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I'm extremely happy to present Professor Eric von Hippel here. Um he's actually one of the PIs on this uh grant project. Uh he's a great supporter of MIT bootcamps. And um as we like to say, he's a father of user innovation philosophy approach and trying to bring this to the world. And uh he kindly agreed to um come today and present even though you're actually in right now in California, right? Yeah, it's about yeah, couldn't miss this. Um and so we're happy to hear me by the way? Yes, we can hear you. It's it is really good. It's everything is working.
Yeah. All right, good. Eric, so please take it on. Okay. So, hello everybody. I hope you have your feet up on the tables and are acting entrepreneurial. Uh I can't actually see you. I wish I could, but uh Hannah, I don't know if you can swing that other camera around so that I can see the audience. Can you do that? Okay, I know that room. Okay, I can do something. Actually, we have another computer. Maybe I'll I'll use that um and log in into the Zoom, but you can go ahead.
Okay. So, first of all, hello. You look as though you are really entrepreneurial. I can tell from looking from behind. So, uh what I want to do is tell you about how to get user-developed innovations in the space of um uh substance abuse. So, it's it's uh as Hannah said, I study user innovation. And uh in the course of doing that, we see all sorts of innovation in the substance area that is negative as hell. Like, how do you get around a um a urine test? You know, that's all user innovation. There's no producers that come up with that. Um Hannah, can you hear me? Is everybody Am I doing all right? Yeah, okay. So, what I'd like to share with you is um some research and some ideas about how you can find
innovations not that you develop based upon the needs of people suffering from substance abuse, but the solutions that they have developed to help themselves. That's where important things often come from. Like, as you may know, Alcoholics Anonymous did not come from clinicians or producers, it came from alcoholics trying to help themselves. Okay. So, let me share my screen. And by the way, during the course of this, I will ask you uh for your own examples of user innovation that you may have observed, because I find that unless you sort of try it out on your own experience, you won't really remember a lot of this, okay? So, let's see here.
Uh Okay. So, um I know that you're working in this very important area of uh substance use disorders. I mean, it's a terrible social plague, and we're all worried about it. And so, it's wonderful that you're thinking about it. Um let me now say, well, should you be looking for unmet user needs. Or can you also look for actual prototype solutions developed by lead users? The latter is the approach I focus on. And as I'll try to show you, there's some pretty amazing results uh that come from this particular approach. So, um let me begin then with conventional wisdom.
Conventional wisdom is whoops, wait a minute here. Conventional wisdom, it's all the fault of Schumpeter. Is that Schumpeter said 100 years ago almost that oh, it's the producer who in innovates and consumers are educated by him as necessary. Now, in marketing research, economics, and the rest, what came out of that was this producer innovation and diffusion model. Namely, what you as a producer or somebody trying to supply a solution does is you do market research. You talk to the users not about their solutions, but about what their problems are. Then you say, "Aha, I will invent a solution to that unmet need."
That's why in marketing research they often say, "Find a need and fill it, right?" Then I will do R&D, I will do production, I will do market diffusion, and I will sell you the solution to the problem that you have. Well, that's one way. But there's another way that I will describe to you here that I think you can use to more effectively find the product or service that you want to commercialize in this space. So, first of all, it turns out that Schumpeter's wrong that users in the population innovate all over the place. We now have 10 of these national innovation surveys, nationally representative ones. And what we see is that a lot of people in the population innovate in a lot of areas, including
medical. So, to choose the first column there, or the second column, there was the first study was did was in the UK. And we found that 6.1% of the population developed something for themselves to solve their own problem. They didn't sit around and say, "Oh, I wish a manufacturer would survey me and help me." No, they said, "You know what? I can help myself." So, the number of people in the UK doing these kind of innovations, and we did elaborate work to make sure, you know, about what their innovations were and were they truly innovative and the rest, it was 2.9 million people in the UK who did this.
