Talks@Google: Jane Chen

FEMALE SPEAKER: Hi, everyone, and thank you for coming.
I'm so excited to introduce Jane Chen, who's the
co-founder of Embrace.
As she'll tell you shortly, Jane is saving millions of
lives with an incubator that sells for 1% of the
traditional cost.
Her mission is to create innovations that represent a
new trend in technology--
simple, localized, affordable solutions that have the
potential to make huge social impacts.
Prior to Embrace, Jane worked with nonprofit organizations
on health care issues in several developing countries.
She spent several years as the program director of a startup
HIV AIDS nonprofit in China, and worked for the Clinton
Foundations Initiative in Tanzania.
She also worked at Monitor Group as a management
consultant.
Chen has been selected as TEDIndia fellow, a TED senior
fellow, an Echoing Green fellow, and a
Rainier Arnold fellow.
Recently, she was also named a young global leader by the
World Economic Forum.
She holds an MBA from Stanford University and a master's in
public administration from Harvard.
With that, let's all welcome Jane, who will be speaking
about embracing life.

JANE CHEN: Thank you so much for being
here on a Friday afternoon.
So I wanted to start by walking you
through a quick exercise.
I'll ask everyone to play along here.
Please close your eyes and open your
hands in front of you.
Now imagine for a moment what you could
place in your hands--
your keys, maybe an apple.
Now open your eyes.
What about a life?
What you see here is a premature baby.
He looks like he's sleeping peacefully, when in fact, he's
struggling to stay alive because he can't regulate his
own body temperature.
There are millions of babies like this born every year
around the world and the mission of Embrace is to give
these babies a chance to survive through a low cost
infant warmer.
Embrace is a social enterprise that aims to provide a line of
innovative and affordable medical devices for emerging
markets, starting with our warmer, and
was started at Stanford.
Back in 2007, when I was doing my MBA, I took a class there
called Design for Extreme Affordability, which is half
MBAs and half engineers.
And we were given the challenge to build a baby
incubator that cost less than 1% of the cost of a
traditional incubator, which is $20,000 in the US.
My own background before business school, I was doing
HIV AIDS work first in China and then in Africa.
And through those sets of experiences, I saw these huge
health care disparities in developed
versus developing countries.
In the US, anyone who needs AIDS medication can get it.
But in places in China and Africa, this was virtually
impossible.
So I saw many people who lost their lives or children who
lost their parents because they weren't able to access
these medications.
And the most frustrating part of this, to me, was that these
are medications that exist and these are people that were
dying for preventable causes.
So Embrace has become a platform for me and my team to
try to bridge that disparity in health care.
And up here are my three co-founders, who I've been
incredibly fortunate to work with.
So I wanted to walk you through some of the design
process that we used to develop Embrace.
There's a lot of talk about design thinking these days,
and I think it's really just a fancy way of saying
humancentric design that's very experimental.
As I'll walk you through each of the steps, first is to
really understand the problem at hand, to be out where the
problem is, to observe it, and develop that user empathy.
And defining the problem is the most important step in
this entire process.
It seems very simple, but that's what paves the way for
human centered product development.
And there's ideating, prototyping, and finally
testing, and this is all an iterative process.
So the first step for us was to really understand the
background of the problem.
There are 20 million low birth weight and premature babies
born every year around the world.
Four million babies die in the first 28 days of their life.
That's 450 babies every hour.
One of the biggest problems they face is staying warm.
Because they're so tiny, they don't have enough body fat to
regulate their own temperature.
And for this reason, many either die or they grow up
with extreme long term health problems.
Incubators, of course, are the most common
solution to this problem.
But not only are they expensive, they require a
constant supply of electricity, so you're not
going to find them in rural areas where most of these
babies are dying.
And instead what you see are light bulbs-- light bulbs are
the most common solution out there, but in every clinic
I've been to that uses a light bulb, you hear stories of them
shattering over babies because of problems with the circuits.
Or you see parents who tie hot water bottles surround their
babies' bodies or hold them over hot coals-- so, really
unsafe, ineffective solutions.
From there, we went to the observe phase.
So we went across the length and breadth of India talking
to mothers, midwives, doctors, community health care workers,
trying to understand the root of the problem.
And we heard stories like this.
This is a woman that I met on one of my
first visits to India.
She lives in a village in Maharastra.
And she had given birth to a tiny baby girl and had taken
this girl to the village doctor to be
placed in an incubator.
The doctor advised her to take her baby to the nearest city
hospital that was over four hours away, and she didn't
have the means to get there, so her baby died
as a result of that.
And we heard this story over and over again.
We also heard stories like this one.

