Science and Technology Research Institutes

D-REV DESIGN FOR THE OTHER NINETY PERCENT

Design & Deliver

aka D-Rev   |   San Francisco, CA   |  www.d-rev.org

Mission

D-Rev exists to design and deliver affordable medical technologies that close the quality healthcare gap for under-served populations.

Ruling year info

2008

Principal Officer

Krista Donaldson

Main address

695 Minnesota Street

San Francisco, CA 94107 USA

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EIN

26-0642778

Cause area (NTEE code) info

Engineering and Technology Research, Services (U40)

International Development, Relief Services (Q30)

Nonprofit Management (S50)

IRS filing requirement

This organization is required to file an IRS Form 990 or 990-EZ.

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Communication

Programs and results

What we aim to solve

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Our programs

SOURCE: Self-reported by organization

What are the organization's current programs, how do they measure success, and who do the programs serve?

Brilliance

Severe jaundice affects 12% of newborns worldwide and is the number one reason why babies are admitted to hospitals. It’s barely an issue in the West, but a combination of factors in developing countries, including lack of access to medical care, inadequate infrastructure, and ineffective education, diagnosis, and treatment, results in a high level of easily preventable brain damages and deaths from severe jaundice. Existing treatment devices are often ineffective and have prohibitively high maintenance costs, or are maladapted to inconsistent electricity supplies prevalent in low-resource countries. Brilliance, an affordable, world-class phototherapy device targeted at low-resource urban and peri-urban hospitals and clinics serving people living on less than $4 per day, addresses these design challenges and provides effective, efficient, and environment-appropriate phototherapy treatment for $400, 1/10 the cost of comparable Western devices.

Population(s) Served
Infants to preschool (under age 5)
People with diseases and illnesses

Globally, over 25 million people lack mobility due to physical impairment. In the developing world, trauma, disease, and natural disasters result in one million new above-knee amputees per year. For patients living on less than $4 per day, modern prosthetics are prohibitively expensive. Through its ReMotion project, D-Rev provides advanced and affordable prostheses to amputees in the developing world, empowering them through mobility and improved livelihoods. Our ReMotion Knee, a polymer-based knee joint for above-knee amputees, delivers gait performance comparable to Western knees that cost more than $4,000 USD, but retails for less than $85. Since 2008, more than 4,500 patients in the developing world have regained mobility with the ReMotion Knee.

Population(s) Served
People with disabilities
General/Unspecified

7% of all newborns—30% of all premature babies—have respiratory distress, and RDS is the major contributor. RDS generally begins immediately after birth and results in nearly 100% mortality if left untreated. The primary cause of these premature deaths is organ failure due to respiratory distress, where the baby is not able to get enough oxygen. As a global society, we have the know-how, technology, and methods to save these children. In the United States, mortality from RDS is less than 2%, yet in India it is 20%. India represents 20% of the world’s live births.2 Quality and contextually-appropriate Continuous Positive Airway Pressure (CPAP) devices can effectively treat almost all of these babies who would otherwise perish. CPAP and other advanced therapies have revolutionized treatment in high-income regions, but India, for example, lags. To close the quality healthcare gap globally, every baby should have access to safe, effective CPAP to treat respiratory distress. At D-Rev, we believe every baby should have the chance to survive and thrive. In developing a game-changing CPAP device, we are designing for needs not just of the patients, but of healthcare practitioners, the hospitals, and their context. D-Rev is designing a next generation CPAP device that leverages advances in medical research and sensor technology to provide superior respiratory support while lessening the burden on already thinly-stretched NICU nursing staff. Our goal is to end newborn deaths from respiratory distress syndrome. We will improve the delivery of respiratory support to newborns, and enable referral hospitals to effectively manage babies with moderate RDS. In doing so, centralized speciality care hospitals will also have greater space and capacity to treat the babies who are the sickest. While D-Rev designs for global scaling, our initial geographic focus is India and East Africa. We want to create a world where hardworking clinicians have the responsive technology they need to save lives. In recognizing and designing for every day challenges of NICUs, we will end the impossible dilemmas several nurses have reported to us that they face every day: deciding to care for one baby at the cost of ignoring another.