Now, there are only 23,000 product developers who are working for commercial firms in the UK. So, what you immediately see here is that user innovators outnumber producer innovators by over 100 to 1. So, then the question comes, how do we go about understanding whether what they develop is any good? How do we go about understanding whether their innovations, uh, in fact, can be used by others. So, again, the traditional pattern, and one you might well be in as you try to, uh, develop a solution to the substance abuse problem, is you go through that Schumpeterian user seek uh you producer-centered paradigm, namely you look at users, you look for improvement possibilities of which they may not be aware.
Let me interview you. What problems do you think you have? Let me do a survey to assess commercial potential to see if your needs are widely shared. If I see a potential market, I will develop a solution to your problems. Well, that innovation history belies the facts. User hacks, user innovations have always existed alongside producer innovation. A wonderful example is uh that in 1908, Henry Ford introduced the Model T, which you see there. Right away, customers got to work hacking it. So, what you see here is a user conversion of a Model T Ford into a farm tractor.
They used them to power sawmills, they used them for all sorts of things. The only response of the Ford people was, "Wait a minute, you're going to void your warranty." But users were the ones who, for example, built the pickup truck. That was the first of a long line of what has today become a huge market segment, pickup trucks. Users did it. They took the body off their Model T and built a pickup body. Here's a snowmobile that they developed. Again, as you can clearly see, based upon the Model T uh as a platform. But a user innovation, snowmobile, nobody ever thought of doing a snowmobile before.
A race car. Well, why not? And then user hacking still goes on today. I couldn't resist [clears throat] this. So, here is some examples. People were always hacking VW bugs. So, I put a jet engine in my VW bug because why not? Right? And you can notice, I think this is a J58 or something like that jet engine. Uh and you can notice that the driver's window is open. There's a reason for that and the roof is open. And there's a reason for that, namely jet engines take in a lot of air. And you really want somewhere for that air to come from or you'll end up with a vacuum in your car.
My VW is made out of Legos, sort of. My VW is actually a Rolls-Royce. You probably are familiar with all these things, but it what it is user hacking, which in volume actually exceeds car producer investments in R&D. So, now we all know that user innovation to enhance or hack substance abuse exists. Usually, this is seen as a negative because the users are the ones figuring out how to practice their substance abuse without interference. So, look at the huge inventiveness users display in developing methods to defeat substance abuse control. Oh, you want to test my urine, do you? Give me 15 minutes and I'll invent ways to get around that.
Users, not producers, developed ways to adulterate, substitute, dilute urine samples. These are the common ways to beat urine-based drug tests, says Google. Common household chemicals such as laundry bleach, table salt, toilet bowl cleaner, and so on have been used for many years as adulterants of urine specimens. Again, this is not something that manufacturers do. This is something that users do cuz they have a direct need. Carrying a bottle of drug-free friends' urine is a common strategy for substituting urine samples. In fact, you can even go and find yourself uh videos on how to beat drug tests. Nothing more convenient than that.
But, there are also positive innovations that users make. And this is very important, and this is going to be the source of field-tested ideas for innovations that you yourselves may want to put into the market. So, there were many and are many substance abuse disorder programs developed by experts for users. In fact, that is a standard commercial protocol. Find a need and fill it. So, what happens in these things typically is you go and you interview some users, and you say, "Ah, my gosh, you're suffering. What can I do to solve your problem for you?" And they say, "Get lost." But, really within that large population, and you're unlikely to find them by just random interviewing of users, there are users who have developed
positive solutions for themselves because they have a high need, like Alcoholics Anonymous. You wouldn't find those people in a survey of drug abusers cuz they've gotten themselves out of that category by their own means. The user innovations are often more successful because users can experiment on themselves in real use conditions. Users who do succeed are not advertising their solutions typically. The Alcoholics Anonymous people were an exception. There's no incentive to say that I was a drug user and now I figured out how to solve it.
People will not trust you. They will not hire you if you were a drug abusers. So, entrepreneurs often miss these non-advertised solutions. If you have a method for finding them, you will have a way to recognize their commercial potential and be first in that category of commercializing user prototyped innovations. So, here's a method for uh systematically finding user innovations. You know, in the UN, it's always the case that aid workers and others are saying, "Oh my god, look at this problem. These kids, they're just not You know, I mean, everybody, you know, their development is being stunted. They don't get enough nutrition. This is
horrible. Let's go interview them and see how we can help them." But, Monique and Jerry Sternin, who were aid workers in Vietnam, came up with a different approach. They said, "Okay. The population we're in, let's say we're in a village, consists of people who largely have kids in difficulty. But, maybe there are some people in this population who are doing better. Their kids are actually healthier. Let's find those people. They're the positive deviants. Let's learn what they're doing to help themselves.