[SPEAKING HINDI]

JANE CHEN: Sujatha lost all three of her babies.
And again, in every village I've been to in India, you
hear the same story over and over again.
And so it was based on research like this that we
realized the problem wasn't serving doctors
and big city hospitals.
We needed a product that could get to women like Sujatha.
In India, 50% of births take place in a home setting.
In countries like Bangladesh, that number is as high as 90%.
And so we defined the problem, and thought about the user as
a desperate parent in a remote village without resources to
access a major hospital with the need being the means to
give their dying baby a chance to survive.
And so with that, we realized that we needed a product that
could work without a constant supply of electricity, that
has no moving parts, that is portable, that's safe and
intuitive to use so even a mother or midwife could use
it, and something that would allow for close mother to
child interaction.
So we begin prototyping.
You can see all the different ideas we had, ranging from a
hot water incubator to a tent like device to a maternity
vest that my colleague Linus is nicely modeling here.
And the idea that we like the best that fit our criteria was
that of a little sleeping bag that uses a phase change
material, a wax like substance, to keep the baby at
a constant temperature.
And I'll show you the final device and then some of the
evolution of getting to that point.
So this is the Embrace Nest.
As you can see, it looks like a little
sleeping bag for a baby.
It's made out of entirely waterproof materials, so you
can clean it easily between every baby.
It's reusable.
But The core technology sits in the back here.
So this is a pouch of what's called a
phase change material.
It's a wax like substance.
You can heat this either with boiling water or with an
electric heater.
But the key is once melted, it stays at the exact same
temperature for up to eight hours at a time, after which
you can simply reheat it.
So I'll pass this around.

And it looks like a very simple device, but it's
actually taken hundreds of iterations
to get to this point.
This is the very first prototype--
very cliche, but the drawings are on the back of a napkin,
and we used margarine to prototype.
It has very similar qualities to the wax.
And then the first renditions of this, we actually had a
product-- we just went to a Salvation Army, found all the
relevant baby gear, and the very first version of the
product actually has a tube running through it that you
pour boiling water into that melts the wax.
And then someone said to us, it's probably not a good idea
to boiling water right next to the baby's head, so we quickly
scrapped that idea.
Then we went to a second version here.
We realized that babies in these countries don't wear
diapers, so we needed something that was really easy
to clean and that was waterproof.
This is where we started moving to those materials.
I'm going to skip a few of these here.
This one's really interesting, because initially we had it
such that the wax would just sit right inside the sleeping
bag and the baby would lie on top of that.
The wax is food grade, it's completely nontoxic, that
would be totally safe.
But there is this perception of fear from mothers of the
wax leaking onto the baby, and so that led us to create a
separate compartment that you see in this current edition
where the wax sits.
Because cleanliness is so critical-- you don't want
cross infection across babies--
we created this sleeping bag out of one piece of fabric, so
there are almost no seams in there, so dirt
can't collect inside.
You see a little plastic window in the front there This
is something doctors were requesting, because they
wanted to monitor the baby's breathing and color, and so we
added that in.
This is a picture of my nephew that I
stuffed into the device.
We show it, because user testing is key, so use your
family members if necessary.
And this is an interesting story.
So on the wax pouch, what you'll see is a temperature
indicator that tells you when the pouch needs to be reheated
or when it's too cold or too hot.
And initially we had a numeric scale going from about 30 to
40 degrees Celsius.
But as we went in villages and tested this, mothers would say
to us we don't trust Western medicine.
If you give me a certain dosage of medicine to give to
my baby, I'll cut in half because it's too strong.
So if you told me to keep this at 37 degrees Celsius, I'll
keep it at a little less than that, because it's
probably too warm.
So it's something we certainly didn't expect to hear sitting
in Palo Alto.
But that led us to this version of the design, which
is a happy face, frowning face.
And now it's just simply a OK, not OK.
So, just really simple cultural nuances have had a
huge impact on the way we've gone about designing the
device and making it really locally
appropriate to these markets.
And from there, we went to testing.
So this is the very first low birth weight baby Nisha that
was placed in the device.
And since then, we've done randomized controlled trials
now and across over 200 babies showing that our product is as
safe and efficacious as a standard of care, even in a
tertiary level setting.
So our progress to date-- our product is available in
hospitals across south India with initial pilots being done
across seven countries.
As I mentioned, we have
multi-center studies completed.
We have an ISO 1345 certification, meaning that we
meet international standards with both regards to
manufacturing and design.
We have a global partnership established with GE
Healthcare.
They're our largest global distributor.
And Embrace has been recognized as one of the top
innovations by the World Health Organization.
But what's been most exciting is seeing our product in use
in the field and the impact that it's having on lives.
This is one of the very first babies to use the device.
This is an 850 gram baby, less than two pounds.
And when I went to the hospital, the doctor said to
me, there's no way this baby's going to survive.
And If it weren't for your product I would just
leave him to die.
I went back two weeks after this photograph was taken and
the baby was still alive.
Two weeks after that, he was sent home with his parents.