Population(s) Served
Infants to preschool (under age 5)
Economically disadvantaged, low-income, and poor people

Pneumonia, diarrhea, and sepsis are together responsible for almost one-third of all under-5 deaths. These and other common infectious diseases are the leading causes of death among children under 5. All of these diseases are preventable and treatable—the technology and know-how exists. In high-income countries, rarely do babies die from them. To achieve the UN’s Sustainable Development Goal 3 we must close this gap by ending preventable deaths of newborns and children under 5 years of age, reducing neonatal and child mortality to 12 and 25 per 1000 live births, respectively. The spread of infections through the air and touch is a major challenge in low-resource hospitals. In many cases, the infection leads to death or disability. Every year, 85 million babies in their first days of life receive formula or animal milk. While formula, also derived from animal milk, offers the potential to save lives when a mom is unable to nurse, it also has a dangerous downside: 14 times increased risk of death. Human breast milk prevents infection in a way that animal milk cannot, helping a baby’s digestive system colonize healthy bacteria, while preventing harmful pathogens from attaching to the stomach lining. Exclusive breastfeeding in the first months of life would save over 800,000 babies each year. D-Rev is working with global partners to develop a suite of user-centric products to support mothers with lactation, and support health professionals to strengthen human milk banking and Lactation Management Centres. D-Rev’s focus is referral hospitals in low-income regions, starting with India and Sub-Saharan Africa. Our fieldwork indicates that 30-50% of babies in neonatal intensive care units (NICUs) require nutritional support, ideally human milk. The reasons why mothers are unable to breastfeed range. Among those we’ve heard: physical separation from their baby, challenges nursing, and/or maternal death in childbirth. Investing in Under 5 Nutrition is already among the most cost effective investments in low resource settings. Within Nutrition, breastfeeding projects provide the highest returns by a factor of 3, $35 per $1 spent.

Population(s) Served
Infants to preschool (under age 5)
Economically disadvantaged, low-income, and poor people

Where we work

Our results

SOURCE: Self-reported by organization

How does this organization measure their results? It's a hard question but an important one.

Number of patients treated

This metric is no longer tracked.
Totals By Year
Population(s) Served

People with diseases and illnesses

Type of Metric

Output - describing our activities and reach

Direction of Success

Increasing

Context Notes

Unique number of patients treated by D-Rev devices each year.

Averted DALYs (disability adjusted life years)

This metric is no longer tracked.
Totals By Year
Population(s) Served

People with diseases and illnesses

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Increasing

Context Notes

Number of years of healthy life made possible through the use of D-Rev devices.

Our Sustainable Development Goals

SOURCE: Self-reported by organization

Learn more about Sustainable Development Goals.

Charting impact

SOURCE: Self-reported by organization

Five powerful questions that require reflection about what really matters - results.

What is the organization aiming to accomplish?

At D-Rev, we are struck by the paradox of world-class designers and engineers who can create artificial limbs high-tech and robust enough for amputees to compete in the Olympic Games, while amputees in India and much of the world do not have access to prosthetic technology sophisticated enough to endure daily walks around their village or to participate in family meals squatting on the floor. <br/><br/>D-Rev, a nonprofit product company, believes all people deserve products that can improve their lives regardless of their gender, age, or purchasing capacity. We develop products that improve the health and increase the incomes of people at the base of the pyramid (BOP) – ensuring that no matter where you were born you have access to the world’s best technologies. D-Rev drives the whole design process: identifying the need, designing a solution, delivering the product to target users, and scaling the solution to achieve impact. We don’t design products for poor people – we design world-class, affordable devices for people who need them. <br/><br/>We currently have several products in development, but our priorities are the ReMotion Knee, a high-performance, radically affordable knee joint for above-knee amputees; and Brilliance and Comet, two phototherapy devices that use blue light phototherapy to treat life-threatening jaundice in newborns in developing countries. <br/><br/>D-Rev develops solutions to address the needs of people in the developing world that are frequently overlooked or undervalued. Too often, people concerned with international development or global health direct their efforts toward solving the world’s biggest health problems and neglect diseases like jaundice – which are so easily treatable that it is easy to ignore the access gap that leaves nearly six million babies at risk each year. <br/><br/>And in the West, we often think that excess supply, such as overstock or used prosthetic legs, will be helpful when donated to low-income amputees without realizing the harm it will cause. Donated devices were not designed for the context where they end up, receiving institutions often aren’t educated on device specifics, and replacement parts are near impossible to come by. D-Rev designs sustainable, tailor-fit solutions to these problems. <br/><br/>D-Rev designs and develops products that have the potential to create measurable, data-driven, positive impact on people at the BOP. Our products are currently in use in Colombia, Ecuador, Fiji, Guatemala, India, Indonesia, Iraq, Liberia, Malawi, Pakistan, Philippines, Senegal, Sri Lanka, Tanzania, and Uganda.

