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Providing Accessible Medical Care through Low-Cost Fracture Detection

By Emily Denny

Treating bone fractures in the developing world is increasingly difficult due to the lack of x-ray accessibility. Emily Huynh, a senior at UC Berkeley studying Bioengineering, thought: if bone fractures were diagnosed and treated properly in an affordable way, large populations of people could avoid the chronic pain, disability, and socioeconomic disadvantage that mistreated fractures cause. This past spring, Huynh and her team won third place in Big Ideas’ Hardware for Good category for a medical device that provides orthopedic care in underdeveloped countries and remote settings called Fractal.

Big Ideas spoke with Huynh to learn about the inspiration behind the idea, what she and her team are currently working on, and how Fractal can create a positive impact to communities in the developing world.

Q: How is Fractal a solution to the growing numbers of untreated and mistreated bone fractures in the developing world?
A: There is about one orthopedic surgeon for 700,000 people in Nigeria — that’s a long waiting room. Despite the fact that the number of mistreated fractures is growing in developing countries, the number of professionals trained to treat these fractures isn’t growing with it. If bone fractures are not treated properly issues like bone-shortening, chronic pain, infection, and in an extreme case amputation can occur.

Fractal allows a clinician — one who may not have five years of training in orthopedic residency, but are familiar with the medical environment to triage patients — to rapidly diagnose and treat patient’s fractures properly, and accelerate recovery. By providing developing countries with an inexpensive, accurate tool for diagnosing and monitoring of bone fractures, we will facilitate better orthopedic care and reduce the incidence of mistreatments, misdiagnoses, and the ensuing complications.

Q: How is Fractal’s technology different than traditional technologies used to diagnose bone fractures?
A: The most common technology is x-ray, but abroad this can be inaccessible because x-ray is expensive to buy and maintain. A common alternative to x-ray is portable ultrasound which is relatively cheap, but it is hard to read, especially for fractures. Fractal fills this gap: it’s inexpensive like ultrasound, but is quantifiable and easy to use.

Fractal leverages and automates existing solutions in order to detect bone fractures without the use of imaging. We are basing the technology off of a technique physicians used before x-ray and ultrasound was invented called auscultatory percussion. It’s the same idea as when a doctor places a stethoscope on your back and asks you to breathe in. We are applying that same kind of “apply an impulse and listen to what you hear” methodology to the leg. By sending controlled audio waves through the bone, Fractal records and analyzes the sounds physicians listen for during bone auscultation, eliminating the chances of misdiagnosis that may occur without the proper equipment.

Q: How can you ensure Fractal is trusted in remote communities?
A: For patients in remote areas of many developing countries, going to urban care centers where people can be treated properly, can sometimes take days of walking. So, traditionally people living in these remote areas depend on bonesetters to treat a fracture. We do not want to upend or disagree with these trusted bonesetters, but to facilitate their care. If we are able to gain the trust of local caretakers, I think that Fractal could become a very helpful tool in treating larger populations of people.

Q: Through a partnership with The Lemelson Foundation, Fractal and other Big Ideas applicants in the Hardware for Good category participated in environmental responsibility workshops. How do you hope to implement sustainability into Fractal’s prototype?
A: Big Ideas’ Hardware for Good category was really interesting because sustainability is something innovators don’t really think about because we are so focused on how our product is going to work, how we are going to market it and how we are going to sell it.

The body of Fractal is printed with PLA (polylactic acid) which can be melted down and recycled. We are also hoping to create a service where if a device is broken it can be sent back to us. Once we receive the broken device we can repurpose it for the parts that don’t work. This will extend the device’s end of life, ultimately allowing us to limit our waste.

Q: How has your own academic interests led to the development of Fractal?
A: When I came to Berkeley I structured my coursework around learning how to build medical devices. I learned about hardware, how to build it, how to write the code so it can communicate, and how to do hands-on prototyping. Justin Krogue is my partner for Fractal. He is a fifth year orthopedic resident at UC San Francisco (UCSF) who rotates at San Francisco General Hospital (SFGH). When Krogue came to me with this idea, I ran with it. I thought Fractal tied my Bioengineering degree and skills together in a way that addressed social concerns.

Q: How have mentors and medical industry experts contributed to the development of Fractal?
A: Mentorship is one of the most important things that comes from Big Ideas. I was connected with Jeffrey Lu who won Big Ideas a few years ago. He made a big difference to my proposal because he is still in the start-up phase himself and provided significant insight from his experience to identify areas of improvement for both the proposal and the device itself. He helped me envision how to create a device that can be successful and I couldn’t have asked for a better mentor.

