Distributed Design for Distributed Care
How is distributed design being used to enhance the performance of products that have a direct effect on our health and wellbeing?
Last updated
Was this helpful?
How is distributed design being used to enhance the performance of products that have a direct effect on our health and wellbeing?
Last updated
Was this helpful?
By Massimo Bianchini and Stefano Maffei, Polifactory, Department of Design, Politecnico di Milano
Why should a project that promotes the creativity of European designers, makers and Fab Labs be concerned with care and well-being? Because in the last decade, in Europe, a growing number of designers, makers and Fab Labs are developing a professional and scientific interest and experiences in designing and materializing solutions for care and well-being. Talking about “distributed design for health and well-being” basically means to design open source solutions that have three aspects in common. First, we talk about solutions created by designers, makers and indie innovators directly involve users and specialists. Second, we talk about solutions materialized through the combined use of digital enabling technologies and prototyping spaces. Third, we are talking about digitally accessible and distributed solutions to be implemented on-demand and on-site through digital fabrication platforms and community-based fabrication labs. This emerging field of “open and distributed design-driven innovation” is built thanks to the convergence between products, processes, places and people enabled by the digital transformation. Digital transformation changes the role and perspectives of people in the processes of care or in the performance of daily activities related to their psychophysical well-being. It allowed patients to access and exchange data and information on care, to organize themselves in associations that dialogue with health services and health ministries, to raise funds to develop scientific research, to generate forms of independent innovation (user-driven healthcare and patient innovation). Digital transformation evolves the relationship between the sector of medical-scientific research, the health system and users not only in the field of care, but also in the field of prevention and in lifestyle education. A system that works increasingly personalized on monitoring the body and its physical performance - from daily to extreme ones - and on the generation and exchange of biometric data enabled by interactive personal and environmental devices. Finally, digital transformation increases the possibilities and innovation horizons for designers. The development of e-health and the spread of technologies such as 3D printing in places such as hospitals or prosthetic centers offer new opportunities for creative professionals to design products and services. In parallel, the growth of spaces such as the Fab Labs offers to designers and makers an opportunity to independently materialize solutions to improve the quality of life of people or reducing their physical and cognitive gaps. The digital transformation also defines a new field of opportunity not only for users and patients, designers, and makers but also for service and manufacturing companies, public bodies and institutions. Nowadays, there is a growing demand for smart and personalized healthcare products[2]. User innovation in health and well-being is a more complex process than mass-customization, on-demand manufacturing based on biometric data, or digital participation through apps or social media. In fact, some not standardized solutions need alternatives resources and facilities to be designed, prototyped and distributed: open knowledge and design, open software and hardware, digital fabrication, co-creation processes. These innovation processes are mainly driven by personal interests and motivations or can be focused on collective and social missions and initiatives, because there are not personal solutions in the market or because the existing ones are not economically accessible or don’t provide a concrete answer. Moreover, the development of open source solutions for health and well-being is almost never linear and often is characterized by the aggregation of people with creative and technical skills, organizations such as patient, cultural and sport associations, and healthcare specialists and technicians. This means to develop new communities, alliances and coalitions characterized by a “distributed agency” that operate in a perspective of mission-oriented innovation[3] creating a new potential market with convergent public and private investments.
What precisely concerns distributed design for health and well-being? Basically, we talk about product-service systems solutions that support the autonomy and quality of daily life of aging people, people affected by chronicle and rare diseases, people affected by temporary or permanent disabilities, including their families and caregivers. We are referring to personal objects that support daily actions such as eating, sleeping, walking and washing or activities such as working, cultivating hobbies, and playing sports. In particular:
personal, customizable and wearable prostheses and orthoses, which embed new functions or digital enhancements. These solutions can structurally and functionally integrate the features of orthopedic prostheses with those of fashion clothes and accessories;
prostheses and aids that typically hybridize everyday objects or become add-ons. We talk about "augmented" tableware, furniture and furnishing accessories, sport equipment, and walking aids that can be redesigned by directly integrating the prosthetic or auxiliary component or "parasitic" elements that hack existing objects increasing its usability;
analog and digital tools for personal or environmental monitoring, prevention and health education or objects conceived to reduce physical or cognitive gaps or stimulate training and re-habilitation.
