v.4: New machine design can broaden accessibility

[Wakanda]

Please vote. This version has incorporated many of your ideas from a previous thread.

To: VP's of Product Design for Respironics, Resmed & others
Fr: BiPaP User/Architect/Product Designer
Re: Next Generation of Machines - Broadening Accessibility with PR S2's and RM S10's

The intention here is to provide:
- a truly portable machine for those able to travel (i.e., packing up, airplane. hotel-staff issues, camping, etc.);
- a machine suitable for the injured or disabled or for seniors who sleep in multiple locations;
- a preferable machine design in hospitals for easier delivery to patients, for keeping masks off the floor(!), for keeping machine and components safer and cleaner, for assurance there is water in the humidifier;
- a machine that enables an option for greater modesty.

I've done some design work for nursing homes and for individuals using wheelchairs. A story that might interest you is about a quadriplegic ('triplegic', actually) who wanted a second and more comfortable wheelchair that he might use while he was at home. I bought an off-the-shelf, very handsome, classic bentwood and rattan rocker. I added exotic wheels that you would see during FDR's era. He thought it was a ridiculous idea as if the 'ambulatory look' of medical equipment was a badge of honor. For a few months it sat around and he wouldn't even try it. When he finally did get in the chair he never wanted to get out of it. People visited him more often and he was more comfortable sitting in groups with others. There is a role for beauty, for dignity.

Many people have injuries, infirmities and disabilities that result in them sleeping in several locations at home on the same day - bed, recliner, guest room or couch. Others travel with both machines and humidifiers. Some camp. Others find themselves in hospitals or nursing homes. We all end up in hospitals some time or other. The market would benefit from a truly portable machine that would operate WITHIN a highly-breathable fabric bag. For example shoulder bags and team bags can be quite handsome and are recognized worldwide. Resmed bags look great. Think of the design hoopla and enormous pricing regarding hand bags, fine shoulder bags, attache cases; even backpacks may be exorbitant in price because of good design. Such bags do not look like medical equipment. The bag style that is needed here would not up the cost of a current machine since our machines already come with bags. The suggested bag should have a flat bottom to rest on a table. The carrying handles need to encourage the bag to remain flat. It need not be expensive - just as many bags are reasonably priced and made from off-the-shelf materials. Resmed bag designers would find this right up their alley. Respironics would need to engage a more sophisticated design firm.

A practical idea would be to use a one liter water bottle for the humidifier tank. Plug it in, pop up the bottle vertically and put on the mask. Done. Machines that sit on night tables pretending to look like radios don't address the fact that the tube/mask must be connected, managed and put somewhere. Moving the machine from room to room is difficult for many, particularly because of the large power supply 'brick' and additional wiring. Traveling requires packaging everything up.

It's an incorrect assumption that all people want to show-off their medical equipment on their night tables as they would a Tiffany lamp. Some enjoy celebrating their maladies and chat about them continuously. Some prefer more modesty and perceive a greater dignity in discussing more varied topics. For those who prefer modesty it is important not to be queried about a medical device by visitors, relatives and children.

The respiratory groups in hospitals are often not fully trained. They forget to bring patients needed components. There is no sleep monitoring in progress. Other hospital workers come into the room, move rolling tables and masks fall to the floor. The humidifier tank dries up and no one can see that it's empty. A bag that held the hose and mask would be easier for all. Most hospitals allow us to bring our own machines. A good bag means no setup required - less anxiety.

About 7 years ago I did take a breathable-fabric bag, put in a peg-board bottom and 1-inch feet on the bottom of the bag, added many extra holes around the sides of the bag and provided a larger cut-out for the air-intake area of the Resmed S8. When I acquired a PR 760 I cut a new air-intake area for that machine and its modem. With the hose and mask removed for use, and the bag open fully open, there is no functional degradation of any kind. No overheating - plenty of airflow. It is because this idea works so well that I brought it to this forum. I empty the water tank and wash the mask daily with vinegar/water. I allow these to dry in a cabinet though a mesh area on the back of the bag would sometimes be preferred. The bag is zipped up during day and remains perfectly clean with neither dust nor anything else invading the bag. Wonderful for travel as well. It would be better if the bag 'sprung' fully open when unzipped.

