Saturday, April 7, 2012

A  Reverse, Disruptive Innovation That Does No Harm  But Possibly Helps Lower Leg Conditions
Reverse innovation or trickle-up innovation is a term referring to an innovation seen first, or likely to be used first, in the developing world before spreading to the industrialized world.

A disruptive innovation is an innovation that helps create a new market and value network, and eventually goes on to disrupt an existing market and value network (over a few years or decades), displacing an earlier technology. The term is used in business and technology literature to describe innovations that improve a product or service in ways that the market does not expect, typically first by designing for a different set of consumers in the new market and later by lowering prices in the existing market.


As to diseases make a habit of two things- to help, or at least to do no harm.

(c.460-377BC), Epidemics

April 7, 2012 –  As readers of this blog know,  I am always in search of  simple innovations that lower the cost of care,  offer more efficient and effective care, can be applied  by non-specialized medical personnel  and by patients themselves, and do more good than harm

Examples are use of ultrasound by primary care physicians to evaluate abdominal masses,  aortic aneurysms, and appendicitis in their offices;  nostril dilators to alleviate sleep apnea; and in the developing world  , African mothers  carrying non-refrigerated peanut butter paste laced with vitamins and  essential minerals to save  their starving infants.  

A Blog Joy

One of the joys of writing a blog is the feedback you receive. On March 22, I titled a blog “Lighting the Candle of Innovation i at Obamacare’s 2nd Birthday Party.”

My theme was: It’s better to light a candle than curse the darkness.

As part of the innovation lighting ceremony, for would-be entrepreneurs I suggested these questions to test the viability of a bright idea.
“Ask yourself five questions. Is my idea better than what it’s replacing? Is it compatible with the way people currently do things? Is it simple enough to use? Can I try it small doses? Can I find other people to use it – and watch other people try it out?”

A Few Days Later

A few days later, I received the following email, which I have the sender’s permission to reprint:

"Hi Dr. Reece,

“My name is Tony Phillips. I came across your blog by search the web for some variation of ‘healthcare innovation’ and/or "medical devices."
“The reason that I am sending you this email is that you live in Connecticut. I live in Suffield.”

“If you have any interest, please let me know what you think about my healthcare innovation.”
“It can be very frustrating, at times, being the inventor of an American "Reverse Innovation," especially  in healthcare.”

Here is how I explain why my device, called Vaso-wraps®, may be useful for treating common leg problems  caused by  poor circulation of the legs, I conceived and patented these leg wraps,  and they have  received FDA approval as a type I device Vaso-wraps®  are being used in VA hospitals here in Connecticut” and in wound-healing clinics who treat arterial or venous disorders,  the most common of which is non-healing diabetic leg ulcers.”
One of the most common and important complications of diabetes that harm people who have poor or inadequate circulation in the lower extremities.”
“Eighty-five percent of lower extremity amputations in the US are preceded by ischemic diabetic ulcers.”
“The human body’s physiological response to warmth is vasodilatation. This is basic
“Vasodilatation, which is the widening of blood vessels, increases circulation or blood flow in the area warmed.”
“Currently, people who have diabetes and suffer from cold legs, which often indicates poor circulation, are repeatedly warned not to use electric blankets, heating pads, or hot water bottles to warm their lower extremities. This is because they may burn themselves. “

“Unfortunately, the people with diabetes and poor circulation are deprived the circulatory benefits of vasodilatation.”
“Vaso-Wraps® are indicated for Safe Warmth. There are NO electrical wires or heating elements that might burn a person. Diabetics can safely SLEEP all night in Vaso-Wraps®.”
“Vaso-Wraps® are made of custom quilted nylon and wrap quickly and easily around a limb, usually a lower leg, with Velcro. The thick quilted nylon insulates the warmth of the wearer’s body in just as it keeps colder air out. Most people feel the warmth in seconds.”
“The Safe Warmth provided by Vaso-Wraps® produces SAFE VASODILATATION in the micro-circulatory system in the area where they are worn. In some cases, the collateral micro-circulatory system may provide the vasodilatation.”
“Prolonged Safe Vasodilatation from Safe Warmth, and its associative increase in circulation or blood flow, is a MEDICAL MILESTONE for people with diabetes.”
“This is how Vaso-Wraps® have successfully avoided at least two lower extremity amputations at the VA in West Haven, CT. Both patients had suffered from non-healing ischemic diabetic ulcers.”
“Vaso-Wraps® are patented and FDA Registered, Class 1 medical devices. In addition to being indicated for Safe Warmth, Vaso-Wraps® are also indicated for Limited Protection.”

"There are a number of  other leg problems for which may  invention  may have applications – leg cramps, peripheral arterial disease, Raynaud’s disease, diabetic neuropathy.   The important thing is that these wraps  do no harm  and are praised by patients who have used them. "

Speaking to the Inventor  
I spoke to Mr. Phillips, a 55 year old data processing analyst who once worked for insurance companies . He informed me his simple device had been shown to keep cold legs warm, and even to heal leg ulcers secondary to diabetes, prevent amputations, and alleviate diabetic neuropathy in some patients.
I asked him to send a package containing Vasowraps ® to me, and he did so.
The vascular wraps look simple to me. Each wrap consists of a 20” by 13.5 ” cushioned nylon pad with a strip of Velco on each end. The material reminds me of the 3M Thinsulate product, which is used for thermal warming in gloves and jackets.  I am told these wraps come in multiple colors.
Mr. Phillips’s product meets my criteria for innovation: It as well or better than long stockings.  It is compatible with the way people do things – like wearing them during sleep or under trousers  during the day. It is simple to use- wrapping it around one’s legs People can try it in small doses – like trying it by wearing it overnight for a couple of nights. You can find other people to try it .  It is affordable,  and if it prevents even  one lower leg amputation, which may run $15,000 to $20,000 , it is worth its modest price.
This is not a solicitation to buy, but rather a comment on a practical, useful, and simple clinical innovation
That’s a wrap.

Tweet: Reverse or disruptive innovations are  worth a try, when they do no harm  and address  problems like vascular insufficiency of the legs.

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