Originally published October 7, 2016: To mark the arrival of the Vodafone xone business accelerator, Idealog is interviewing heaps of established New Zealand innovators, as well as the founders of the 10 startups selected by Vodafone to receive mentorship, funding and the potential benefits of working with a global network. For this edition, Idealog editor Henry Oliver speaks with oDocs chief executive Hanna Eastvold-Edwins.
What does oDocs do?
What oDocs do? That's a good question. We're doing lots of things. I guess, broad scale, we're looking to save millions of people from going blind by improving accessibility to diagnostic hardware that can be used with mobile phones. Quite simply, I guess, we're turning iPhones into eye clinics to prevent people from losing their vision.
You're wanting to improve access by making your own hardware, is that right?
By making more affordable hardware, yeah.
How do you do that?
Several ways. First of all, we produce commercial versions that cost a hundred times less than conventional equipment. These versions can be used currently by optometrists and ophthalmologists to assist the referral process in order to better triage patients who are at risk of losing their vision due to diseases of both the front of the eye and the back of the eye. Front of the eye is a little bit easier to see. We have a product called visoClip and what it does is it can pick infections and abrasions of the front surface of the eye that are often missed. It can, obviously, with a phone you can take a photo and send it.
The other thing is we have another product called visoScope. It takes photos of the back of the eye, and it's hard to see, usually, the back of the eye. You have to get through the pupil, which is a tiny hole. This is, at the moment, available for ophthalmologists and optometrists but in the future we'll make a version that's more accessible by front line clinicians, like GP's. Then you'll be able to get retinal examinations a lot easier and for lower costs, as well.
We also have an app that has some visual acuity tests and can test your vision, color blindness, and a variety of tests that make up a comprehensive eye exam. The whole system is to put that fifty thousand dollar eye clinic into your pocket, I guess, so that people don't need to have these clinics and they don't need to pay, sometimes, the large amounts that... it's really developed originally for the developing world but also has applications in the developed world for self-care.
How did you know this would be possible? Obviously the phone has put a camera in everyone's pocket. How did you realize that phone could be a sophisticated eye examination equipment?
The whole idea was conceptualized by Dr. Hong. We was an ophthalmology registrar in Gisborne at the time. He'd traveled overseas and practiced overseas. He came up with the idea, why don't we just come up with a simple system that has the right optics to visualize the back of the eye and the front of the eye and just cut it down to the bare essentials.
I think that what the world needs is more basic solutions. We have all the really high tech gadgets and things, but the expansion, the real problem is that five and half million people will go blind this year due to preventable conditions. 90 percent of those people live in developing areas. It's a real problem that's actually growing.
Dr. Hong thought, hey, we've got these supercomputers in our pocket. This shouldn't be that difficult. He approached myself and another designer a couple years ago to start looking at a prototype. We designed that prototype for him just for his research. Originally he wanted to do this as part of a paper. Since he was only going to produce around ten or fifteen we said let's optimize this for 3-D printing because there's no sense in expensive manufacturing methods. We did that and then Dr. Hong got a spot at TEDx Auckland and he announced at that event that he would make it an open source product. That he would allow people do download the 3-D plans of the adapter which was an adjustable fund-us adapter.TEDx Auckland and he announced at that event that he would make it an open source product. That he would allow people do download the 3-D plans of the adapter which was an adjustable fund-us adapter.
A lot of people got excited about it and started printing it out. I think he got five thousand downloads within five months. He started producing...some people didn't want to have to 3-D print. They didn't have printers or they didn't have time to learn how to do that so they asked him to produce it. It was an interesting evolution. Once you find out that people who have 3-D printer's aren't usually the ones most in need we thought about more traditional manufacturing methods that would lower the cost. We started a business.
How did you turn an open source model into a business?
