What’s a parent to do when he learns that his child has a chronic disease such as type 1 diabetes? If you are like Lane Desborough, you don’t wait passively for progress, you connect with others who are likeminded—and then you start a company.
Type 1 diabetes renders the pancreas incapable of producing the insulin necessary to shift glucose out of the bloodstream and into cells where it can be converted into energy. Without insulin, blood-sugar levels spike and the body can’t get the nourishment it needs to survive. When his son, Hayden, was diagnosed with the disease, in 2009, Lane was a product manager at GE Energy. Like so many others living with diabetes care, he stayed awake late into the night managing his son’s blood sugar, checking and adjusting every few hours. He was dealing with diabetes-related medical devices that communicated poorly — or not at all — with mobile
and the rest of the burgeoning Internet of Things (IoT).
As he recalls now, “I was working on the world’s energy problem, but my passion and empathy were driving me in another direction altogether.”
Before long, Lane left GE to join medical device firm Medtronic and within months he was leading the engineering team commercializing an “adaptive cruise control” system to partially automate insulin delivery. When I met Lane, in 2012, he had just returned from a Medtronic-sponsored skills-based volunteering trip to Dr. Mohan’s Diabetes Center in Chennai, India. He was becoming fully immersed in the diabetes diaspora, and when he really started to look around he found a thriving global community of people with diabetes and their loved ones, all desperately searching for better solutions. A subset of these individuals were DIY enthusiasts trying to hack their own solution. Why? There were massive gaps in the system – ones not being addressed by large corporations. Yet, when Lane took promising ideas to management at his company, they were uninterested.
That was enough for Lane. He left to pursue the ideas on his own. In late 2014, he joined forces with two other leaders in the space, Bryan Mazlish and Jeffrey Brewer, to form a technology startup called Bigfoot Biomedical. Lane and his co-founders have remarkably similar stories. Each has a child with type 1 diabetes, and each had became disillusioned and impatient after years spent working within the existing establishment of diabetes care. Each also had a vision to hack the system to improve diabetes outcomes.
Lane and his co-founders at Bigfoot Biomedical are hacking healthcare—using passion, formally and informally garnered knowledge, and social networks to chip away at problems and design their own nimble solutions. While technology is a huge enabler of this brand of disruption, it’s more about solving problems based on user need and moving away from assumptions based on what worked in the past.
In Lane’s case, he recognized that exhausted parents needed a reliable way to monitor blood sugar levels remotely. To get there, he and a number of individuals collaborated to create a remote monitoring solution called Nightscout. It uses continuous glucose monitoring devices and open source code to enable loved-ones to easily eyeball glucose levels in the cloud via web browsers, smartphones, computers, tablets, and even smartwatches. There are no warranties, and it’s not yet FDA-approved, and the technical support consists of a Facebook group. But their system is simple and available—right now.
Today, a few big healthcare companies, including Medtronic and DexCom, are beginning to collaborate with such citizen hackers—but it’s slow going. So where can corporate leaders jumpstart the process and what should they look for in opportunities?
Look for passion. Citizen hackers are enabled by technology but they are motivated by passion. They can envision creative solutions because it is an imperative for them to do so. That passion not only fuels innovation, but it also brings together communities that have common hopes and challenges, and are willing to float ideas and resources. In Lane’s case, he and his partners share a deep desire to improve diabetes outcomes for their own children, while their larger goal is to create a sustainable business to improve outcomes for anyone with type 1 diabetes. Bring these individuals into your organization, and allow those already working with you to work on their passion projects.
Prioritize problem-solving. In most cases, individuals like Lane, or groups like Dads battling Diabetes, hack solutions to problems that larger organizations overlook or simply choose to ignore. Big businesses bypass crucial unmet needs, such as monitoring a child’s blood glucose while they’re at school or asleep, because they operate based on current assumptions. Here’s what has worked for us before, so we’re going to continue to do it. We’ve built an infrastructure around this product or service, so let’s support it because this is what we do. In other words, they create products and services built to serve their existing business model, rather than the needs of the consumers they serve. Citizen hackers have little overhead and can operate from a clean slate based on empathy and the desire to meet a pressing need. They don’t have to worry about cannibalization of an existing products or services. Organizations must ask themselves: are we asking the right questions, and building solutions to customer needs—or are we trapped in a model that may no longer address these needs?
Look outside. Passion for a particular cause and the ability to solve an unmet need can’t always be found within the walls of a corporation. Of course, organizations with big R&D budgets must comply with standards and operating practices. Yet simply knowing what’s going on in hacker spaces, interest groups, and the DIY community adjacent to your corporate space, and even joining these communities, may create opportunities to move in a new direction and create a conduit to collaborate on a project that will someday create significant revenue.
Consider alternative business models. Companies such as Johnson & Johnson and Abbott Laboratories manufacture much of the existing hardware for diabetes care, including glucose monitors and sensors that come with a moderate price tag for consumers. In contrast, the citizen hackers behind NightScout pioneered a solution that uses a free app that uploads data to the internet thereby making existing hardware far more useful and accessible. In many cases, hackers simply want to make the solution available, leaving the door wide open for corporations to partner or run with new business models based on a freemium upgrade, a subscription service, education and training or technical support.
Lane and others like him leave established organizations because the culture and organizational design fail to support their desire to make a difference. At the moment, following an acquisition and a recent strategic partnership, Bigfoot is on its way to developing a comprehensive Type 1 diabetes management system employing simple design, cloud connectivity, and human-centered automation. They are not completely alone in the race to development (Medtronic is working on a similar system) and they will need regulatory approval. However, they have the full attention of the expansive diabetes community.
Citizen hackers are doing their own research, self-funding or securing micro funding, and reaching out virtually to mobilize their network. They are producing prototypes in venues such as hacklabs and maker spaces. This should serve not only as a wake-up call to companies, but also be seen as opportunity chance to innovate: it’s an opportunity to engage and retain the intrapreneurs and problem solvers within your organization.