Let's figure out how to diffuse their solutions to others. So, a an example that comes from their experience is, again, children in this village are malnourished. I'm going to find the children who are flourishing best. I will ask their moms how they do what they do. What are they doing different? And I'll see if I can apply that solution more broadly. So, specifically, what they found that in the families that were doing better by their children, they were making pots of soup, just like everybody else in the village, but instead of just using the rice that they grew, they were also scooping up the crawfish and insects and so on and so forth that were in the rice paddy
and putting those into the soup as well. In effect, what they were doing was using what normally was regarded as trash and something to avoid in food, and figuring out it was a protein source, and mixing it in their soup. Now, they did not talk to other people about this because that would be considered bad behavior. What? You're feeding your children trash? But, in fact, their children were doing well. And it took these people, Monique and Jerry Sternin, to find these parents and convince them to tell them what they were doing to help their own children. Then, one could start to think about, well, how can I in general develop this approach so it's not that we have to ship in protein powder, but
that we can use locally developed protein sources that are being ignored. Now, here's what I want you to do. I'm saying and it for a moment we're going to take a break and we're going to have uh a discussion of innovations that you know, user solutions that you know. The reason I want to do this with you, I want you to take 5 minutes to chat amongst yourselves about what they might be. The reason I want to do this is because unless you derive from your own experience a realization that what I'm talking about is real by finding examples you won't believe it and uh you'll go on from here. Because standard procedure again is to
ask for unfilled needs and solve the problem yourself. Now, I'm arguing that it's better if you find solutions from users because they have actually developed something which works for them in the field. They prototyped it. So, it's bound to be a better solution than one that you come up with that once you get it into the field may or may not work. So, now um can those of you who are in the audience get next to somebody else? I mean, you'll have to shift chairs. I know this is just horrible. Who could do that? But, get next to somebody else and say hello first. It's always considered a wonderful thing to do. Just say hello. And then start sharing experiences.
Think about user innovations in the area of substance abuse or some you can't think of those that you have either done yourselves or have encountered. Okay? Talk together for 5 minutes, share your stories, and then we will ask you to give us feedback, a few of you, uh you know, who have cool ones, okay? So, 5 minutes started now. It is now 1:00 my time, so I guess it's 4:00 yours. Now, this is super cool. Who has an example they want to share that is just really cool? And that would give us all a feeling. You can volunteer others if you want. You can say, "Ah, Jeremy, yours was fantastic."
Okay? We want to hear from somebody. Who? Uh anybody? Oh, can you speak here? So, um Professor van Nieuwenhuizen here. Hi, I'm Ray Danny, and uh an observation that I've noticed is individuals withdrawing from opioids tend to self-medicate with psychostimulants to treat their withdrawal symptoms and vice versa. So, individuals withdrawing from psychostimulants such as cocaine or methamphetamines tend to treat it with opioids like heroin or fentanyl. That's fantastic. And what do you think about that solution? Is that a viable one or not? Um well, for them, it's what they have access to, and it's it works for them, but uh a viable solution, I'm not sure what you mean by viability.
Well, in other words, when you see that, do you think, "Oh, that helps them, it appears. They're positive deviants. Somehow, if we could spread that info, others would benefit, too." Or do you think, "Geez, that's a dangerous idea. Don't do it." That's a dangerous idea, but it may give some insight in how to treat withdrawal. Okay. All right. All That's good. So, you're observing a user innovation which is not just a thought experiment as Schumpeter would say, "Oh, tell me your needs. Oh, I have to withdraw." You know, it's like they're trying stuff. Mhm. And they're trying stuff because they have a desperate need. Yeah, no one wants to withdraw. Very uncomfortable.
