08/28 Spencer Moros (Updated 09/03)

Blog #1 Spencer Moros

While trying to develop a low-cost syringe for the developing world context, you (the designer) hit a cross-roads. Constructing the syringe to auto-disable after a single use, an important safety feature, significantly adds to the cost of the design – making it potentially unaffordable for some hospitals and clinics. However, if you don’t add the safety feature, you are enabling the potential for the spread of disease. How do you as a designer proceed?

A syringe with a the auto-retraction safety feature protects those who are uninfected which slows the spread of the disease, however this is a costly feature.

The stakeholders of such a situation are the hospital + healthcare providers who are conducting tests and are directly at risk by providing testing, and community + individuals who are receiving the tests to inform them what precautions they should take or what treatments are appropriate. By implementing a retractable needle the healthcare providers benefit in that they do not contract the disease and the hospital benefits because the personnel can continue to provide care instead of becoming a patient and further taxing the hospital infrastructure. The communities benefit because they may be able to administer the tests themselves better preparing them to take precautions or get treatments, and there would be less stigma around being tested for fear of spreading the disease to others who are conducting the tests. A third party is the government because investing in the auto-retracting technology can reduce the spread of disease which thereby allows for the reallocation of funds to other essential areas.

Solutions:

  1. Subsidize costs to lower income hospitals by increasing costs to well-funded hospitals.
  2. Base the distribution of auto-retracting needles off of the training of the healthcare professionals.
  3. Provide trainings to lower-income using collaborative program with higher-equipped facilities.

Pros/Cons

  1. Pros: Reduce costs for lower-funded hospitals, Less concerns about wider distribution of needles Cons: Well-funded hospital personnel are at higher risk – not everyone may have the same training at the more well-funded hospital (possible less funded facilities have personnel with better training), unable to purchase same quantity as what could be purchased at lower price point (more funded hospitals most likely serve a greater number of individuals in more urban environment), distributing to less-funded facilities may only improve geographical coverage area – more efficient to increase coverage of people
  2. Pros: Giving personnel the proper equipment based on training helps to prevent accidental sticks Cons: “Better” trained individuals at higher risk and training may not have went over proper use and disposal of needles, losing a more highly trained provider is a much greater loss to the healthcare system
  3. Pros: Well equipped facilities have more outreach, Increase training of healthcare personnel in less-equipped environments, Lower risk of accidental sticks Cons: Need to compensate trainers to go out to other facilities, although training will decrease probability of sticks equipment such as sharps containers and gloves may not be accessible thereby decreasing the impact of such training

As an Emergency Medical Technician I have seen first hand the difficulty of a similar situation. Epi-Pens have a proprietary auto-retracting needle, which leads to an exorbitantly high cost. However, this cost has proven to be worth it in life-threatening allergic reactions. Laypeople are unable to properly draw up epinephrine and administer it, using an Epi-Pen this issue is solved. It has enabled many to provide emergency care before paramedics are able to arrive and saved countless lives.

 

My personal experience has given me reason to believe the best solution is to raise costs to more well-funded hospitals in order to subsidize the costs to the less-trained and funded facilities. By doing so, those are not trained can still provide care in a manner which eliminates or at least minimizes their risk of being exposed to a blood borne disease. Getting proper equipment in the hands of the greatest number of people will result in the greatest impact, while also mitigating the risks.

 

By implementing this venture the society’s technological level will be raised and hopefully the social stigma around seeking or providing treatment due to the fear of spreading the disease will be solved.

 

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