Shani Sigman, aged six, wanted to paint like all the other children, but her ability to move her hands is limited because of cerebral palsy. Recently, a device specially developed for her has allowed Shani to raise her hands to the height of the page, enabling her to paint with minimal movement. This product was developed at a hackathon run by TOM (Tikkun Olam Makers), which was founded in Israel and has since gone global. And, like all products developed at the association's events, it was developed by volunteers. Whoever helps one person is as though they had helped the entire world, to paraphrase the rabbis, but does help like this scale?
TOM founder and president Gidi Grinstein believes this is the only scalable approach to developing devices for people with disabilities. Development of off-the-shelf products by venture-backed companies sets profit targets and revenue levels the disability market simply can’t meet, he says. His organization has a goal: to help no less than 250 million people - persons with disabilities, poor people, and the elderly - one at a time.
"TOM was launched in July 2014, but it was preceded by two and a half years of planning and formulating the concept," says Grinstein. "Our goal was to address a systemic problem that exists around the world, which is that some sectors are excluded from the innovation and invention processes. They’re excluded because they have no purchasing power, and they have no purchasing power for several reasons: either their situation is too niche, or their situation is similar to that of others but still needs a very customized product.
"In entrepreneurship and venture capital, the incentive is to build unicorns, where one company’s success makes up for others' failures. That’s why these companies have to cover a broad market. That’s how the business is structured. But there’s a long tail of needs the market doesn’t meet - the solutions are either too expensive or insufficient."
Is this basically the market failure you identified when you set up TOM?
"It's not a market failure, because the market, as far as it’s concerned, is working. When you have a product with low demand and a high production cost, the price goes up. We said, let’s try setting up a platform specifically to meet the needs of the people at the base of the pyramid."
According to Grinstein, no one knows what those people requiring a specialized medical device actually need. "Statistics count disabled people as a uniform bloc, but we don’t know the amount or type of needs that exist, because a person with a disability usually has more than one need, and no one has ever done market research on it, because as I mentioned, there is no market."
The goal: 2,500 products in a library
To meet the needs of so many, Grinstein says, TOM begins by identifying the need of one person, and convenes a maker event for volunteers tasked with finding an inexpensive and not very complicated solution.
"These solutions exist. We just need creative people to meet the person in need, listen to them, and apply their capabilities. But we don’t end up creating a product for one person. The goal is to provide a million products. So, we build a product portfolio for each product, and file it in our product library. The library contains clear and simple instruction sheets that explain how to manufacture the product. We expect this library to contain up to 2,500 products in the future, and we’ve already started building it. Today, we have 50 portfolios for finished products and hundreds for prototypes.
"Now, someone else in the world with the same disability can search and see if the library has a solution to their problem. They can take the product portfolio to a maker, paid or volunteer, where they live, and that person can make it. Our intention is to build a product portfolio that will allow a person who isn’t necessarily an expert in medical devices to make a product to order easily, including whatever customization the end consumer requires. This way, we save on the price differences between different countries and shipping costs. People can even manufacture for their family members, or in some cases, for themselves."
If someone can't find a relevant product in the library, they can suggest the need for the next hackathon. TOM has built a network of communities that regularly donate their time to developing new products. The organization has also written a playbook detailing the process of development at the hackathons, a model used by all TOM communities. Other organizations around the world can also incorporate this process, and develop products for people living in their regions.
The potential of the universities
Grinstein offers an example of the development process. "A team of students at Shenkar developed a prosthesis that allowed a girl named Yael whose hand had been amputated to play the violin. But this product didn’t start with the violin. It was because of a handless disabled veteran named Noam who wanted to cook and use a knife and fork. He couldn’t do this with the very expensive prosthetic he’d been given by the Ministry of Defense. Meanwhile, in Singapore we met a handless fellow named Boon, who desperately wanted to go to the bathroom by himself. After the team working on Noam's product uploaded it to the library, the team of volunteers working on Boon's problem based their solution on that, and the team that developed Yael’s product based it on both.
"Production of this product today costs $60, and that’s written in the product portfolio as well. If you bring it to a local maker, I don’t care if they charge $120. But if they try to charge $1,000, that’s already theft."
You rely heavily on volunteers. It is possible to execute a scale-up based on large amounts of goodwill?
"So far, we haven’t encountered a shortage of volunteers. Quite the opposite. People are eager to contribute their talent and creativity in this way. There’s tremendous potential at the universities as well. Engineering and product design students have to do projects anyway. Every year, there are 1,500-2,000 student projects taking place- and that’s in Israel alone. In the US, there are 850 campuses for engineering and product design doing 50,000 projects a year, and 99% of them go nowhere. Nothing happens with them, which is also kind of frustrating for the students.
"When we present to them a real need for a real person, we significantly increase the chance that at least one person will use what they’ve developed or produced, and maybe many people will. Our product portfolio is so detailed and simple, a tenth grader at a technological-vocational school could make most of them.
"TOM is a very social enterprise, but it’s also an almost libertarian enterprise in that it relies on small units, small communities, and doesn’t use too many market resources."
In essence, you've founded a volunteer organization instead of a market that could bring in billions of dollars?
"No, because this market couldn’t sustain itself. Our products aren’t the sort a commercial manufacturer makes. They don’t always look lovely."
A world of mass customization
Various entities involved in care of the disabled and elderly around the world have set up product development initiatives, but Grinstein says, "The problem is they don’t always have the ability to take the process all the way to the end, and their desire to profit - on behalf of their institution, which is absolutely acceptable - raises prices in a way that excludes users. Some institutions also compete with each other, and then they develop the same products over and over again. I really don’t think there’s a solution to this issue within the market. Perhaps yes for, and there are products for the disabled on the market, but not for most of the needs or most of the consumers."
Still, says Grinstein, "We’re not sure what revenue model will enable this venture to keep going over time, but we produce a great deal of value, so there must also be a revenue model somewhere. We’ll never be mass market, but I do envision a world of mass customization, in which the disabled sector is just the pilot. The market often doesn’t provide solutions for the elderly or the poor. We want to produce radically accessible, radically inexpensive solutions. It’s got to happen, it's the future, and the only question is whether it will really be us or someone else."
ALYN Hospital Director-General: Investors are beginning to take an interest in the assistive technologies market
Dr. Maurit Beeri, Director-General of ALYN Hospital, a rehabilitation center for children with severe disabilities, says the market for assistive technologies for young people with disabilities is expanding, and a larger market is being created for commercial products in this area, alongside customized products like TOM's.
"We’ve established ALYNnovation for the development of commercial products, and also the PELE center, which offers customized solutions to specific problems.
"The problem with one-off products is safety standards. That’s a legal and development issue. Another challenge is what to do if the product breaks down. Just try to find the person who made it."
Beeri has observed a change in the purchasing power among people with disabilities that could change the commercial market for these products. "Today, more people with disabilities are entering the labor market, and their purchasing power is rising. And, as the population ages, there are more people who’ve saved up a bit of capital and they have special needs, too.
"The solution may be to produce products that are relevant both to disabled people and to the wider market, such as a speech-to-text app suitable for a child and a grandmother."
In the wake of these changes, Beeri says, investors are also beginning to show interest. "Funds that rejected proposals a few years ago saying 'This isn’t our field' are now re-examining the possibilities."
Published by Globes, Israel business news - en.globes.co.il - on December 9, 2021.
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