Report

Teaser, summary, work performed and final results

Periodic Reporting for period 1 - Made4You (Open and Inclusive Healthcare for Citizens Based on Digital Fabrication)

Teaser

Digital fabrication labs and maker spaces have emerged across the globe in recent years to become local community hubs for a wide range of Do It Yourself-activities. In parallel, open source information and tools have triggered grassroots solutions in healthcare. Patients...

Summary

Digital fabrication labs and maker spaces have emerged across the globe in recent years to become local community hubs for a wide range of Do It Yourself-activities. In parallel, open source information and tools have triggered grassroots solutions in healthcare. Patients, their families, carers, health professionals and designers started to create personalised ‘open’ healthcare solutions in a bottom-up way. Instead of waiting for public healthcare services to satisfy their needs a growing number of citizens takes action themselves, regardless of national healthcare policies and regulations.

The careables project is building on these scattered initiatives and proposes an open and inclusive approach to healthcare based on digital fabrication, distributed manufacturing and collaborative making. Within careables we aim to link local communities of citizens with disabilities, their families, and healthcare professionals with makers/designers to establish collaboration between these separate communities to develop open-source interventions and solutions, so called “Careables”.

Our current working definition defines a careable as an open solution that aims to improve the quality of life for people with unmet needs or facing physical limitations. Careables are co-designed, replicable, accessible, adjustable, and shareable online, using digital technologies. Careables is a new category that promises readily customized solutions and a horizontal and collaborative approach to health and care.

Careables are driven by a methodological commitment towards co-design of ‘open’ healthcare solutions, involving all relevant stakeholders. Key to co-design is that people become creators, not only users of innovation. In our case, patients, their families, healthcare professionals and designers are involved in the co-design process as experts in their specific environments, together with makers, who are experts in the use of digital tools, such as 3D printers, laser cutters, etc. At a global scale we offer a platform for sharing open healthcare solutions, including detailed documentation to facilitate the replication and adaptation of careables.

The specific objectives for the project are to:
● Connect existing communities of makers, engineers and fabricators with communities of citizens (including patients) and healthcare professionals;
● Co-design open healthcare solutions for citizens facing physical disablements, and for healthcare professionals to improve the healthcare services they provide;
● Improve access for citizens to grassroots healthcare solutions via co-design methods and open standard documentation, and provide them the tools to become active innovators;
● Establish a wide user-base open and dedicated platform to share and exchange open healthcare solutions as well as co-design experiences;
● Collect available existing solutions and make them more accessible via open standard documentation on the platform.

Work performed

The project team has shown great commitment during the first 18 months to establish careables as an open and inclusive approach to healthcare, and connecting patients, healthcare professionals and related stakeholders with actors in digital fabrication, distributed manufacturing and collaborative making. An impressive amount of engagement activities has been performed, from co-creation and co-design sessions in fablabs and maker spaces to training activities and presentations in health and care related international events. We have drawn important lessons learned, especially from the close interaction with our users. The technical development for the platform and its related tools for knowledge sharing and documentation has been driven by real user needs and a co-design process from the onset.
The current version of the careables platform includes almost 100 projects that have either been co-designed in careables sessions or that have a strong connection to our aims and have been quality approved for being included in our Open Healthcare Map.
With our dissemination and communication activities we have achieved global visibility.

Final results

An inspiring example has been the co-production and replication of a tricycle for Lorenzo, a 6-year-old who suffers from a complex neurological pathology that makes most daily actions difficult. The patient organisation TogetherToGo teamed up with Milano’s Fablab Opendot to engage in co-design, customization and rapid prototyping to produce a tricycle with reduced cranks, ergonomic saddle, support for the back and adjustable handlebar. The 3D model is customized on Lorenzo, but can be quickly adapted to the needs of other children with different disabilities, using personal digital fabrication. In the Netherlands a replication of Lorenzo’s bike has been made in the Fablab of WAAG society, showing the potential of ‘open’ healthcare solutions.

Another example of a careable available on our platform is a low cost slit lamp, which is a medical device used to diagnose issues with eye health. Currently, slit lamps are large and expensive. They have a very complex structure and although some portable ones are available they are also very expensive. To make slit lamps more accessible, Fracktal Works, an Indian startup in the 3D printing sector, has made a portable slit lamp which can be 3D printed for a low cost and shared the details for replication of the slit lamp, including the 3D print files on our platform. This slit lamp is now reproduced in India and other parts of the Global South.

In implementing this innovative approach towards open DIY health and care careables is concerned with legal and ethical aspects and receives guidance from an expert partner in the legal field. We make sure that we adhere to the requested privacy and data protection laws while co-designing and creating a Careable. Concerning IPRs, it is suggested for makers and designer to consider the adoption of Creative Commons licenses, as most appropriate tools to protect their rights while sharing knowledge on Careables. But when it comes to Tort Law and Liability, establishing roles in the DIY environment becomes difficult due to legal uncertainty in the field. Key considerations stress the fragmentation of the legal requirements in the DIY environment, where makers and designers liability should be evaluated on a case by case basis. To this regard, makers and designers should also verify liability and warranty clauses for Careables to limit, where possible, their liability. Finally, the Medical Device Legislation in its current form, can be rather restricting when it comes to transformative innovations in open health and care.

Website & more info

More info: https://www.careables.org/.