At D-Rev we design and deliver affordable products that address needs in the developing world. But we don’t stop at creating products; we drive the entire design process from need-finding, prototyping, and design to deliver, manufacturability, scale up, and impact assessment.<br/><br/>We work to ensure that our innovations are not only designed well, but that they reach their target users. At D-Rev we design not just for our intended end-users, but for every person that our products touch. ReMotion Knee patients get the mobility they need, nurses learn to be savvy in operating our phototherapy devices, and hospitals and clinics purchase our products at a reasonable value. We also view patients’ families, service technicians, purchasing decision makers, even salespeople and manufacturing staff are important customers whose needs need to be considered in the design process.<br/><br/>D-Rev believes a market-based approach to product development is challenging but critical. We know it is not enough to just design a product, but to ensure it reaches people. To do this we offer products for purchase – not relying on donations. After a product is ready for sale, we leverage established local markets, working closely with suppliers, manufacturers and distributors to ensure that our products are fully integrated into delivery channels that bring them to places where they are needed. <br/><br/>For our Neonatal Jaundice line of products we work with Phoenix Medical Systems, the largest manufacturer of neonatal equipment in India. Brilliance became commercially available in India in November 2012 and has since taken off around the world. More than 200 units have been sold; we estimate that more than 10,000 babies have been treated with Brilliance. In 2014 we will continue to scale Brilliance phototherapy to hospitals around the world and develop Brilliance 2.0 which takes the lessons we have learned from doctors and nurses, manufacturers and distributors and improves on the life-saving power of Brilliance. We will also conduct field trials for Comet, a phototherapy lamp designed for the most rural of areas, whose babies still require jaundice treatment. <br/><br/>To scale the first version of the ReMotion Knee we partner with the JaipurFoot Organization, the largest supplier and distributor of prosthetics in India, for clinical fitting and critical user feedback. JaipurFoot currently uses ReMotion v1 to treat its patients in 22 clinics in India and has fitted over 5,000 amputees. In 2014 we will launch the ReMotion Knee v3 onto the market for worldwide production, distribution, and scale. ReMotion will retail at $80, or 1/10th of the price of comparable knee joints.

D-Rev is composed of a world-class, talented team of engineers, designers, and business professionals. Krista Donaldson, Ph.D., is D-Rev’s CEO. She has driven innovation for over 15 years in product design, engineering, and international development. Because of her leadership of D-Rev, she has been named to the Silicon Valley 40 Under 40, Fast Company’s Co. Design 50 Designers Shaping the Future, and the Public Interest Design 100. She was also a TEDxStanford, TEDWomen, and a Clinton Global Initiative speaker, 2010-2012 Rainer Arnhold Fellow, and 2011 Pop! Tech Social Innovation Fellow. <br/><br/>Dr. Donaldson oversees a talented team, including: Randy Schwemmin, Director of Technical Operations; Vinesh Narayan, ReMotion Knee Product Manager; AJ Viola, Neonatal Jaundice Initiative Product Manager; Garrett Spiegel, Comet Product Manager; Samuel Hamner, Design Engineer; Michael Hong, R&D Engineer; Sara Tollefson, Director of Impact; and Nicole Rappin, Operations Manager.<br/><br/>D-Rev is structured as a non-profit, but operates product delivery similarly to a for-profit technology firm. D-Rev relies on grant funding and earned revenue from product sales through licensing and royalty agreements to cover R&D, design, and development costs. Once a product launches commercially, it sells and scales profitably through build-in profit margins without outside support. We re-invest profits from product sales in R&D for new products and impact assessment