A good design for some:

- A plain, handsome, easily opened bag with huge zipper pulls. The zippers should be openable with one hand because some of us have had strokes or injuries. The bag should be available in several muted colors such as black, navy and forest green. The bag should NOT have logos on it. It should be visually interpreted as a simply a carry-all.
- Un-zip the bag, pop up the water bottle to use the machine.
- The machine must be able to operate and breathe within the bag itself; yet, the machine must not be visible through the bag.
- A fancy plastic machine case is not needed in this design concept. Thin, protective foam is required for travel purposes. Impact testing is required, in particular, for overhead luggage compartments on airplanes.
- The humidifier should be a tiny component supplied by a good-sized, standard water bottle such as a liter bottle. When the bottle is lifted vertically it flows into the tiny humidifier compartment.
- The water bottle must be removable easily for refilling.
- The bag must be sized for a 10-foot tube, the largest mask and nothing else - no books or other compartments. Size and weight matter - the smaller the machine the better.
- Two power cords should be supplied. The power cord should plug in on the TOP of the machine. This may seem odd but for those of us who sleep in multiple locations in the same night this would be an advantage. Too many of us also have back problems. Too many of us would prefer not to be fumbling around in order to find low receptacles located behind furniture.
- The machine needs to have built-in wifi for browser access so we can download our own data ourselves if we use proprietary software.
- Built-in wifi should also enable automatic uploading to central databases. We should be granted database access of our own accounts just like we have for banks, investment accounts, hospitals and government websites.
- A standard battery needs to be built in to sound an alarm if there is a power failure; therefore, an on switch is probably required for the machine. Consider using the water-bottle lift-assembly for the on/off switch.
- An excellent, high-quality, easily-replaceable surge-suppressor must be built-in. Many are on the market.
- When the bag is unzipped a flap inside the bag must provide an easy to read label with all of the medical equipment information required for national and international flights. Several languages are required.
- An on/off option is required to alert users if no SD Card is installed.
- A quick-disconnect with 360 swivel on the humidifier itself to make it easier to remove andwash hoses.
- Mesh pocket in the back of the bag to dry mask and any humidifier components.

Several users of this forum have offered good, thoughtful ideas. I've incorporated as many as possible. I have not addressed good ideas such as Zeo, Clock Radios, Android/iPhone Ports and Oximeter options since these are beyond my own experience. The issue of batteries is a very separate one because of weight.

UPS Systems (Uninterupted Power Supplies) are ideal for normal use and should always be used if affordable. Inverters with additional support from sealed car batteries can provide extended power. However, all of these devices are extremely heavy for many and cannot be included in this concept of a portable, accessible machine. Various generators of many styles, sizes and fuel sources are also on the market.

Please remember that Industrial Design is a sophisticated art these days so the technical issues that some of you have addressed represent 'easy workarounds'. Breathability, air source, heat, materials for humidification, etc are all the arena of good designers and by no means a difficult task. For my company's products we still use the tried-and-true method of good drawings, mockups and multiple prototypes.

In the case of xPAP machines the cost of production does not determine price. The gravy-train of the medical market is the determining factor in machine cost. Production costs for a machine in a bag, whether less expensive or more expensive to manufacture, is not going to affect market price.

One last story. In my design experience with the disabled one woman in particular influenced me lifelong. This woman had multiple strokes and used a wheelchair for 11 years. She never, ever, complained of her maladies no matter how severe - and I've seen her screaming in pain. She lived to be 100.

[mollete]

This version has incorporated many of your ideas from a previous thread.

Apparently it doesn't. The overwhelming majority of responses said the whole idea is stupid.

[VVV]

I am interested in therapy and function and will not pay for fashion.

The transformer "brick" is my only complaint. It's a bit much to pack and carry around.

[49er]

This version has incorporated many of your ideas from a previous thread.

Apparently it doesn't. The overwhelming majority of responses said the whole idea is stupid.

Perhaps I am missing something but I am surprised people would think a redesign to broaden accessibility would be stupid since there is a significant amount of people (forget the exact percentage) will have disabilities to deal with when they get older. Actually, since I assume that many people with disabilities currently need pap machines, accessibility should be a priority. I mean, if a blind person needed a pap machine and lived alone, I would think it would be very difficult manipulating current machines without speech to text software.

