-Rev has 6 years engaging on-the-ground with more than 50 prosthetic care organizations across 17+ countries. We have a deep understanding of the prosthetic sector, and are uniquely committed to serving low-income patients with excellent product design. User-obsessed design is in D-Rev’s DNA. D-Rev is uniquely focused on end-to-end design that endeavors to ensure the product gets to the people who can benefit from it. With the ReMotion project we’ve built the supply chains – relationships with manufacturing and logistics partners; a network of prosthetic clinic partners in 17 countries – to deliver at scale. D-Rev is a very small, nimble team. Despite our size, since 2009 D-Rev has brought 5 medical devices to market across two health areas in 50 countries. Our model relies on partnerships, such as is proposed with IDEO, to succeed.

Tell us more about you

D-Rev is a non-profit in San Francisco that exists to design affordable, high-quality medical devices to tackle health issues that disproportionately affect the poor. Our products scale via the market with direct sales and sales through distributors. The ReMotion Knee, an $80 modern prosthetic knee designed at D-Rev, launched in 2016 and has been sold in 17+ countries. D-Rev is a Tech Awards Laureate, and has been recognized by the World Economic Forum as a Technology Pioneer.

What are some of your unanswered questions about the idea?

The technical risk involved in adding new features keeps us up at night, which is one reason we would hugely benefit from working with IDEO designers. The question of how much redesign is involved in adding priority features, and what technical trade-offs may be required, is an unknown. Frequently, changing the design to improve one feature can impact another feature; for example, increasing extension assist force to help amputees feel more stable can also increase the amount of unwanted noise heard upon extension. Leveraging IDEO’s extensive experience across the design process will result in a better knee reaching high-need amputees faster, as well as learnings that we can integrate into other product development across D-Rev.

Where will your idea be implemented?

  • Bangladesh
  • Burma
  • Kenya
  • Nepal
  • Rwanda
  • South Africa

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • I've worked in a sector related to my idea for more than a year.

Organizational Status

  • We are a registered non-profit, charity, NGO, or community-based organization.

Idea Maturity

  • Prototyping: I have done some small tests with prospective users to continue developing my idea.

How has your idea changed based on feedback?

An OpenIDEO community member posted about Bespoke Innovations, a company empowering patients to custom design their own cosmetic coverings for their prostheses - resulting in intricate designs reflecting their unique personalities and goals. Although at D-Rev we design our products based on feedback from users, because medical devices are regulated, we sometimes feel it's hard to give too much "creative control" to the end-users. Yet, here was a company that put the end-user customizations radically at the center of its model. How could an analogous concept work for ReMotion Pro – could we give the user more choice? One possibility is making the knee's features modular, allowing the customer to customer order a knee with the features they want, like a locking mechanism, and subtract the ones they don’t. That would also give us excellent data on what features are important to clinicians and patients that we could use to further optimize the product.

Who will implement this idea?

Two San Francisco-based staff would be devoted to this idea, a product manager and an R&D engineer. The role of the product manager is to participate in need-finding, manage the design process, and liaise with partners. The R&D engineer's role is to participate in need-finding, feature selection, and concept generation. The D-Rev team would aim to hire a person in one key market in order to maintain close relationships with end-users and allow us to rapidly obtain feedback on prototypes.

Using a human-centered design approach, you may uncover insights that lead to small or foundational changes to your organization’s existing strategy or processes in order to unlock the potential of your idea. How would your organization go about making such changes?

D-Rev is an unusually horizontal organization; seeking new ways of thinking is built into our DNA (one core value is "improve"). D-Rev staff regularly give presentations on new ideas; team members at every level of seniority are encouraged to implement new processes and strategies with input and support from their colleagues. In my 4 years at D-Rev, I've had the opportunity to introduce new strategies around how we release products to market; other colleagues have taken initiative to revamp our onboarding process; introduce project planning tools, and co-develop and implement our rigorous quality system. This is one of the reasons we're excited about Amplify - what the Mobility team learns about HCD will be shared with intellectually curious, eager-to-learn, folks across D-Rev!

What is it that most attracted you to Amplify instead of a more traditional funding model?

Amplify was attractive for two primary reasons. This challenge offered a source of funding uniquely aligned with our goal of empowering persons with physical disabilities using innovative technology. Just as importantly, Amplify offered an opportunity to partner with IDEO as a "force multiplier" to help us make a more impactful product, and to bring the HCD methodology more deeply into our culture. We are excited to work side-by-side with IDEO designers and effect long-term change at D-Rev.

What challenges do your end-users face? (1) What is the biggest challenge that your end-users face on a day-to-day, individual level? (2) What is the biggest systems-level challenge that affects your end-users?

On an individual level, our end-users (young, active amputees) report facing difficulties getting back to normal life. This means that schooling is disrupted; they have trouble convincing employers of their abilities; feel like it's harder to attract a partner in marriage, and even just simple things we take for granted like riding a bike or dancing. At a systems level, there's a difficulty in accessing great prosthetic care - meaning the prosthetic limb itself, and the accompanying rehabilitation support - that's nearby and affordable. Far too frequently we hear from patients that they've journeyed tens or even hundreds of kilometers to find prosthetic care in their price range; even then, their options are more limited than they would like.

Tell us about your vision for this project: (1) share one sentence about the impact you would like to see from this project in five years and (2) what is the biggest question you need to answer to get there?

I: By 2019, we aim for more than 5,000 amputees to be remobilized with ReMotion Knee. By 2020, we aim to release ReMotion Pro device that helps improve the patient's experience. Q: How do we take a quantitative goal (# of amputee patients remobilized) and deepen it to reflect the quality of that mobility achieved? How might we measure impact both by with quantitative methodologies like Amputee Mobility Predictor (AMP) and quality-of-life indicators to reflect changes in health and well-being

How long have you and your colleagues been working on this idea together?

  • More than 2 years

How many of your team’s paid, full-time staff are currently based in the location where the beneficiaries of your proposed idea live?

  • No paid, full-time staff

Is your organization registered in the country you intend to implement your idea in?

  • We are a registered entity, but not in the country in which we plan to implement our idea.

My organization's operational budget for 2016 was:

  • Above $1,000,000 USD

If your team/idea/organization has a website, please share the URL below.


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Photo of Shihao Song

Hi Rob, Very happy to see your contribution. i hope your project can be perfected. disable people can run and think with us, it's a good aim!

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