This a woman named Mandala who gave birth to baby slightly
over two pounds.
Mandala lost her first two babies, as is so often the
case in the women that we help.
And in this case, what was wonderful is that you could
see Mandala's confidence starting to come back as her
baby gained her health.
And in many of these settings, what happens is not only do
women lose their babies, but they are blamed by their
communities for the loss of their babies.
And oftentimes their families, their husband's families, will
pressure him to leave her if she can not
produce a healthy baby.
So there's a really important aspect to this work which goes
beyond saving babies, and that's empowering these women.

This is one of my favorite stories.
This is a woman named Kurthi.
Kurthi also lost her first baby and gave birth to a
second, a 3 and 1/2 pound baby, who was placed in our
product for about seven days' time.
And I went back and visited Kurthi a few months later.
You can see now the baby's nice and healthy, very chubby.
And she'd gone back and told her entire
village about Embrace.
Even the 110 year old great grandmother knew about the
product and did a little dance to thank us
as we left her home.

And this is another favorite story of
mine, which is in China.
I just visited this orphanage that we're working
with two weeks ago.
And this is baby Long.
He was born about seven months ago.
He was two pounds when they found him.
This is an orphanage that rescues abandoned babies.
They brought him to the orphanage and kept him in our
product for about 30 days.
And this is baby Long seven months later.
You can see that he's healthy, he's very happy, very
interactive.
And they informed me that this was the first time a baby of
this size had survived in the orphanage.

These are some snapshots of our product being
used around the world.
And what's been really, really exciting is seeing the product
go from this to this, which is now a standard of care in many
of these settings.
So this is just the start for us.
Over the next five years, we hope to
impact a million lives.
And we continue to get requests every day from people
all over the world asking when can we buy this product?
I won't go into all of these, but I'll read one in
particular that's always touched my heart.
It's a woman from Uganda who says, the majority of
premature babies are never given a chance to make it out
of the hospitals--
sorry, it's hard for me to read this.

Because there are no incubators, they are left to
die without the comforting touch of their mothers in
those final moments.
And they're placed directly in the trash can.
So we get stories, requests, like this every day that just
really breaks our hearts.
And our goal is to scale this globally as quickly as we
possibly can.
So with that, I thought I'd end with a video so you guys
can see the product in use.

FEMALE SPEAKER: Almost every second of every day, a baby is
born premature or with low birth weight.
Where they're born makes all the difference as to what
happens next.
In the developed world, these babies are placed in an
incubator until they're able to make it on their own.
But for babies born in parts of the world without reliable
electricity or modern medical equipment, desperate mothers
and fathers wrap their babies in blankets, pack them in hot
water bottles, or place them under bare light bulbs to keep
them from freezing to death.