Dr. Nirmal Ravi from eHealth Africa has experienced how developing countries such as Nigeria, Tanzania, and India have an inadequate healthcare infrastructure due to a lack of personnel and high equipment and maintenance costs, making it difficult for all communities access appropriate care. He has helped us get a better understanding of how we should market to developing countries. A lot of people reach out to developing countries thinking they can’t help themselves. We wanted to ensure that we assimilate with these countries and work into their culture to try and help solve this problem.

Q: What is your vision for Fractal over the next few months and what do you look forward to the most as you continue with Fractal?
A: Right now we are trying to go to a couple conferences to gain exposure and see if anyone else in the academic community has opinions and advice on the Fractal. We also currently collecting data at UCSF and SFGH on more tibia and hip fractures and of course looking for funding. In the long term, we hope to partner with Muhimbili Orthopaedic Institute in Tanzania so we can send our devices to become a part of a global clinical trial.

As my team and I continue to take these next steps, I look forward to seeing how Fractal can help just one patient and enable them to live a normal life. I am excited to see how Fractal can positively impact a community.

Big Ideas Integrates Sustainability into Its Competition

By Emily Denny

“Sustainability is something innovators don’t really think about because we are so focused on how our product is going to work, how we are going to market it, and how we are going to sell it,” said Emily Huynh, a senior studying biomedical engineering at UC Berkeley.

Last spring, Huynh won third place in the Big Ideas Contest’s Hardware for Good category for Fractal, a medical device that provides low-income countries a tool to diagnose and monitor bone fractures. Huynh said that one of the challenges when building the Fractal prototype was how best to incorporate environmental concerns.

In 2018, Big Ideas responded to Huynh’s knowledge gap by introducing a pilot Environmental Responsibility Program into the contest. Supported by The Lemelson Foundation, the program offers a curriculum on sustainable design approaches.

In August, Big Ideas hired an environmental design fellow to support the program, Mimi Kaplan, who is a master’s student at the Goldman School of Public Policy. Kaplan recruited Jeremy Faludi, a Dartmouth College professor and expert in green design and engineering; and together, they have developed two Inventing Green workshops for Big Ideas contestants in the Hardware for Good category.

“Having studied sustainable development at Columbia University, I have relevant academic experience to support Jeremy in developing the workshop content in a way that was suited to the needs of the students,” said Kaplan. “After college, I worked with the Milken Innovation Center in Jerusalem, assisting and managing the logistics and coordination of conferences and workshops on agtech developments and water management in Israel and in California.”

Big Ideas teams in the Hardware for Good category attended the first environmental workshop in the fall semester and the second in the spring.

“The purpose of the first Inventing Green workshop was to introduce students to the concepts of environmental design and circular economy, which includes using locally sourced and environmentally responsible materials and making recyclable and modular products,” said Kaplan. “The purpose of the second workshop was to give students the tools to implement these concepts in their designs and training to help make them confident in doing so.”

Emily Huynh and her team at Fractal attended the Inventing Green workshops, and then restructured how their medical device was built. The Fractal team reported the workshops helped them understand that the production phase of a medical device has the highest impact on the environment. As a result, they decided to use PLA (polylactic acid), a plastic that can be melted down and recycled, to print the body of the medical device.

“Learning about the process of sustainable design led us to reconsider how our product is going to work, how are we going to market it and how are we going to sell it.” said Huynh. “We are also hoping to create a service in which, if a device is broken, it can be sent back to us. Once we receive the broken device, we can repurpose it for the parts that don’t work. This will extend the device’s end of life, ultimately allowing us to limit our waste,” said Huynh.

Similar to Fractal, team members from the Sonic Eyewear Project (SEP) also reported that the workshops helped them reconsider the production of their prototype. Darryl Diptee, founder of SEP, won second place in the Big Ideas’ Hardware for Good Category in 2019 for developing a technology that enables people who are blind or visually impaired to use echolocation to better navigate their surroundings.

“The sustainability workshops helped us introduce and infuse sustainable approaches into our product development,” said Diptee on the workshops. “As a result, we are implementing green sustainability into SEP by using renewable plastics. We are also working on a clip-on product that can be affixed to existing eyewear, eliminating the need to buy an additional pair.”

Kaplan noted student feedback on the challenges of integrating sustainable design into their inventions. “In a roundtable feedback session at the end of the contest year, multiple teams mentioned the difficulty of local sourcing, modularization, and ensuring circularity of their products if it meant justifying a higher up-front cost to investors,” she said. “The group discussed methods for overcoming this challenge, including how to pitch the long-term financial savings that sustainable design brings as well as the importance of environmental responsibility.”