Exactly. Yeah, so fabulous. Good one. Thank you. Uh thank you very much. Anybody else have a cool one? So, I was uh commenting on uh patients with substance use disorders for whom controlled substances are not prescribed tend to abuse other medications such as uh gabapentin uh or even for that matter quetiapine because it sort of sedates them and calms them. Uh but then it becomes a problem because then they become addicted to it and they begin to use it compulsively. So, that's a end-user innovation. I would not recommend it, though. Okay. All right. Thank you. Very helpful. So, you're the one you look at it because you have clinical experience and you say some subset of these innovations are really good and worthy of development. Other ones not so good.
So, let me now go back and say I'll tell you we'll go back to the slides for a moment. And what I'll And then we'll at the end uh we'll have another chat for a minute, but what I want to show you is that there are now methodologies for finding these innovations in big data. So, this plan to say, "Oh, well, if one out of 10,000 users has come up with something amazing, how do I find them?" That difficulty, that practical difficulty, is now being eliminated and we're working on methods with Ipsos where you can find them in 90 seconds through big data. So, it can be a really cool solution for you. So, let me go back to um not that you haven't already thought of brilliant ideas and you don't want
any from those damn users, but anyway. Uh let me go back to my talk. Okay. So, you did this, you were virtuous. Now, uh I want you to notice that whether it's a product or an activity, what the user develops is much cruder than a commercial product. You are not standing there expecting them to come up with something finished that you can test for marketing tomorrow. Here's a wonderful example. Uh there's a guy named Hans Berndt, uh who I work with. He's in Sweden. And uh you can actually on that left-hand thing, he was we were talking and he's in his attic and uh you could see we're zooming together.
I'm on the screen there. And uh he said, "You know, damn it, my back is starting to hurt. Von Hippel, my back is starting to hurt." So, I said, "Well, what are you going to do?" He said, "Solved it." So, he picked up the chair he was sitting on, put it on the table, and made himself an instant standing desk. Now, that tests the principle, and of course he was not the first to do it. That tests the principle at zero cost, right? But, you can see ah, if it helps my back, then maybe it's worth making the investment to make the kind of fancy
things that you see on the right hand side. You can't You often cannot just take the user prototype, whether it's a you know, drug self-administration or whatever, and apply it. You've got to then figure out how to make it sort of more reliable and safe and so on. So, uh the reason maybe that a company would never do that hack that you see on the left hand side is cuz oh, there are all sorts of hypotheses. What if a kid came along and pulled down that chair on top of himself or herself? Et cetera, et cetera. So, you end up with huge investments to make things like on the right. But the critical importance is you do it because you've learned from that quick and dirty thing on the left
that something there is going to work. Okay. So, here's what we have. On the bottom, you see that Schumpeter's principle, producers innovating. On the top, what we now see is something I call the free innovation paradigm. That's users innovating for themselves. Unlike producers, users are self-rewarded. That is, they're doing it cuz they want to avoid withdrawal, for example. And then if they do it successfully, others see it or close to them in some way, whether or not they're sort of advertising it, and they sort of fix it up for themselves, they improve it and so on. And then you get peer-to-peer free diffusion.
Now, it's free, and producers, the bottom line again, which is what you guys presumably all are wanting to be or are, can pick up these designs, see that downward curving arrow, and actually figure out how to make a product out of it. Somebody was mentioning the FDA. One of the advantages in medicine is that users can innovate and share without FDA intervention as long as it's for free. So, I can do anything I want to myself medically. And I can tell others about it because of my First Amendment rights. You only get into the issue of uh okay, uh we better figure this out uh in terms of the FDA is once you start to produce something. So, for this reason, you've got enormous amounts of medical experimentation
amongst users because they don't have to deal with the FDA and it's free. So, what we uh have studied, we found a million in our national surveys, a million patients innovating to help themselves often with chronic diseases. You know, for example, patients are innovating to improve their administration of diabetes drugs and so on. Patients are innovating to ease their pain. You know, when you think about the fact that uh medical clinicians deal with me if I have diabetes or some other chronic condition, deal with me once a quarter for 15 minutes, I've got to innovate. The real innovation process is going on invisibly in that top arrow.