49er

PS - Just like with other accessibility products, initially they are clunky but eventually become more practical to deal with.

[chunkyfrog]

Bad idea from the get-go.
Is this another "college project"?
A good business plan never originates from a point of ignorance.

EDIT: I see the OP has already changed the poll, eliminating all the votes
which disagree with him. (all the votes but his)
I am going to my user control panel to add him to my foes;
so I don't have to see any more of his nonsense.

[allen476]

Please vote. This version has incorporated many of your ideas from a previous thread.

To: VP's of Product Design for Respironics, Resmed & others
Fr: BiPaP User/Architect/Product Designer
Re: Next Generation of Machines - Broadening Accessibility with PR S2's and RM S10's

The intention here is to provide:
- a truly portable machine for those able to travel (i.e., packing up, airplane. hotel-staff issues, camping, etc.);
- a machine suitable for the injured or disabled or for seniors who sleep in multiple locations;
- a preferable machine design in hospitals for easier delivery to patients, for keeping masks off the floor(!), for keeping machine and components safer and cleaner, for assurance there is water in the humidifier;
- a machine that enables an option for greater modesty.

I've done some design work for nursing homes and for individuals using wheelchairs. A story that might interest you is about a quadriplegic ('triplegic', actually) who wanted a second and more comfortable wheelchair that he might use while he was at home. I bought an off-the-shelf, very handsome, classic bentwood and rattan rocker. I added exotic wheels that you would see during FDR's era. He thought it was a ridiculous idea as if the 'ambulatory look' of medical equipment was a badge of honor. For a few months it sat around and he wouldn't even try it. When he finally did get in the chair he never wanted to get out of it. People visited him more often and he was more comfortable sitting in groups with others. There is a role for beauty, for dignity.

Many people have injuries, infirmities and disabilities that result in them sleeping in several locations at home on the same day - bed, recliner, guest room or couch. Others travel with both machines and humidifiers. Some camp. Others find themselves in hospitals or nursing homes. We all end up in hospitals some time or other. The market would benefit from a truly portable machine that would operate WITHIN a highly-breathable fabric bag. For example shoulder bags and team bags can be quite handsome and are recognized worldwide. Resmed bags look great. Think of the design hoopla and enormous pricing regarding hand bags, fine shoulder bags, attache cases; even backpacks may be exorbitant in price because of good design. Such bags do not look like medical equipment. The bag style that is needed here would not up the cost of a current machine since our machines already come with bags. The suggested bag should have a flat bottom to rest on a table. The carrying handles need to encourage the bag to remain flat. It need not be expensive - just as many bags are reasonably priced and made from off-the-shelf materials. Resmed bag designers would find this right up their alley. Respironics would need to engage a more sophisticated design firm.

A practical idea would be to use a one liter water bottle for the humidifier tank. Plug it in, pop up the bottle vertically and put on the mask. Done. Machines that sit on night tables pretending to look like radios don't address the fact that the tube/mask must be connected, managed and put somewhere. Moving the machine from room to room is difficult for many, particularly because of the large power supply 'brick' and additional wiring. Traveling requires packaging everything up.

It's an incorrect assumption that all people want to show-off their medical equipment on their night tables as they would a Tiffany lamp. Some enjoy celebrating their maladies and chat about them continuously. Some prefer more modesty and perceive a greater dignity in discussing more varied topics. For those who prefer modesty it is important not to be queried about a medical device by visitors, relatives and children.

The respiratory groups in hospitals are often not fully trained. They forget to bring patients needed components. There is no sleep monitoring in progress. Other hospital workers come into the room, move rolling tables and masks fall to the floor. The humidifier tank dries up and no one can see that it's empty. A bag that held the hose and mask would be easier for all. Most hospitals allow us to bring our own machines. A good bag means no setup required - less anxiety.