[SPEAKING HINDI]


In 2008, graduate students at Stanford University were
assigned the challenge of designing a baby incubator for
the people who need it the most.
Compelled by the cause, these students abandoned their
career paths, moved to India, and dedicated themselves to
testing and developing their design.
After dozens of iterations and years of testing, the Embrace
infant warmer is being distributed to disadvantaged
communities and is saving lives.
Using an innovative phase change material, a pouch is
heated with a short burst of electricity or boiling water.
Once activated, it maintains a constant temperature
for up to six hours.
One unit can save dozens of lives, and it costs a fraction
of the price of an incubator.
Kurthi's baby weighed less than four pounds at birth and
was in danger of dying.
An Embrace warmer kept her alive and three months later,
the baby has doubled in weight and is doing well.
When baby Long was abandoned at an orphanage in Beijing, he
weighed only two pounds and was hypothermic.
The orphanage had no incubator, but they did have
an Embrace Nest.
After 30 days in the Embrace warmer, baby Long had
stabilized and put on weight.
He is now a healthy and happy seven month old.
MALE SPEAKER: Yesterday we saw that there was a 1.9 kilogram
baby who was wrapped very well but still had a temperature of
34 degrees centigrade and that baby was not suckling.
Two hours from the time of putting it into the Embrace
Nest, the baby spontaneously started to suck.
The baby is doing well and the rest of the babies from now on
will be in good care.
DR. KUMAR: The main advantage of the warmer, the Embrace
warmer, is its portability, its ease of use, and safety.
There is no separation of the mother and child.
The mother can feed the baby and the bonding is improved.
DR. BENAKAPPA: We had a 900 baby.
We needed to put him on radiant warmer.
Not a single warmer was available.
Immediately, we thought of Embrace and we put the baby
inside that.
So as far as neonatal mortality in terms of low
birth weight preterm babies, term babies with very low body
weight-- all of them are safe and sound and
comfortable in Embrace.
FEMALE SPEAKER: Embrace has received international
recognition, and now has the manufacturing infrastructure
in place to rapidly scale for global distribution.

With your support, Embrace is poised to help one million
babies in the next five years.
[SPEAKING HINDI]

FEMALE SPEAKER: Embrace.
Every child deserves the opportunity to
live, to grow, to dream.

