welcome to our talk
on stopgap medical
maker response to COVID 19.
I am udaya presenting the work we did
last summer in understanding the
organization
of medical devices in a safe and timely manner
personal protective equipment was in
short supply over the summer of 2020.
overseas supply of devices dried up and
lockdown measures across the U.S.
closed down local manufacturing plants
manufacturing regulations were relaxed
by state and federal authorities
especially
the FDA's emergency use authorization
encouraged temporary response from the wider
community. Our other paper on
grassroot maker response
describes the use of online communities.
This study is about institutional response.
Medical engineering and research
institutions collaborated with maker
communities
to create PPE for healthcare settings.
We set out to understand making across two
stages of crisis.
The first was the stage where shortage
was acute between march to may
and persisted through the months of may
to august. We interviewed 13 organizers
who acted as go-betweens or intermediaries
managing makers across eight
organizations in
five U.S. regions. Notably only two of
them are healthcare providers themselves.
These six types of ppe was mentioned by
all of them and remain
accessible in design repositories.
We framed our findings around repair
keeping in mind this unusual crisis
instead of the lens of innovation
typically used in HCI.
To understand maker activity,
we wanted to learn how re-use
repurposing, and repair drives the making process.
We found institutions prioritize PPE
that increase their stockpiles for
immediate use
the process of prototyping and
production as a key area of focus for
our participants led to insights into
how they produce at scale
lastly the expertise and skill of
volunteers were
managed through clear protocols for
safety
Priorities changed based on hospital
needs as one clinician maker in our
study said
there's no debating the power of
distributed manufacturing
and saying when the supply chain goes
down you have the ability to manufacture
things on premises
but to say you're going to manufacture
everything?!
even if a highly producible part like
*this one* for an expensive ventilator
existed they would rather focus on
maximizing
the 3D printers' use for face shields on premises
On the other hand of
hospital premises
in academic lab we
heard of how industry partners like
Prusa, a 3D printing company were trying to
get people
who have machines and networks to print
device parts
and *this aspect* of community production
of devices
is well understood in low scale
settings like academic labs where
materials may be low. The labs capacity
was to create 300 parts and they would
3D print them and drop them off at the
hospital areas.
This kind of effort became clear to us
in understanding the intermediaries role
between communities. Intermediaries
would not only prototype designs and
protocols but also procure materials
and partners in their local community to
start working towards the production of
devices and parts.
Their main role was to establish safe
use, find sources,
and maintain quality. But as the pandemic
progressed, and repeated shortages
occurred over six months,
they would return to prototyping devices
and parts over and over again.
They were able to hand off their
responsibilities to other parts of the
community based on
these protocols and designs.
To medical experts, industry experts as well
as makers as volunteers could step in
and take over for intermediaries.
This revealed a community production
cycle to us.
Framing the process from the point of
view of repair let us understand that
the activity
intermediaries undertook at institutions
was basically establishing...
repurposing of designs for safe use
not so much innovation. Where they could
establish protocols for
safe production elsewhere, they
redistributed these protocols and
designs
to volunteers in the community apart
from partners
in the industry. It is in creating this
kind of manufacturing momentum 04:08
where we had lessons to take away for
the HCI community.
This scale of unprecedented making effort for
healthcare use was possible because of
the kind of efforts that intermediaries
took to make community roles possible.
The first implication is in
understanding how we create
decentralized
tools like the NIH 3D print exchange to
include
different kinds of technologies and
materials. The second implication was to
understand
both material and human networks the
role they play
and should be considered in
policy regulations.
the main takeaway of our study is that
community production happened at scale
it was made possible through distributed
manufacturing. These systems could
use better design to ensure community
participation over time.
I hope you will read our papers and I look
forward to your questions.