About 7 years ago I did take a breathable-fabric bag, put in a peg-board bottom and 1-inch feet on the bottom of the bag, added many extra holes around the sides of the bag and provided a larger cut-out for the air-intake area of the Resmed S8. When I acquired a PR 760 I cut a new air-intake area for that machine and its modem. With the hose and mask removed for use, and the bag open fully open, there is no functional degradation of any kind. No overheating - plenty of airflow. It is because this idea works so well that I brought it to this forum. I empty the water tank and wash the mask daily with vinegar/water. I allow these to dry in a cabinet though a mesh area on the back of the bag would sometimes be preferred. The bag is zipped up during day and remains perfectly clean with neither dust nor anything else invading the bag. Wonderful for travel as well. It would be better if the bag 'sprung' fully open when unzipped.

A good design for some:

- A plain, handsome, easily opened bag with huge zipper pulls. The zippers should be openable with one hand because some of us have had strokes or injuries. The bag should be available in several muted colors such as black, navy and forest green. The bag should NOT have logos on it. It should be visually interpreted as a simply a carry-all.
- Un-zip the bag, pop up the water bottle to use the machine.
- The machine must be able to operate and breathe within the bag itself; yet, the machine must not be visible through the bag.
- A fancy plastic machine case is not needed in this design concept. Thin, protective foam is required for travel purposes. Impact testing is required, in particular, for overhead luggage compartments on airplanes.
- The humidifier should be a tiny component supplied by a good-sized, standard water bottle such as a liter bottle. When the bottle is lifted vertically it flows into the tiny humidifier compartment.
- The water bottle must be removable easily for refilling.
- The bag must be sized for a 10-foot tube, the largest mask and nothing else - no books or other compartments. Size and weight matter - the smaller the machine the better.
- Two power cords should be supplied. The power cord should plug in on the TOP of the machine. This may seem odd but for those of us who sleep in multiple locations in the same night this would be an advantage. Too many of us also have back problems. Too many of us would prefer not to be fumbling around in order to find low receptacles located behind furniture.
- The machine needs to have built-in wifi for browser access so we can download our own data ourselves if we use proprietary software.
- Built-in wifi should also enable automatic uploading to central databases. We should be granted database access of our own accounts just like we have for banks, investment accounts, hospitals and government websites.
- A standard battery needs to be built in to sound an alarm if there is a power failure; therefore, an on switch is probably required for the machine. Consider using the water-bottle lift-assembly for the on/off switch.
- An excellent, high-quality, easily-replaceable surge-suppressor must be built-in. Many are on the market.
- When the bag is unzipped a flap inside the bag must provide an easy to read label with all of the medical equipment information required for national and international flights. Several languages are required.
- An on/off option is required to alert users if no SD Card is installed.
- A quick-disconnect with 360 swivel on the humidifier itself to make it easier to remove andwash hoses.
- Mesh pocket in the back of the bag to dry mask and any humidifier components.

Several users of this forum have offered good, thoughtful ideas. I've incorporated as many as possible. I have not addressed good ideas such as Zeo, Clock Radios, Android/iPhone Ports and Oximeter options since these are beyond my own experience. The issue of batteries is a very separate one because of weight.

UPS Systems (Uninterupted Power Supplies) are ideal for normal use and should always be used if affordable. Inverters with additional support from sealed car batteries can provide extended power. However, all of these devices are extremely heavy for many and cannot be included in this concept of a portable, accessible machine. Various generators of many styles, sizes and fuel sources are also on the market.

Please remember that Industrial Design is a sophisticated art these days so the technical issues that some of you have addressed represent 'easy workarounds'. Breathability, air source, heat, materials for humidification, etc are all the arena of good designers and by no means a difficult task. For my company's products we still use the tried-and-true method of good drawings, mockups and multiple prototypes.

In the case of xPAP machines the cost of production does not determine price. The gravy-train of the medical market is the determining factor in machine cost. Production costs for a machine in a bag, whether less expensive or more expensive to manufacture, is not going to affect market price.

One last story. In my design experience with the disabled one woman in particular influenced me lifelong. This woman had multiple strokes and used a wheelchair for 11 years. She never, ever, complained of her maladies no matter how severe - and I've seen her screaming in pain. She lived to be 100.
Last edited by Wakanda on Sat May 18, 2013 6:25 am, edited 1 time in total.

Standard C&P since the OP has no netiquette.

