Hi thank you for joining today, my name is Kelly Mack and on behalf of my collaborators Megan
Hofmann, Udaya Lakshmi, Kelly Mack, Rosa Arriaga, Scott Hudson, Jennifer Mankoff I’d like to present
our work titled Making a Medical Maker's Playbook: An Ethnographic Study of Safety-Critical
Collective Design by Makers in Response to COVID-19
Medical Making is the application of digital fabrication to create
medical devices and support the point-of-care.
Using technologies like 3D printers and hobbyist electronics, medical makers create medical and
assistive technologies outside of traditional manufacturing infrastructure. Sometimes
this happens within expert-amateur communities, sometimes it happens in hospitals and clinics
Prior to COVID-19, Medical making was emerging as a practice across
a variety of institutions and grass roots communities
In 2019, we presented a work at CSCW where we interviewed many key
stakeholders in these communities, such as clinicians at the Veteran’s
Health Association who are bringing 3D printing into hospital practice.
And groups like Glia in Gaza who use consumer
3D printing to supplement failed supply chains in the Gaza strip.
At that time, Medical Making was a growing effort of maybe a few 1000 makers world wide.
However with the onset of COVID-19the medical maker community grew to 100s
of thousands of members who were working to supplement a global supply chain crisis
of Personal Protective Equipment like N95 masks and face shields
We conducted an ethnographic study of one of these newly emerged communities between
March and August of 2020. Megan Hofmann, the first author of this work, joined Make4COVID,
a Colorado based medical maker community, as a core organizer for that period. Our team met
weekly to discuss and analyze her experiences and data she collected from their online community
through a small social media tool called the Mighty Network and an organizer Slack.
At the same time we were more broadly analyzing a number of social media based
maker communities who were conducting similar efforts across the world and interviewing
clinical staff who were interfacing with these groups in the United States
Of all of the communities we investigate, Make4COVID developed one of the most
advanced supply chains. Ultimately they delivered more than 100,000
pieces of ppe to clinics in the state of colorado
Beyond their 3D printing efforts, they developed a delivery infrastructure that
even included a relationship with Civilian Air Patrol to deliver PPE
made by makers in the larger Denver Metro area to the rural regions of the state.
Make4COVID was structured around 3 sub communities:
community organizers, mask sewists, and 3d printing makers.
Many of the pain points that they faced derive from conflicts in what each
constituency expected and wanted to be doing, and what was asked of them by other groups. In
particular, Makers often wanted to contribute novel PPE designs while Organizers need
them to consistently manufacture PPE to specifications. Essentially, Make4COVID turned
an engaged volunteer work force of 2000 hobbyist engineers into a distributed factory line.
There is a strong desire for makers to participate in the prototyping process,
But in Medical making, where clinical review is essential to ensure that products will
be safe and effective in clinical care, the highly limited efforts of clinical
reviewers becomes a bottleneck. Make4COVID managed this bottleneck in a variety of ways
such as design competitions and triaging lower-risk design tasks,
but ultimately this proves to be the core conflict in community based medical making
Once makers adjusted to their manufacturing role, the challenges shifted to adapting technology that
is designed for one-off imperfect prototypes to rapid manufacturing of safety critical devices
3D models alone do not communicate all
of the challenges of printing a high quality face shield.
Makers used a variety of consumer 3D printers, each which needed to
be tuned to produce quality results. Unlike a factory floor, where this tuning is done once,
medical making is distributed across 1000s of participants and unique environments. This
complexity often overwhelmed the community organizers who supported these makers
Make4COVID managed this with ever evolving design specifications and a thorough,
if not efficient, quality control effort at their warehouses. However,
this is a task better served by the design tools these communities rely on.
Beyond specifying the geometry to be printed, design tools should integrate manufacturing
instructions and make them portable across a variety of 3D printers and situations.
These designs need to adapt to the many physical contexts the geometry will ultimately be built in.
Medical making requires engagement with a number of different experts. Clinicians
and biomedical researchers, regulatory experts, engineers,
and the makers who are ultimately responsible for producing these items
However design tools are almost exclusively targeted at technical
experts who can engineer complex devices…
Or at novice users, such as children, who are assumed to have no particular expertise
However, we can instead consider these not technical experts to
be “orthogonal experts” who have some external expertise,
such as a clinical background, that must be integrated into the design process.
Expanding who can participate in Making, requires us to build tools for the diverse communities that
put making to novel and critical uses, rather than simplifying traditional engineering practices.
Make4COVID and communities like them show the potential of maker communities
and digital fabrication to serve a critical role in supplementing and
transforming critical supply chains However, these communities are
currently fighting the affordances of design tools that support small
scale prototyping while ignoring the substantial challenges of production.
They are also limited by affordances derived from engineering practice,
rather than the diverse backgrounds of orthogonal experts who serve these
communities. Thank you for listening and please feel free to reach out with questions.