The open source aspect is really exciting, right? I think that the thing is people know that water is free but they still buy bottled water, right? It's just that people buy the quality level that they can afford, you know? Doctor's are no exception. A doctor might use a 3-D printer device and some of our customers do, but then often they come back and they say, "Hey, I see you've got a commercial version. I'd like to purchase that." I guess it's a really good entry level product but they still have to add their own optics, their own lenses. In effect, it actually costs probably the same to purchase on that's already made up and that's been designed from the get go by the company. I think there definitely is... it's a really good add on to the business but it's not, probably, the core value of the business, long term.
Once you started getting the design out there was it difficult to reach the people who needed it most? I know it can be hard sometimes to get into the areas and the people working with people that are in isolated areas or out of the distribution channels, et cetera. Was that a problem?
Yes and no. The first things that we noticed were a lot of people that were downloading 3-D printing weren't in those areas. What was happening was a lot of ophthalmologists and optometrists wanted to volunteer using the equipment. They were using it to that kind of work and then they were taking it into those regions. We contacted Fred Hollows and I think that they have quite established routines. It's going to take a little bit of time before... but we are talking to them now in more depth. I think as you win over the optometrists or ophthalmologists one by one they will pull the product into their practices as they get more familiar with it and they trust it more. I think it naturally will happen. I'm expecting that over time it won't be too long before more people are using it for screenings in those regions.
There are lots of medical procedures that are based around trying to see something more clearly. Are there other applications that you're looking at? The obvious ones being ears, throat, et cetera, or are you just focused on the eyes for now?
At the moment we've got a lot on our plate so we're trying to focus around eyes. I guess there are people doing similar things and we may partner with them at some point. For instance, the agencies in South Africa that downloaded our device over two hundred times, and printed it, they are doing something like that. They're using our adapter for the eye portion to do mobile screenings and things. I see that we become a hardware supplier for companies that are doing things like that. It's a big problem. There could be lots of people doing this and it still couldn't touch the edges of it.
You use smartphones and smartphones change over time, particularly Apple devices get upgraded every year. Does that cause any issues with the way that the cameras work?
Yes, I do think. The latest release this last week of the new iPhone seven means that we'll have to revamp our design. The thing is that what we've done is leveraged low volume production methods. We are a team of designers so it probably poses less of a problem for us than other companies because we're quite lean and able to adapt quickly. That is part of our strategy. The open source story makes more sense when you realize that as soon as you spend eighteen months trying to patent something your phone is outdated or your product's outdated. It probably makes more sense to prioritize speed and leverage the 3-D printing and all of the other kinds of technologies around that to create devices quickly and add features and things and adapt.
You've had a pretty cutting edge business model combining 3-D printing, open source and smartphones, obviously. What's the thing that you know now that would have made the biggest difference for the journey that you've had to get where you are?
That's a good question. I think it's interesting, you say all those things and those are all like... Probably the most challenging aspect of the business has been around the social impact, yet it's also one of the best things about the business. As soon as you say social impact people get images of not a very profitable business but I think it absolutely is a benefit to us.
We are filling as new sector. They say that it's government sector, private sector, and non-profit sector. Social enterprise is really the fourth sector. In New Zealand there isn't actually a legal structure around it so it causes a little bit of confusion to people when they're looking at investing and they're like, is it investing? Is it donation? We are a commercial company with a social conscience. We exist to solve a problem which is to end preventable blindness. I guess just the confidence around that and the way to speak around all the benefits that being a social enterprise can get you, that's the thing I wish I would have known when I started talking about this ten months ago. Now that I know it I definitely see it as an add on to the business.
If someone else has a great idea for a business, a commercial enterprise that would contribute to solving a social good, do you have any advise for them?
I think the advise is that don't be afraid to be a company. Some of the most impactful in the world started just to make money because the more money you can make and the faster you can scale, the more impact that you can actually have. Always remembering or structuring the fact that that social mission is the reason you exist. I guess, we spoken to Akina Foundation and they've helped up clarify that in the past. There are a few key people out there that understand this really well. It is a new market, but it is a good one and one that needs to happen. I'd be happy to talk to anybody that's interested in it, as well, if I have the time.