Overall, Kaplan said the workshops increased contestants’ confidence in applying principles of sustainable design in their invention process, and that the workshops had an impact on participants’ perception of the design process cost, ease of manufacturing, marketability, and quality.

In the spring, Dr. Maria Artunduaga won Big Ideas’ first-place prize in the Hardware for Good category for Respira Labs, a startup for a medical device that tracks and monitors lung health, providing an early warning for COPD (Chronic Obstructive Pulmonary Disease) attacks.

“It’s our social responsibility as innovators to be mindful. The sustainability workshops helped us at Respira Labs realize that you can build a prototype while also being mindful of the environment.” said Dr. Artunduaga.

Already aware that healthcare sector accounts for nearly 10 percent of U.S. carbon emissions and generates an average of 25 pounds of waste per patient each day, the Respira Labs team saw the workshops as an opportunity to reconsider how its prototype can incorporate sustainable design. Respira Labs intends to use reusable sensors as well as tie the use of smartphones to the COPD technology, eliminating the need for excess medical devices.

In addition to learning how to reduce waste during the production process, teams in the Environmental Responsibility Program also reported learning that sustainable design can reduce legal risk, final product cost, and increase innovator creativity and motivation.

“This year, we plan to again offer a workshop on environmental responsibility in product design for student teams creating physical products,” said Kaplan. “We also plan to take Big Ideas students to maker spaces in the Bay Area, and to share through lectures and conferences what we have learned in implementing the Big Ideas environmental responsibility curriculum with the support of The Lemelson Foundation.”

Empowering Women of Color in the Medical & Technology Field

By Emily Denny

Although Maria Artunduaga, a Colombian-born translational physician and entrepreneur, says that racial and gender bias has played a major role in shaping her career, she doesn’t view it as an obstacle. Instead, she views such experiences as motivation to close the gender and racial gap, particularly in Silicon Valley.

In spring, Artunduaga won Big Ideas’ first place prize in the Hardware for Good category for Respira Labs, a medical device startup for a product that tracks and monitors lung health, providing an early warning for COPD (Chronic Obstructive Pulmonary Disease) attacks. Artunduaga’s mission is to empower people with COPD by using home-based intervention technology that flags lung deterioration before it occurs, cuts hospital readmission costs, and reduces provider and payer healthcare bills.

Big Ideas sat down with Artunduaga to discuss how her personal and professional experiences have led to Respira Labs and how she navigates male-dominated spaces as a woman of color and an immigrant.

Q: How did your personal experiences lead to the launch of Respira Labs?
A: Respira Labs is definitely a product of my personal journey. I am focusing on COPD because my grandmother suffered from it for as long as I could remember. She died from an exacerbation. This was difficult because, even coming from a family of physicians, we couldn’t do much to help her. When I started practicing medicine after medical school, I realized how large of a gap in communication there was between doctors and COPD patients when they are sent home. I wondered: Is this all we have?

That’s why I am obsessed with finding a solution for COPD patients. Respira Labs is building a digital platform that detects changes prior to symptom onset, facilitates early intervention and helps prevent hospitalizations. COPD hospitalizations result from exacerbations, a worsening or “flare up” of symptoms. Survival after admission is poor and related to the number of previous severe exacerbations.

Q: How is Respira Labs a product of your multiple degrees and professional experiences in the medical world?
A: Through my family members, I have observed firsthand the lack of technology for people with COPD. I also have a Masters in Public Health from the University of Washington, where I studied how healthcare technologies are overlooked and underfunded, specifically in low- and middle-income countries. My personal mission is to help the poor worldwide who have no access to healthcare. I want to help improve healthcare delivery with digital technologies and tools that are cheap and work well. Democratize access.

Q: Could you speak about a time when you encountered bias in a professional setting?
A: My experience at the University of Chicago, as a plastic surgery resident, was probably the strongest example. Most of the chief residents and faculty in the department were white and male. I soon realized that the way I looked, the way I behaved, the way I talked, everything I am and represent made them uncomfortable.

As a result, they started targeting me, bullying me, making comments about my accent, my personality, my height, I could go on. They would tell me, “You’re too too friendly, you talk too much.” A white, male surgeon told me that there was something “wrong” with me, that I didn’t look like a “surgeon.” Another one kept asking me questions about how I managed to get there. As an immigrant, woman of color, I didn’t understand that I was experiencing racial bias until it became very clear to me that they didn’t want to train me. While my classmates were doing eight to ten surgical cases per week, I was doing a couple, sometimes none at all. That obvious difference prompted me to complain to my program director, but he told me that this treatment was the status quo and the only thing he could offer me was a “quiet transfer” to a more “immigrant-friendly” residency in a community hospital. I refused.