JANE CHEN: So that's Embrace in a nutshell.
And if there are any questions, I'd be
happy to take them.
AUDIENCE: I notice that there's a liquid on top of the
phase change material.
What's that for?
JANE CHEN: So it serves two purposes.
One, it's a heat conductor, so we make sure the heat is
evenly transferred throughout the whole pouch.
The second thing it does is it acts as a cushion for the
baby, so even when the wax hardens, the baby is lying on
a soft surface.
AUDIENCE: So I was just kind of curious on what some of the
factors are that are limiting the expansion.
I know you guys have a really good reputation and your
product's effective, so I was just kind of
curious what else.
JANE CHEN: Sure.
So I think there's a couple different things
that go into that.
One is certainly distribution--
so, figuring out who are our partners are going to be in
distribution.
And distribution is not so simple just leaving the
product there.
Even though it's a simple product, it does require
training, and training not only of the doctors but of the
nurses, of everyone who interacts with the product.
Things like making sure the product is cleaned thoroughly
between every baby, for example, requires that
constant training.
In addition to just distributing the product, what
we're also doing is building education around the product
because our interest is in the outcome, not just the
technology.
And so if our interest is really in infant mortality,
then the product gives us an entry point into these
communities.
And once we're there, we want to educate around things like
hygiene, nutrition, breastfeeding-- all the other
really important factors that go into saving a baby's life.
AUDIENCE: So maybe this extends into the
distribution question.
So all the pictures I saw was mostly of hospitals.
JANE CHEN: I'm sorry?
AUDIENCE: Of hospitals.
So I am thinking that it is used by hospitals right now.
How are you going to go it at home, because that you're not
going to anticipate a premature babies, so you're
not going to buy it in advance.
So how is that going to happen?
JANE CHEN: That's a great question.
So we actually have two versions of the product.
One is called the Embrace Nest, which is used in a
clinical setting, and the second is called the Embrace
Care, and that one is used in a home setting.
And the difference is one uses intermittent access to
electricity, and the second one uses just
entirely hot water.
So the way we plan to get these into the homes-- we've
started with the clinical product with the reason of
wanting to get the buy in of the medical community before
we go into a village setting.
But what happens is, in India, for example, the government is
actually paying women to give birth in institutions to bring
down the rate of infant mortality.
However, even if the woman gives birth in the
institution, she doesn't have money to keep her baby there
over a few days So doctors are discharging these babies at
one kilo sometimes, at 2 and 1/2 pounds or even
smaller than that.
And so they have requested a product that they can
essentially prescribe to patients and these patients
can take it home with them.
So that's how we'll start getting into the home setting,
and we've just began that initiative.
Over time, what we hope to do is sell the product directly
to midwives and to community health care workers.
So if each community health care worker has one of these
in their kit, then they can take it from home to home,
take it to one family.
After that family's done with it, which usually is a month
at most, then the community health care worker can
sterilize, sanitize it, and can take it to the next baby.
AUDIENCE: So socially minded, how do you think about
intellectual property?
Because on the one hand, you'd like a big juggernaut like
Siemens or GE to copy what you have and get product out to
babies and help them.
On the other hand, you want to make sure that they don't do
bad quality jobs of it and that you're able to innovate
such things.
There's a lot of issues like that in the drug industry.
I'm curious how you think about that.
JANE CHEN: That's a great question.
So we think about it in two ways.
Yes, if other people copied this product, perhaps we could
have larger scale in terms of distribution.
But you're spot on.
What we're worried about is if it's a local copycat, it's
very likely that it will be a low quality product.
We actually take a lot of care to do the manufacturing in a
very rigorous and safe way, as I said, that meets
international standards.
A lot of testing goes into each and every product.
Rigorous clinical tests have been done as well, so we want
to make sure the second rate product is not introduced into
these communities.
Because if it is and if it starts hurting babies, that
will just kill this entire category of devices.
I think the other aspect of this is also we rely on people
like GE or distribution partners to get this to the
people, to the end customer.
And if you're working with for-profit companies who are
making that initial investment and marketing the device, they
expect a return on it.
And so they're going to want us to be protected
intellectually.
So you have to think about this across the entire value
chain and how it gets to your end customers.
AUDIENCE: Point-- what is your guys' corporate structure?
Are you for profit, nonprofit, because you talk about social
enterprise.
What is your---?
JANE CHEN: So we actually have a unique corporate structure
that's a mix of both a for profit and a nonprofit.
We started in 2008 as a nonprofit as a 501(c)(3) and
quickly came to realize that to do things like
manufacturing and distribution, even our
clinical studies, we require capital to do that.
And you could raise it the way we were in $5,000, $10,000
increments, but it was a very, very difficult to do that and
focus on the operations.
