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Defining a new way of thinking: Slower decisions could result in better medical devices

This post is part of the Biodesign’s Jugaad series following a group of Stanford Biodesign fellows from India. (Jugaad is a Hindi word that means an inexpensive, innovative solution.) The fellows will spend months immersed in the interdisciplinary environment of Stanford Bio-X, learning the Biodesign process of researching clinical needs and prototyping a medical device. The Biodesign program is now in its 14th year, and past fellows have successfully launched 36 companies focused on developing devices for unmet medical needs.

2331754875_e6a2a81429_zIt’s now early April - half way through the six-month fellowship - and the Stanford-India Biodesign fellows are still figuring out what medical need they're going to address during their time at Stanford. On June 8 they'll be revealing prototypes. For many past students in this program, those prototypes have gone on to launch successful companies.

That’s not to say that the fellows are slow, it’s just to say that the Biodesign process the fellows are learning takes time – more time than I, for one, had expected.

I asked the fellows if they thought they would be able to take this painstaking approach into the real world, where people make much faster and often less careful decisions when developing medical devices.

“We hope this will define a new way of thinking,” Debayan Saha, one of the fellows, told me. As a group they also said they were learning a lot about the value of slow decisions.

As an example, they pointed to one of the 35 medical needs still on the “maybe” list, down from more than 300 they had identified during clinical visits. This one had to do with measuring levels of molecules in the blood. At each step, they’d scored the medical needs on their list against a criterion, like the number of people it applied to or the cost of letting that need go untreated. That allowed them to strategically eliminate needs that seemed worth addressing at first blush, but that wouldn’t make business sense.

At each round, this one medical need scored near the top. It had been looking like a real contender for the one they might eventually chose to address.

Then came today, when the fellows were scoring whether other devices already address the need and the cost spent each year if the need wasn’t addressed. That gave them a sense of whether there was a market for any device they might develop. That need, which had seemed so strong, scored low, much to the team’s surprise.

“This had been a favorite but this is the first time we are seeing that it is maybe not a great need,” Shashi Ranjan, PhD, told me. Harsh Sheth, MD, emphasized that in other settings where people make much faster decisions they might have ended up wasting time prototyping a device that would never find a place in the market.

To my eye, this careful approach makes the final selection almost seem inevitable (though not obvious at the outset). The team knows the criteria they have to meet (good market size, few competing devices, no patents standing in the way of eventually marketing their device) and they have a list of options.

From there, it's a matter of slowly assessing which option best fits the criteria, which seems like a lesson that goes well beyond designing medical devices: Choosing health insurance. Buying cars. They are learning a lesson in good decision-making along with how to develop and market devices.

Previously: Following the heart and the mind in biodesignWriting a “very specific sentence” is critical for good biodesign and Stanford-India Biodesign co-founder: Our hope is to “inspire others and create a ripple effect” in India
Photo by John Morgan

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