Q: How did you respond to this bias?
A: In medicine, if you don’t follow the rules of hierarchy, especially as a woman and as an underrepresented minority, you are going to be oppressed. That’s the sad reality. So I saw that I could respond in two ways: I could keep fighting the system and continuously get frustrated with it; or I could lean in a little, while also speaking out. I soon realized that I couldn’t reach my full potential as a surgeon; I was cast out because I fought back. But I learned from it, which is precisely why I changed my approach.

I started by searching for people who looked like me, who were dedicated to closing the gender gap, whose interests aligned with mine, because the more things that I found in common with people, the easier it was to have allies. I also saw that I needed to validate myself with degrees and awards, so people would start believing that I was at their level. Last year, I started to apply to everything and anything that I came across, so far I have been quite successful. I work hard.

Q: As a woman of color, how have you navigated a male-dominated atmosphere, specifically in Silicon Valley?
A: The reality is that people like me, women of color, are always going to have a hard time convincing people that we are capable. There are negative stereotypes. My experience in Chicago was the hardest situation in my life, a nightmare, but it made me who I am today. I am actually thankful for that experience because, even after losing everything, not having a job, a reputation, or money to go grocery shopping, I realized that it wasn’t the end. So now, in Silicon Valley, I am not scared of anything and I don’t mind failing. I know I’ll build myself up again.

Q: What advice do you have for early-stage women entrepreneurs?
A: The problem of bias is there and it’s not going to be fixed for a while. But you need to find sponsors, you need to find people who are committed to closing the gender gap, and you need validation. There are many people at UC Berkeley who are supportive of women, who are honest about recruiting female founders — like Phillip Denny from Big Ideas, Jill Finlayson from the Women In Technology Initiative, Kira Gardner from CITRIS Foundry, Caroline Winnett from Skydeck, and Rhonda Shrader who directs the Berkeley-Haas Center for Entrepreneurship. I would tell you to push yourself out of your comfort zone and talk to these people. Email them and tell them I sent you. They can help you realize that your potential is endless.

Q: What are some structural or systemic changes that need to occur across the entrepreneurship/startup landscape to diversify the space and make it more equitable for women and people of color?
A: People don’t like to talk about politics or social issues, but the reality is that we live in a world that is touched by social issues every single second. We cannot compartmentalize business, startups, technology, and money from politics. Yes, we live in this bubble of Silicon Valley, but the reality is that there is a world out there with intolerant people.

We in Silicon Valley, the technological leaders of the world, need to be more responsible. We need to educate ourselves about these issues of prejudice and stereotypes. We need to realize that talent is everywhere, but opportunity is not. We need to open the doors to diverse founders. This can be an uncomfortable topic, but the more people become empowered and have access to money and education, the less inequality there will be. Intentionality should direct our daily decisions, it’s the right thing to do.

Q: Any final thoughts?
A: I am tired of hearing: Latinos can’t become CEOs, Latinos can’t do post-graduate degrees, and they cannot succeed in Silicon Valley. If you have one single person who can demonstrate that those things are possible, that can open doors for so many more. All I can say is: Watch me.

The Big Ideas Contest has been named one of four university social innovation competitions to be a part of The 2019-2020 Rockefeller Foundation-Acumen Student Social Innovation Challenge. The other three universities are MIT, University of Michigan, and University of San Diego.

With the new partnership, Big Ideas will support students at all 10 University of California campuses as well as at the Hebrew University of Jerusalem and Makerere University in Uganda to build innovative solutions to poverty and some of the world’s most intractable social challenges. The total number of eligible students across the 12 campuses will be over 300,000 in the 2019-2020 academic year. Students are encouraged to propose innovative solutions across a broad range of social impact tracks, including: Workforce Development, Global Health, Food & Agriculture, Financial Inclusion, Energy & Resources, Education & Literacy, Cities & Communities, and Art & Social Change.

As part of The Rockefeller Foundation-Acumen Student Social Innovation Challenge, the Big Ideas Contest will offer students an exclusive set of resources that leverage the experience of the Rockefeller Foundation and Acumen in building successful social enterprises. Winning teams from Big Ideas will be invited to join a social innovator network hosted by Acumen, where they can connect with peer innovators and receive ongoing support.

“We at Big Ideas are delighted to be part of the 2019-2020 Rockefeller Foundation-Acumen Student Social Innovation Challenge. Collaborations, networks, partnerships–and especially challenges–are what make the social enterprise sector grow and hum,” said Phillip Denny, director of Big Ideas. “We expect the usual avalanche of world-changing ideas from students this academic year.

