What does duct tape have to do with health?

Jose Gomez-Marquez likes to tell people that everyone can hack health, and he’s made a career of proving this true. He is a medical device designer at the Little Devices lab at MIT and a co-founder of DTC+Labs LLC. When you Google him, the search results are basically a list of his awards and fellowships, and news articles lauding his penchant for innovation.

Now, this isn’t innovation in the buzz word-y, conference-speak sense. It’s innovation where if you give Gomez-Marquez an ink cartridge, he’ll turn it into a no-prick vaccine delivery machine, or if he picks up a bunch of coffee filters at the grocery store, some of those might become TB drug compliance urine test strips.

Having grown up in Honduras and coming from a family of medical professionals, Gomez-Marquez knows firsthand the limitations health workers face in low-income developing countries. Unlike in developed countries, if an essential part of a medical device breaks, there’s no repair person coming to fix it. In part because of his background, Gomez-Marquez adheres to the Do-it-Yourself (DIY) philosophy and recognizes that health workers in resource-constrained settings around the world are capable doing some of the best DIY work. In order to foster this behavior, he and his team at Little Devices have recently released a product called MediKit, a series of design building blocks that empower doctors and nurses in developing countries to invent their own medical technologies.

I had the pleasure of getting an in-depth look at the type of work he does when I attended his micro-lab session at the SwitchPoint conference hosted by IntraHealth in North Carolina. During this short hour and a half workshop, Gomez-Marquez provided us with a list of ingredients: a foot pump, two nebulizers, tubes, a splitter, scissors, and duct tape and told us to create a drug delivery device that would treat not just one, but two patients, suffering from an asthma attack. Before setting us loose, he gave us instructions to not only build the device, but to also create a language for replication.

Of course, once we started playing with the pieces, we completely ignored the second part of the instructions.

It was so exciting to solve the puzzle. We got really into the experience of designing something useful and something that saves lives. But when it came to present our final devices and show off our ingenuity, we quickly realized how important the abandoned second part of the instructions were.

Gomez-Marquez didn’t have each team show off how well their inventions worked. Instead, he asked teams to describe how other teams put the device together. When someone began a description along the lines of “attach one end of the tube to the foot pump”, he’d stop them and ask questions like, “what if your audience doesn’t recognize the word ‘tube’ or ‘foot pump’?”, thereby nudging us closer and closer to the revelation that while we had created these life saving devices using nothing but a $7 foot pump, none of our devices had been designed for easy reproduction.

Gomez-Marquez taught us that it’s not enough to hack the device, but you also need to “hack” the language as well. Device reproduction and design dissemination needs to be able to transcend language, literacy, and cultural barriers. In this case, there was a simple solution — color code the connections between parts with different colored duct tape. So, say you connect the nebulizer to one end of the tube with purple tape and the other end of the tube to the foot pump with red tape, someone who’s outside of the process would look at the device and know to connect purple with purple and red with red. He/she wouldn’t have to know the English words for tube and foot pump.

Really, then, it all comes back to knowledge management. You know how to make a life saving device and you want other people to know how to make a life saving device — use colored duct tape. Easy and simple to understand and adopt. This is knowledge management at its best. This is knowledge management when it works.

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This post was originally published on K4Health.org on May 7, 2013.