And I agree with Mollette, You haven't read one single post.

[49er]

Again, I agree the OP didn't exactly do things the right way. But frankly, as one who has a dual disability, I am very disappointed that the issue of accessibility is being ignored that was raised in this person's post.

Anyway, this thread perhaps does a better job of demonstrating why the issue of accessibility is important:

http://www.apneasupport.org/accessible- ... 31833.html

49er

[allen476]

Perhaps I am missing something but I am surprised people would think a redesign to broaden accessibility would be stupid since there is a significant amount of people (forget the exact percentage) will have disabilities to deal with when they get older. Actually, since I assume that many people with disabilities currently need pap machines, accessibility should be a priority. I mean, if a blind person needed a pap machine and lived alone, I would think it would be very difficult manipulating current machines without speech to text software.

49er

PS - Just like with other accessibility products, initially they are clunky but eventually become more practical to deal with.

It isn't about not wanting products for the disabled but rather the approach used. The focus has been on some god-awful gym bag idea. Instead of imploring that the manufacturers make it, why not design, manufacturer, market and sell the idea himself. Working around the current design of the core system is what the aftermarket is about.

Do we see Karen from Pad-A-Cheek asking manufacturers change their mask designs because it is too hard to make a product to fit the current design. No we don't.

If the OP was really concerned, then he would be making the products.

[chunkyfrog]

IMHO, Wakanda's "ideas" have very little to do with "accessibility", even though he claims it to be.
The stupid bag is the primary concern--just put in the original box, and put it in the closet!
If you are really concerned about accessibility, build an interface allowing remote and vision-assist operation;
make it after-market to use with any machine. Period.
Concentrate on what will really help people, and take your own prejudices out of the mix.

[Wakanda]

i changed the poll not to alter the results but to provide an additional option. i didn't know it would eliminate the opinions of others. it has been clear to me since i first proposed this that a few pit bulls have no sense of what disability may mean, resent the Americans with Disabilities Act and simply enjoy a nay-sayer modality. it is correct that i did not incorporate such comments. simply, greater accessibility is needed for many who are unable to offer their opinions in a forum. at some point a litigious relative of a disabled person will bring suit against the manufacturers and then our machine cost will rise significantly.

also, please note that Resmed has been supplying quality bags for over a decade and the market cost of Resmed machines is not because of these bags. as i said in my post, it's the gravy-train of medical equipment and what the market will tolerate that governs price.

[49er]

Perhaps I am missing something but I am surprised people would think a redesign to broaden accessibility would be stupid since there is a significant amount of people (forget the exact percentage) will have disabilities to deal with when they get older. Actually, since I assume that many people with disabilities currently need pap machines, accessibility should be a priority. I mean, if a blind person needed a pap machine and lived alone, I would think it would be very difficult manipulating current machines without speech to text software.

49er

PS - Just like with other accessibility products, initially they are clunky but eventually become more practical to deal with.

It isn't about not wanting products for the disabled but rather the approach used. The focus has been on some god-awful gym bag idea. Instead of imploring that the manufacturers make it, why not design, manufacturer, market and sell the idea himself. Working around the current design of the core system is what the aftermarket is about.

Do we see Karen from Pad-A-Cheek asking manufacturers change their mask designs because it is too hard to make a product to fit the current design. No we don't.

If the OP was really concerned, then he would be making the products.

Fair points Allen but in my opinion, asking manufacturers to change their design if it would improve accessibility is not an unreasonable request depending on what is being asked. It isn't always about making a product to fit a current design as perhaps a simple modification in the the mask would make it more accessible. By the way, I am speaking in general terms and don't have any specific product in mind.

Also, don't forget that what starts out to be a specific idea to improve accessibility ends up being very popular in general. Perfect examples are text to speech and voice dictation software.

49er

[allen476]

Fair points Allen but in my opinion, asking manufacturers to change their design if it would improve accessibility is not an unreasonable request depending on what is being asked. It isn't always about making a product to fit a current design as perhaps a simple modification in the the mask would make it more accessible. By the way, I am speaking in general terms and don't have any specific product in mind.

Also, don't forget that what starts out to be a specific idea to improve accessibility ends up being very popular in general.