D-Rev is committed to measuring our impact in real-time and using the information we gather to improve our products. Publishing our impact data gets our supporters, peers, and the general public to take action. It also allows us to be transparent about our achievements and challenges. <br/><br/>We decide on quantitative and qualitative indicators to assess our progress toward intended outcomes. We integrate impact collection into our designs themselves. We outfitted Brilliance with an internal counter that tracks the total time that the phototherapy device has been turned on. People can view this information on a built-in LCD screen. We also added a reset button and instructed doctors and nurses to use this button each time they begin treatment with a new baby. We collect data using multiple methods: calling doctors or nurses who use the device, visiting hospitals and clinics and interviewing medical professionals who know the product’s performance, and sending SMS to harder-to-reach rural hospitals. We measure our impact using three main data points: total babies treated with Brilliance, number of babies treated who otherwise would not have received effective treatment, and deaths and disabilities averted because of the treatment received. In our recent data collection, we found that doctors love the device, claiming Brilliance cuts treatment time in half and lowers hospital operational costs with its energy-efficient LED bulbs. [For more information on our methodology see: http://blog.d-rev.org/2013/03/19/how-we-collect-brilliance-impact-data-and-why/]<br/><br/>For the ReMotion Knee, we collect data with help from JaipurFoot Organization and we are currently running our own in-depth field trials with over 100 amputees at 4 clinical sites in Guatemala, India, and Indonesia. We focus on the number of amputees fit with the ReMotion Knee, the compliance rate (the percentage of amputees that are wearing the knee 6 months after being fit), the satisfaction rate, and the failure rate. [For more information on the field trials see: http://blog.d-rev.org/2013/12/03/a-person-first-a-data-point-second/]<br/><br/>Data collection is not simple. It can be challenging to convince doctors and nurses with compelling priorities and tight schedules to build a habit around collecting data and commit to a focus on positive outcomes. We are currently exploring how to best connect with partners in the field to extract data stored in the devices and gain an understanding of patient feedback and experience. We plan to employ the best method that will work best for medical professionals without taking much of their time away from their own jobs.

Since Dr. Donaldson took over the leadership and management of D-Rev in 2009, we have achieved significant progress in meeting our goals and intended impact. In 2012 we successfully launched a life-changing medical device on the market, Brilliance, and we are on our way to bringing another top quality product, the ReMotion Knee v3, to market in 2014. <br/><br/>Since the launch of Brilliance, more than 10,000 babies have been treated with the phototherapy device; more than 8,000 babies have been treated who otherwise who would not have received effective treatment; and over 200 newborn deaths and disabilities have been averted. We have also developed the ReMotion Knee v3 for global prosthetic markets. Through our partnership with JaipurFoot Organization, we have fit more than 5,000 amputees with the ReMotion Knee v1 in India, Sri Lanka, Iraq, Ecuador, Senegal and Fiji. Of these patients, 79% are still wearing their prostheses compared to 65% in a patient study on a previous knee model used by JaipurFoot; and 95% of patients report no failures in ReMotion Knees.<br/><br/>D-Rev’s innovative mission, products, results and leadership have been recognized by a number of leading organizations in the field. D-Rev was named 2014 World Economic Forum Technology Pioneer and as the 25th “World’s Most Innovative Companies” by Fast Company in 2013. Our ReMotion Knee won the Proto Labs Cool Idea Award in 2012, the Stanford BASES Challenge for business models that create a positive social or environmental impact, and the University of California-Berkeley Haas Global Social Venture Competition (GSVC) 2010. Comet, our portable phototherapy device, won a USAID Saving Lives at Birth award in 2012.

Financials

D-REV DESIGN FOR THE OTHER NINETY PERCENT
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Operations

The people, governance practices, and partners that make the organization tick.

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D-REV DESIGN FOR THE OTHER NINETY PERCENT

Board of directors
as of 4/17/2020
SOURCE: Self-reported by organization
Board chair

Bill Unger

D-Rev

Bill Unger

D-Rev

Jenn Buechel

Guardant Health

Stephanie Dodson

Draper Richards Kaplan Foundation

Tony MacDonald

Samasource Inc

Minette Norman

Autodesk

Keywords

social entrepreneurship, international development, technology incubator, health and income, bottom of the pyramid