Okay, so uh are these innovations for free? Yes. So, when you look at these surveys, this is again three, but we have 10 now, you see do any of them protect their innovations? No. Because they are benefiting from helping themselves, not by expecting to sell these things. And because IPRs, that is uh intellectual property right protections, cost money to establish, users just give them away. They say, "Fine. If you want to use my method for withdrawal management, be my guest. Happy to have you do it." And this applies also to companies who might pick it up because companies say, "Hey, you know, there's no protection here. I can uh start to produce it,
add improvements, copyright those or patent those, and be off to the races commercially." So, lead users, in fact, are the pioneers for functionally novel innovations, systematically. This is all research we've done. Because at the start, there's no evidence for a market. So, why would producers do it? So, for example, the heart-lung machine. It was developed by a surgeon. No manufacturer wanted to touch it because they said, "Well, you haven't developed any operations that it can be used for. How do we know there's any market?" So, the story was a surgeon who was trying to His name was Hashem Gibbon.
Uh I forget his first name, but Hashem Gibbon was the last name. Uh he was dealing with patients, children, who uh had rheumatic uh fever and then ended up with heart defects, and he was trying to save them, and he realized that he could put in new valves and so on if he could just stop the heart temporarily. He went to medical firms and said, "Hey, can you make me this?" They said, "No way. We don't know if there's any demand." So, he did it over 10 years with uh charitable help. Then what happened? The signal of commercial interest began to grow. The first thing that happened was that other surgeons came around and said, "Hey, I hear you're having success. What are you doing?"
He showed them. And then they said, "Oh, can we have a roll of your drawings and go back to our technician and build one of these? This is really cool." And then eventually enough evidence of a market developed so that producers began to enter. But users only need to know that they're getting benefit themselves enough to motivate them to hack, which can be very cheap. Manufacturers require evidence of a market because they spend a bunch more money making this thing through the FDA, etc. So, this is the pattern you get.
This means in turn that there are a lot of innovations out there that in fact are down the curve and that you could pick up and commercialize if you knew how to find them. So, we are doing research on how to identify innovating users using big data. And my colleague in this is someone named Sandro Collars who works in a company called Ipsos. They are our uh commercial people who do market research and so on and Sandro and others are really good at the big data story and we're working on that. So, again, they identify lead users. Lead users are the ones at the leading edge in that previous curve. And as I said, manufacturers find this product You can see that Sandro's slides are much better than mine.
Uh okay, so what is the process we use? And we studied it first in a field called kitesurfing. What do is we collect content on the web massively. Massive scan of the web. We do a relevance audit automatically. We're looking for things like say in kite surfing. We're looking for text messages and so on that say things like, "I had a problem and I solved it." And then we're looking for uh innovation diffusion. Let me illustrate. I'm not saying that you could do this right now, but you must know that this method exists so that next time you can. So, what happens here? Uh you do user-generated content collection, lead user innovation
filtering, expert validation. In other words, is this mass data you've screened in fact containing innovations? And then trend analysis. I'm really jumping here. So, here I don't know if you know what kite surfing is, but it's a um a way of having a kite board and you have a giant sail that you use to pull yourself through the water. So, manufacturers of these uh make a fairly standard product. So, what happened here? Well, when we did this kind of analysis, again, rapid what we found on the top row is innovations related to improvements to kite surfing. You know, for example, a kite seat for disabled people. Uh improvement in the control lines. A hard shell harness, something that you know, that kite is pulling really hard
and if it's pulling on a rope on your back, that really hurts. So, making a hard shell to distribute the force is a good thing. All of these are user innovations that will be helpful for manufacturers in that field. Now, we also found really radical innovations. In other words, things that are outside the normal marketing research view of companies in that field. We found people, users, making electric hydrofoils for themselves. A user-developed innovation, you may have seen commercial ones by now.
There's something called foil pumping. And then there's drone surfing. What is drone surfing? Drone surfing is saying, "I'm sick of being held by the wind. I'm going to be pulled instead by drones. That way I know where I'm going and I can adjust it for myself." Users built it, not manufacturers. The one on the far left, again, users built it. Why the hell should I have either drones or a kite when in fact I can just put a little trolling fishing motor on the bottom of my board and go whipping along that way. Now, so we found these innovations, right? By our survey across uh the web. Hosted comments. Then what happened? Well, we found out where they're coming from.