Acumen is a global nonprofit, founded in 2001 with seed capital from the Rockefeller Foundation, Cisco Systems Foundation, and three individual philanthropists, which tackles poverty by investing in sustainable businesses, leaders, and ideas. The Rockefeller Foundation‘s mission, unchanged since 1913, is to improve the well-being of humanity around the world. Since its 2006 establishment at UC Berkeley, Big Ideas has inspired innovative and high-impact student-led projects aimed at solving problems that matter to this generation through an annual contest that provides funding, guidance, and encouragement.

CONTACT:
Phillip Denny,
Director, Big Ideas Contest
pdenny@berkeley.edu
(510) 666-9120

How do you become a social entrepreneur? The question has been the subject of many articles, books, and TED talks. For applicants to the Big Ideas social innovation contest, however, the answer is fairly simple: motivation and mentorship.

The recently concluded 2018-2019 Big Ideas Contest brought together over 400 judges and mentors—from six continents—to evaluate proposals and support teams. This group looked at a record number of applications (337) from eight UC campuses to award prizes ranging from $2,000 to $15,000 to 34 undergraduate and graduate students teams, the majority of which were female-led. While securing funding is necessary for any early stage social venture, winners consistently said the key catalysts  were the Contest’s nine-month structure and access to mentorship.

“The best way to grow an idea into a plan is to research and write under the guidance of a mentor,” said Ryan Barr, a UC Davis PhD student whose RePurpose Energy won first place in both the Energy & Resource Alternatives category and the Big Ideas Grand Prize Pitch Day.

Barr, who is developing a product and service to test, reassemble, and redeploy used electric vehicle batteries to provide commercial solar developers with energy storage solutions at half the cost of new battery alternatives, was motivated by the possibility of Big Ideas’ seed funding. Yet he also knew he needed expert help.

“Beth Ferguson, our mentor, offered a fresh perspective on how to communicate our technology’s potential to investors, current collaborators, and our larger community,” he said. “And Big Ideas has opened doors to additional funding and growth opportunities.”

Other highlights from this year’s Big Ideas Contest included a spike in applications from across the University of California system and the continued success of student teams from Makerere University in Uganda, which has been an international partner of Big Ideas since 2014. Since implementing the UC System Student Innovation Ambassadors program in 2017, Big Ideas has seen an 88 percent increase in overall applications from UC system, proving that student-to-student support helps. The Contest also saw a record number of applications from Makerere University—77 in total—including a first place and honorable mention in Global Health, and second place winners in the Energy & Resource Alternatives and the Food Systems categories.

“Over the past 13 years, it’s been great to see the Contest grow—not only in terms of applicants, mentors, and judges, but also in terms of the gender and geographic diversity,” said Phillip Denny, director of Big Ideas. “This diversity makes sense because, inherently, social entrepreneurs are out to diversify access to the world’s key resources and opportunities.”

Moses Kintu, who led the winning Cloud-based Emergency Response System (CERS) team with classmates from Makerere University in Uganda, said he found the nine-month period of reworking his idea for using mobile technologies to improve ambulance service in Kampala to be crucial.

“The mentorship program was an unbelievable learning opportunity, and participating in Big Ideas helped us to fine-tune our project and execution plan after a lot of chopping and changing and pivoting,” said Kintu, a fourth year Health and Medical Sciences undergraduate student.

Haoyu Niu, a UC Merced PhD student whose agtech robot iBMW won first place in the Food Systems category, viewed the Contest as a skills-building exercise.

“During training and mentoring period, I learned how to write a good proposal, how to show my idea has social impact, and how to build a team,” said Niu. “Big Ideas provided the mentorship and resources that enabled me to make my iBMW project concrete, feasible, and scalable.”

A complete list of this year’s 2018-2019 Big ideas winning teams can be found on the Big Ideas website!

About Big Ideas: The Rudd Family Foundation Big Ideas Contest provides students with funding, support and mentorship for developing their social ventures. Since its launch in 2006, Big Ideas has received over 2400 proposals, supported more than 7,000 students from multiple universities, and provided seed funding for participants that have gone on to secure over $650 million in additional funding. The Big Ideas contest is made possible through the generous support of the Rudd Family Foundation, as well as category sponsors including Autodesk Foundation, The Lemelson Foundation,  USAID, the UC Office of the President, Center for Information Technology in the Interest of Society (CITRIS), Associated Students of the University of California (ASUC), and the Blum Center for Developing Economies.