And so what we ended up doing was spinning out a for profit
arm of the company that allowed us to raise capital in
larger increments.
And the way it works is the nonprofit holds the
intellectual property, it takes donations to give away
the units to the poorest communities and provide all of
these educational services around it.
The for profit then licenses the technology, manufactures,
sells it to the clinics that can afford to pay for it-- so
these are still bottom of the pyramid clinics, but they have
a revenue stream.
They can pay for the product--
and then does future research and
development for new products.
And so the idea is that by leveraging private and
philanthropic capital, we can cover all
segments of the market.
AUDIENCE: One thing I'm always curious about in
entrepreneurship and technology
innovation, why now?
Like, why is this happening now?
Why hasn't this been done before?
And I don't mean it in a bad way, but very much like what
happened at that sparked this and why is it successful now?
Why hasn't it been done before?
JANE CHEN: Yeah.
You know, I am not entirely sure about that.
But I love getting that question, because I think it
means you're under a good design when someone looks at
something and says, this is so simple.
How come no one's done this before?
Yeah, it's a really good question.
Part of it, I think, definitely is about timing,
and that if you think about this
issue of infant mortality.
It's getting more attention internationally in the global
public health community than ever before.
It's the Millennium Development goal that we're
the furthest away from reaching.
I'll give you some stats here.
So of all deaths of children under five years old, 40% of
them happen in the first 28 days of a child's life.
Now beyond 28 days, vast improvements have been made
because of vaccines.
That's brought down the death rate significantly.
But there have been very few, if any, interventions in that
first 28 days, and that's really what Embrace is trying
to address here.
AUDIENCE: Hi.
Thanks for giving the speech.
It's really interesting to learn about your product.
I actually used work and development before.
So one of the questions I had for you was how do you get buy
in, and by buy in, I mean cultural buy in, because a lot
of countries are not open to having products coming from a
foreign country?
And then also how you get monetary buy in, because a lot
of developing countries like to get things for free?
JANE CHEN: So in terms of buy in, one of the things I really
stressed here was our efforts in making the product locally
appropriate.
So right after Stanford, the entire founding
team moved to India.
All of our operations are based in India, all of our
manufacturing is done in India, and so I think we're
perceived more as an Indian company, or at the very least
a hybrid, than an American company trying to bring in
Western technology into the market, which is what many of
these incubators are.
And so I think from that perspective, buy in has not
been so difficult.
I think, however, this is a new concept and a lot of what
we're doing now is around thinking through how do we
effect behavior change?
Just because something is needed as demonstrated by the
number doesn't mean demand is necessarily there.
And that requires a lot of education, awareness raising,
marketing, so that's the part of the process
Embrace is at now.
In terms of monetary buy in, we really believe in market
mechanisms where they work.
And so in the areas that we operate, we work with a lot of
private clinics.
And in countries like India, you see a rise of private
health even in rural settings.
And there, we are very much selling the product, selling
it at margin.
That's really important for the organization in our
efforts to become sustainable.
To the segments of the population that we reach
through our NGO partners, the ones we know cannot be served
by the market, there we do give away the product.
But because we accompany it with so much training and
programs, we ensure that it's being used-- again, that it's
not just being dumped at the clinic.
AUDIENCE: Hi.
Thanks for coming out.
So I imagine that success rate is not 100%.
You can correct me if I'm wrong on that.
Have you found instances where there have been times where
these children just aren't able to be saved, and what is
the effect about the perception of the product when
that happens, and how do you counteract that?
JANE CHEN: That's a great question.
Fortunately, we have not seen that as of yet, or if it's
happened, we haven't been notified.
We don't follow every case of usage of the product.
But the fact is, these are sick babies, these are
vulnerable babies, and there will be babies who die in this
product because our product is not a cure all.
It solves some of the problem in terms of keeping the babies
warm, but oftentimes these babies need to be
resuscitated, they need oxygen, they need further care
beyond just the product.
And so I think that's why the clinical studies for us have
been so critical, to show the efficacy of the product, to
show the safety, why we follow very strict processes in our
design and our manufacturing, so if and when that does
happen, we can go back and say, here are all the
safeguards that we've put in place.
And none of this, by the way, is required by the Indian
government.
Our product doesn't fall under any regulatory standards.
We've just done this to really go above and beyond for this
exact reason.
AUDIENCE: I noticed in the beginning your mission
statement is to bring low cost,
affordable medical devices.
So beyond the incubator, what are the other products that
you're thinking about or working on or
are currently testing?
JANE CHEN: So we're really focused on the maternal child
health care space.
As I said, we've just launched a second version of the
product that you see today.