We analyzed them, as I say. We had experts in the kitesurfing field say, "Is this really new?" And then we did something important for you. We said, "Fine. This may be a new thing, but is it going to grow like the case of the heart-lung machine? Or is it going to be something of only minor interest?" So, what we did was we studied the social mentions. How many people were talking about, for example, the electric hydrofoil. How many people were searching for that design before it was commercialized? And what you saw was quite a lot of activity. In other areas, you didn't see much activity. And those things like for
instance the drone one never took off. So where were we here? Yeah, so looking at that first we find them then we say fine, are other people adopting them? Is the early part the user part of the diffusion curve showing promise that might be commercially converted? So I want to just tell you then that this is the story and it's possible to do. So comments or questions most welcome. Damn, I can't hear a thing about that wonderful applause. That's terrible, Hannah. I am so sorry. Oh my god, you guys I couldn't hear. I could see your hands but I couldn't see the applause.
Anyway, we it was a round of applause that There you go. I saw it standing ovation. It was amazing. yeah. Okay, so are there comments or questions? Orlando. Where can we find Oh, wait. He won't hear you. Where can we find the methodology? Well, there's a paper on it. Hannah, can you distribute it? I did with Sandro. We can. And what we're trialing this spring in a student course is a sort of a very user-friendly method that people can use. So I would say you'll get the idea of the methodology if you're skilled at analysis of uh big data,
the present method will work for you. If you are saying, "Hey, I just want to get in this and do it in 20 minutes," then you got to wait. You can join my course in the spring. And I just wanted to say that Orlando here, I think, is a user innovator. Uh do you want to share uh what you're working on? What did you do? Well, we collect quite a bit of data on hospital. Oh, well, first of all, I'm Orlando Wright. I'm with uh University of Maryland Baltimore in the Department of Addiction Research and Treatment um under the leadership of Dr. Eric Weintraub. Give him a shout-out all the time. But um most of what I'm interested in is looking at big data for our patients who are uh coming through our treatment centers and in particular those who are
experiencing social determinants of health. And we've been you were speaking. Your music to my ears because I got uh quite a bit of information that I'm collecting and hoping to find ways access that information through our health information exchange. Fantastic. I mean, you will find that uh normally people look at the people with problems, but if you look at the positive deviance, that's where you're going to find the innovations. Uh so, my daughter, uh who's in public health, uh did a survey of uh cancer patients, women, breast cancer, who often, you know, afterwards have sexual function difficulties. So, they're innovating. No doctor's going to discuss with them what to do.
They have developed innovations that can help others like themselves. And it's totally, you know, something that's not diffuse, but could be because uh, you know, people like you could find it in the data. So, thanks for your comment. Praneeth. And introduce yourself cuz Hello, Professor Hippel. My name is uh Praneeth John. Um I'm a data scientist by training. So, my question is kind of along those lines. So, you talk a lot about uh user innovation and um what I my head went towards was uh how adverse the problem is. So, for instance, you know, when your back hurt, you had to put it on the chair so that it won't hurt anymore. Are talking about withdrawals, uh you're trying to solve a
problem there, which is, you know, in the situation of adversity. So, if you had alternatives available, you would not perceive it. So, um in your research Yeah, I can't hear you now. What? Uh yeah. So, sorry, there's some echo technology. So, uh in your research, I wonder if you've taken a look into sort of like a variable for adversity, and if um that led to the success of an innovation or a user-driven innovation? Do you mean adversity, you mean this the intensity of the need? Yeah. Yes, the more intense, that's why lead users do this. The more intense the need, the more you're going to struggle for a solution. So, what we find is that user innovators
with the best stuff are widely distributed in the population. So, you have to have a method to search for them. So, for example, I suspect you would find doctors who are addicted coming up with better solutions than laypeople in some instances. So, uh it's it's a matter of saying that they are there in the population. But, once they've solved their problem, they're probably not advertising it. You know, you wouldn't want a surgeon who said, "Oh yeah, I was a drug addict last week." So, you have to have a systematic way of searching, and that's that's it's there. That's what we know. We've studied this a lot. Important innovations largely are developed by users. So, you know, the methods to find them are what's at
issue here, and that's what we're working on now. Yeah. Thank you so much. But you could be a lead user and develop better methods than us, and please share them. Hey, I'm Kelly Clark. I'm a psychiatrist and an addictionist, and this is a very innovative population. People who suffer from substance use disorders or the disease of addiction. But what we are discussing is the way that they innovate is your example was excellent. How to cheat on a drug test. How to get use RC Cola to make a an abuse deterrent formulation injectable. How to like one of the biggest innovations that people with addictive disease have really driven is the use of the