The projects presented in this section tell about these emerging categories. Next Steps, is an experimental DDMP initiative aims to materialize a collection of open source walking aids co-designed by designers, makers and patients: aesthetic and functional add-ons for crutches, IoT devices to augment the mobility of a rollator, and personal 3D printed sticks generated by parametric design. Lorenzo’s bike is a project developed by the Fab Lab Opendot with TogheterToGo Foundation and is the result of a co-design process that involved a child, his family and some therapists and use digital fabrication to create a personal object to support rehabilitation. Mole Mapper is a small tool to monitoring skin health developed by three Italian researchers in design – Ilaria Vitali, Mila Stepanovic and Patrizia Bolzan – using laser cut scraps. It is a part of FabCare, a DDMP initiative developed by the Fab Lab Polifactory with Centro Medico Santagostino in order to design a collection of open source non-medical devices conceived for skin and blood oxygen monitoring, breast cancer prevention. Finally, Digitally Speaking created by Indian designers Nidhi Mittal and Avik Duphar is a smart underwear equipped with safety tech to address the issue of women safety across the globe.
What we learn from these experiences, exactly? Distributed Design for care and well-being evidences positive characteristics and some critical aspects, but also reveals promising innovation directions. Not only medical devices. Distributed design promotes and stimulates the biodiversity of solutions, exploring the theme of prosthetics, orthoses, aids not only and no longer as medical devices but as new generation of personal objects. Many solutions, especially in the field of healthcare, are influenced by the regulatory system, which is fundamental to protect and safe users and patients. Certainly, this is a bottleneck for distributed design, but it is also and opportunity. In fact, the development of non-medical devices can be complementary to the medical ones. Moreover, distributed design can support user innovators in order to create solutions that demonstrate the possibility to reconsider existing rules, standards, and market barriers. Not only functional solutions. Many solutions are designed following functional and technical requirements, while their aesthetic dimensions are as important as working on functional aspects. Many healthcare objects and aids tents to become physical extensions of the people. Aesthetic personalization is important, because characterizes the identity of objects establishing a personal or family feeling with the users. Not only complex and expensive solutions. Many objects and devices are (too) complex and expensive. Distributed design can work to design solutions that can be adapted to objects already available on the market, also considering the replacement with open hardware and low-technologies that are easily accessible and usable both by common users and disadvantaged people. Not only new products. Many objects are unique, not replaceable also because there is a relationship that is established with their users and owners. Distributed design perfectly fits with hacking repairing and upgrading practices and is compatible with re-manufacturing and refurbishing processes.
Finally, distributed design and making require people to question themselves, to overcome their limitations, to do new things or to experiment with new ways of doing things, and above all to take care of what you do. In a certain sense, these activities have therapeutic power, which can be considered as part of the process of care or well-being of people. We are probably at the beginning of an augmented concept of "care" where people can develop a distributed awareness, responsibility and participation in the design of innovative open source solutions that work to take care not only of people but also of other living beings and environment. Distributed design for distributed care.
We can mention national projects like MakeHealth Lab by Waag Society (), MakeToCare by Sanofi Genzyme and Polifactory (www.maketocare.it), Crew by Fondazione Cariplo (progettocrew.it), Hackability (hackability.it) and European research projects like Made4you and its platform careables.org, Open Care (opencare.cc), Digital Social Innovation () and other platforms like patient-innovation.com.
See Christian Weller, RobinKleer and Frank T.Piller (2015). Economic implications of 3D printing: Market structure models in light of additive manufacturing revisited. International Journal of Production Economics, Volume 164, June 2015, Pages 43-56
See Rainer Kattel and Mariana Mazzucato (2018). Mission-oriented innovation policy and dynamic capabilities in the public sector. Industrial and Corporate Change, Volume 27, Issue 5, October 2018, Pages 787–801