So we want to make sure we get these products right first.
But the way we're thinking about it is working within the
same space and leveraging those distribution channels to
bring other technologies to market.
So a lot of early stage idea.
Nothing I can talk about quite yet, but it's something we
certainly intend to do.
AUDIENCE: I heard you speak at SOCAP yesterday as well.
And I think one of the themes that I saw at SOCAP-- social
capital conference that was interesting, which I'm curious
about your thoughts.
Once you've proven the efficacy of a product, it's
almost better for the world as fast as you can scale.
And in that sense, is there any thoughts on whether you
want to license it out and start sort of having contract
manufacturing for helping it scale and get delivery at a
scale that's beyond your manufacturing capabilities at
some point?
And how do you make that decision?
JANE CHEN: I think we're certainly open to that.
It's kind of step by step process.
I think when you launch something like this that is an
entirely new concept, you do have to micromanage the
process initially to understand a number of things.
How is it being used?
How do we continue iterating the product to make sure it's
appropriate each of these different settings?
Even things like how do we sell the product, how do we
position it, how do we price it--
I don't think anyone will do as good of a job as the
organization that founded this.
So I think once we have figured that out then the next
step is to work with local distributors, and then beyond
that-- yeah, licensing is definitely a possibility.
AUDIENCE: What is Embrace's greatest need right now?
JANE CHEN: What is our greatest need?
A number of different needs.
So definitely, great partners.
That's really how we're going to scale.
We don't have the capacity to go into each of these
countries and so we rely on NGO partners that have really
strong infrastructure in place so they can help with that
scaling process.
Connections to--
again, to NGOs, to governments, to people in the
public health community who can help to scale this.
We're always looking for more human resources.
So, I don't know where Will went.
One of our interns works here now.
We have a really fun internship program that we
have every year.
And then, of course, funding-- so funding on our nonprofit
side to continue scaling these programs and to get more
products out there.
AUDIENCE: I saw that when you guys started, you had a really
small team.
And I was curious to know what kind of background you came
from, whether it was engineering or business or
design, something like that?
JANE CHEN: I personally did my MBA and a public policy
degree, and I had experience before that in consulting and
then with non-profits.
There was a mix of nonprofit and private sector.
But I think I've come to realize is you don't need to
be a designer to do design work.
Anyone can be a designer.
And this design process I showed is just an organized
process for creativity.
And so our product is a mix of engineers--
or our team is a mix of engineers, of clinical folks,
operational folks.
It's just a really fun multidisciplinary team that's
been able to bring this to market.
AUDIENCE: Maybe I missed this because I came a little bit
later, but what are some of your success metrics like
number of children saved?
As in like growth, how many units are being purchased?
JANE CHEN: Right now, it's all about the number of units
being purchased or distributed, as well as the
number of babies who've used those.
So each product can be used by multiple babies.
That's the metric that we're looking at.
We're also trying to establish the metrics to look at within
our educational programs-- for example, how many people are
touched by those.
And over time, through more studies, how has the incidence
of hypothermia been reduced among this population?
And when we have enough numbers, then looking at
things like mortality and morbidity, how we've been able
to impact those.
AUDIENCE: Going across the design thinking philosophy--
how long did it take?
If you look at step one to the final step, how long did you
spend in kind of each of those phases and which one did you
spend the most time in?
JANE CHEN: Let's see.
It's probably taken five years.
So it's a process that never ends.
It's iterative, so we continue to iterate on the product all
the time as we find new things on the market.
I think that's a really important aspect of design
thinking is this innovation never ends.
You can always make the product better, and we're were
always listening for customer feedback.
And being in the field, so we're able to do that.
I think, though, as I said the most important part of that
process is really that point of view.
So who's your user and what's the need?
It sounds simple.
But by shifting the focus, in this case, away from the
doctors and the medical practitioners to a simple
enough product that could eventually be used in the home
setting, that really guided the entire direction of the
product and the organization.
AUDIENCE: You're in a really interesting space, because
it's non-profit and for profit at the same time.
And I was curious to know what are some of the challenges you
think are unique to that space, or something that
you've overcome or struggled with?
JANE CHEN: You mean in terms of being a hybrid structure or
in doing both?
Sorry, we just had a long meeting about this yesterday.
My colleague Pria is sitting in the audience, so she's on
the nonprofit side of the organization and I'm on the
for profit side.
I think that's what's really important, I mean, in terms of
legal structure and contracts--
that can be figured out-- but making sure the teams are in
constant communication, that there's alignment, and that
they continue to be aligned over time is really critical.
And it's actually difficult in the sense that we have one