dark web to get drug delivered to them 24/7 wherever they are. Okay, so the innovations that are coming from what you were saying by user, we haven't we didn't hear any examples of positive innovation there. Other than your earlier one about AA using fentanyl to treat heroin withdrawal is you know, using an opioid to treat opioid withdrawal. That's not what we want to do. And if you were to be looking through this population, that's the innovation that you're primarily finding. But then I look at your other example, which was for heart lung machine, and you redefined user. The user's not the patient with the disease. The user who did the innovation was the physician.
Right? The people who are treating there that was using that device. Yes, exactly. So, I wanted you to kind of maybe speak a little bit more to so that we don't all walk out if you're thinking user means person with the disease of addiction, user means customer for your product or service. I just wanted you to Well, no, user of your product or service or now, if you go to end user, you know, the ones that are out there dominantly because in fact, a lot of people have a lot of money invested in addicting more people in the rest, you will see primarily negative innovations. But, you don't need thousands of positive innovations.
What you need is the few scattered throughout the population like Alcoholics Anonymous. Those will be diffusible and testable. So, it's it's not the general noise that you're looking for. It's the small positive signal in the noise, and I guarantee because we've done it in everything from aerospace to patients. I'll guarantee you that it's out there in that population. So, it's a search issue. Ab- absolutely. There is some innovation that in the patient population that's positive innovation. Yeah. Yes, that's the point. And the advantage of a patient innovation that's positive is they have developed it in the real circumstances of use
and found it still works. It's not something hypothetically developed by somebody else that might work. Right? Right. I'll just go for a lung machine. So, thank you for your comment, by the way. Thank you very much. Could I just make a comment and maybe a statement? Sorry. Could I just make a statement about the user population? So, I do some work with a colleague in Vancouver and they have very progressive laws around controlled substances there. And one use case that we were discussing was that they have testing sites for controlled substances and that dealers go to those sites often times to make sure that their products are not fentanyl-laced or counterfeit. So, they're using that as a value
proposition. I mean, I'm not saying that it's not nefarious indeed, but it is a value proposition that people are not dying from that supply. And I think that was the value prop- proposition that Silk Road was actually trying to make back when they were still in operation. Yeah. You know, I think what all of you would enjoy uh is something a website start- started by a colleague of mine called patientinnovation.com. So, that has been supported by the UN and others. It has thousands of user-developed innovations. And the reason that Pedro Oliveira and I set it up was we're trying to get around this issue that innovations by patients are not often diffused even when they're successful cuz the patients, once they've solved their problem, you know,
they have no incentive. I wonder uh maybe Hannah, do I have a second or not? You do. You have as much time as you need. We've been pretty relaxed with time. Yeah, there's uh more questions, too. All right, let me get this one. All right. Uh hi, I'm Jeremy Gutman. I run a company called Biomotivate. We are working on uh ways to use technology to help people uh to uh stay in recovery for substance use disorders. And our current methodologies have used wrist wearables and virtual reality. And uh Dr. von Hippel, I'm glad you mentioned positive deviance. I've actually been a huge fan of that methodology for uh
a long time. And uh in the couple years that I've spent exploring this space, I've tried to pay attention to positive deviant stories. And I was struck by how the examples people gave uh were kind of I don't know if it's negative deviance or just positive deviance in a not fully positive manner. So, I thought I could share some of the things that I have heard people talk about. Um please do. One is uh someone told me that they listened to motivational videos and paced around their house for hours and hours every day. And now he's 10 years uh sober. So, like it was like repetition and a certain type of audio-visual
stimulus that he found. I've talked to someone who had a little pebble that they put in their bag. And it was some kind of like tangible physical reminder for them that always kind of like helped them to stay on track and uh keep in mind what their goals are. I talked to someone who put little like tchotchkes and motivational quotes and um I think it was like maybe NA/AA phrases all over their entire dashboard of their car. And there was like 300 different things all over them in their space to remind them. Um and I've also uh had I've also thought that treatment centers um have sometimes figured out really good ideas that they don't share.