49er

I am not saying that some of the changes are unreasonable. Some however are better dealt with the aftermarket.

After spending a month in a wheelchair after back surgery, I do have a better appreciation for the disabled and what some have to go through on a daily basis.

However in the context of this discussion, we are working with what the OP wants in redesign. Again somethings are better left to the aftermarket such as the gym-bag idea which is the bulk of the change prayed for by the OP. Somethings are impossible such as the humidifier idea as the additional requirements in temperature would mean heavier and more expensive materials because you can't use plastic. A few things aren't bad and I can agree with.

Perfect examples are text to speech and voice dictation software.

Those were born in the aftermarket unless I missed a big lobbying effort to insist that Microsoft deal with what was needed.

[allen476]

a few pit bulls have no sense of what disability may mean, resent the Americans with Disabilities Act and simply enjoy a nay-sayer modality.

No you have never read any of the comments nor have you even delved in further to find out why some ideas are not workable. Like I said in a previous post, I can give you an experiment that proves that your humidifier idea won't work. And as you can see in my avatar, that hardware kept me in a wheelchair for the first month, so I do have a good appreciation for the disabled and now see things in a different light.

at some point a litigious relative of a disabled person will bring suit against the manufacturers and then our machine cost will rise significantly.

For what?

[NateS]

Wakanda,

I respect the notion of making suggestions to improve the usability and accessibility of CPAP machines for the partially disabled, but perhaps you might now see that you got off on the wrong foot with your method of presentation.

You addressed an audience of people, including myself, who worked hard to overcome an natural unwillingness to accept sleeping with a breathing machine and mask all night, in order to accept the higher priority of treating a serious health condition, and you told us that, no we should be embarrassed and ashamed to let friends and family see our machines! And that by leaving them undisguised on our nightstands, we are seeking emotionally unhealthy attention by doting on our health needs! You actually said that! Many, like myself, were initially in denial and resisted treatment because we did not wish to be seen as being dependent upon a breathing machine, and we worked hard to overcome our initial resistance and to develop a sense of satisfaction and pride in being courageous and intelligent enough to treat the problem and to be proud that we are treating it, and now you come along and try to tell all of us that, no we should be ashamed of our need and should hide it!

Not exactly a way to win friends and influence people! How undiplomatic can you get without expecting a stinging response!

Perhaps you might now see that a wiser approach might have been to first define and narrow your potential audience of interest:

1) People, perhaps some young people, who need CPAP treatment but are still resisting it because they are not yet ready to be seen as using a machine and wearing a mask at night and for whom a "disguise scheme" might help them overcome their final objection and line of resistance; and

2) People who have disabilities and/or employment which makes it difficult to repeatedly plug in and set up their machines and move them between numerous locations during the same night (a group you referred to but never clearly defined or provided examples of and still haven't)

By failing to first narrow and define your potential interest group, your notion of people wanting instead to keep a gym bag on their nightstand or next to their bed did in fact seem ridiculous! You should be able to see that now. As did the idea of traveling around with one. Maybe your idea might appear more plausible if you could explain and define just what group of people it would appeal to? Then perhaps it might not seem so implausible? Maybe persons who have a physical disability but want to adopt an appearance of being on their way to the gym?

So far, you have never really explained the physical condition(s) or employment or routines of the type of person you think your idea might appeal to. Perhaps you might want to take a stab at that? For example, who are these people who move from place to place during their sleeping hours? If you are a person in that line or work or with that type of disability, you should not be ashamed to define and explain it to us.

Best wishes,

Nate

[49er]

Perfect examples are text to speech and voice dictation software.

Those were born in the aftermarket unless I missed a big lobbying effort to insist that Microsoft deal with what was needed.

It looks like Microsoft has had a commitment for several years to improve accessibility to their products. Unless I have missed something, it doesn't look like a lobby effort was needed That is the way it should be and obviously, this hasn't hurt their profit margin.

http://www.microsoft.com/enable/microsoft/history.aspx

At some point, I will look up the history of text to speech software.

Anyway, it looks l need to go back and reread the initial post to see what I have missed. I just zeroed in the accessibility issue because in my opinion, it needs to be addressed.

49er