organization, part of the organization, that's sitting
in the US, and another part of the organization that's
sitting in India.
And so you have to be really proactively communicating all
at the same time to make sure the left arm and the right arm
knows what the other side is doing.
And the whole idea behind this is two entities together will
be much stronger than either of them individually.
But to make that work well, it's all about execution,
ultimately, in communication.
AUDIENCE: This is sort of more generally about when you're
building up the company and when you
decided to be a nonprofit.
When you're fund raising in the start and trying to get
sort of bootstrapped and move up to, like, raising funds,
what were your challenges and how did you learn and adapt to
what you needed to do?
JANE CHEN: I think initially it's always difficult as a
startup to prove your credibility.
I think because we're a products company raising money
for product development it's actually very difficult.
I think it's easier once you have a program out there, you
can show impact.
But if you're raising money for years of product
development in a nonprofit model, it's a little unusual
and can be quite difficult.
But I would say persistence is the way you overcome it.
So I always say in my books no means maybe and maybe means
yes, so never take no for an answer.
And over time, once you start building a core group of
funders, they start spreading the word about your work.
And so I think that those relationships become
absolutely critical in the early days of
doing that fund raising.
AUDIENCE: This is a question for the observation phase.
So I'm assuming that once you went to the community, that's
probably where you found the most information about the
context and environment of people.
I just want to know what techniques or tools did you
guys use in order to bring--
to reveal the most interesting discoveries and which helped
influence the design of the product?
And from a cultural perspective, were people
comfortable with you applying those techniques to ask them
about personal experiences or how they live in their homes?
Was there that pushback from the culture, because if you're
not from that culture, maybe it's a
stranger, they look different?
So was it a kind of cultural pushback?
JANE CHEN: So a lot of it ranged from just observation,
sitting there observing, that's it-- just being a
silent observer and watching how these people interacted,
not just with regards to babies, but in their day to
day lives to understand the overall context.
We also did a lot of focus groups and we did individual
interviews, as well as with groups of women.
We even had sessions where we asked them to co-create with
us, so we gave them materials and asked them to design or
sketch and help us understand how they were
thinking about things.
So there are a number of tools.
The cultural sensitivity is-- there definitely are.
We had to have translators go with us into the field.
And when we brought people who were local, we'd get
information that was much richer.
The other thing we realized was the gender disparity or
the discomfort in talking about some of these issues are
really sensitive with men versus women.
And so initially, I had translators that were men, and
then I bought ones that were women.
You'd see this huge difference in how open the women were
willing to be.
I also I think that trust just takes time to build.
And so the communities where we've gone back over and over,
they've began to trust us as a partner.
Those are definitely areas where we get the richest
information.
And that just takes time to build.
AUDIENCE: You had mentioned that there were no safety or
regulatory burdens to overcome in India.
Is that universally true or are there are places where the
regulatory landscape is more of a burden?
JANE CHEN: They are.
So India right now is the process of, I think, figuring
out and articulating what that regulatory landscape is.
So there is a drug controller, for example.
There are certain medical devices are regulated under
that, but ours doesn't fall under any category.
But I think that's going to quickly change over
the next few years.
AUDIENCE: There's many needs within the world.
How did you decide that this was the one
you wanted to pursue.
And then what was a turning point for your whole team to
say, this is going to happen, we're all
going to move to India?
JANE CHEN: So this one-- you may have missed the beginning
of the presentation.
It came about through a class project, actually.
So it was a challenge that was posed to a few of us taking
this class together, and that's how everything started.
But in terms of how we decided to move forward with it, I
think the end of the class came and we thought if we
don't take this forward, no one else is going to.
We're sitting on a great idea here.
We really wanted to see it through to the end.
So we started applying for different grants and there's
one in particular that required a two year
commitment.
And so once we got that, we knew we were locked in for a
couple of years.
And slowly one by one, everyone either quit their
jobs or graduated.
And as a team together, we decided to do this full time
and move to India, and have grown since then from four
people to 60 people.
So it's been really fun to see the growth of the company and
building the organization has been one of the most
interesting things for me.
Cool.
Well, thank you guys so much.
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So again, if you sign up for the newsletter, we'll give you
more information on that.
It's going to be at the design school there.
We're going to be doing some really fun activities around
the design thinking process that I introduced here today.
So thank you again for being here, and we hope that you'll
get involved in some way.