I've always thought there was a lot of gold that was had the potential to be mined from what they've figured out since they've spent so many years trying to help people. And then you know, like there's very mixed long-term success with uh some of the methods they do. A lot of them are perceived to be not evidence-based. Um but I've always uh heard about techniques that seem promising and I was always surprised people weren't studying them more. Um I mean, one that's becoming more known is EMDR, eye movement desensitization and reprocessing, where you neutralize the intensity of your negative memories. And I've heard of that uh some treatment centers using something called brainspotting, where
you like use your mind's eye to um find a spot uh that feels triggering and then desensitize that. Um and uh yeah, so there's a so there are positive things that I've heard about uh by trying to pay attention to them. And um and I'm I'm curious if you have any suggestions on uh like if there could be some kind of crowdsourcing initiative for SUD positive deviance methods that we could even initiate starting with this group, if you have any suggestions for that. I think it would be excellent. I mean, good for you because once you see somebody doing something like for instance uh the motivational self-motivational stuff, right?
You have a basis for saying what's the principle here? What's going on? How do we turn that into a general method? So it's not that your role is simply to copy what they're doing. Your role is also to say what's going on underneath it. I see that it works, right? Now, let me show you something uh and thank you for that. Let's see if I can do it. Uh share. Yeah, so this is patient innovation. Okay? It's a website. Can you see it? Um and you notice they're saying you can either post a solution or search for a solution. So, these are innovations that users have developed or their caregivers for
themselves. So, for example, uh and they can be simple or complex. Uh let's see here. search a solution. Here's an amazing one. Let's see if I can get it. Yeah, so this is an amazing one. Uh this is a guy who had Marfan, he's a patient. He's a hydraulic engineer, actually. And he's a patient. And uh basically the uh solution was uh given by surgeons was, "Well, we operate on you, you know, your aorta gets thinner and thinner, we cut it up and we uh so and so." Uh and eventually you die because it's just too thin and uh it breaks and you bleed out. So, he said, "Listen, I'm a hydraulic engineer.
We don't treat leaky pipes by uh by slicing them, we add a support around it." And so, he And this is an extraordinary one. He developed uh the idea of these kind of Dacron uh supports that wrap around an aorta. They're specially designed for each patient and he convinced his surgeon to put it in. And now this is a new approach to uh to that particular problem and again, he's the innovator, right? So uh they go anyway, you should take a look at this thing. There are about 5,000 innovations. And it's a it's an attempt to get around the issue of where do you find stuff? Well, you know, this particular website has doctors vetting it so that stuff that's dangerous is not posted. And there are many patients who are willing to post their innovations.
And yeah, free source. patients do have some incentive to post. Uh but in addition, there is this general search process we're developing. So bottom line again is it's out there. It's positive deviance just as my previous commenter said. And it's a fantastic source of things that work in the field that you can go to and screen for new product ideas. So that's what I wanted to say and I know I'm keeping you late for lunch or whatever I'm doing evil. It's dinner time. But we have another session before we go there. Um Are there any more questions? Should we Okay. Uh so yeah, um I think I feel a lot of response in the audience. Definitely neurons firing up um about That's good. We've confused
them enough, you know, with all the different ways you can go about things. Anything you would like to say before concluding the sessions? Are you talking to me? Yeah. No, I'm just a huge fan of what you're doing, Hannah, and of what the people here are doing. It's clearly an enormously important problem. And all I'm doing is saying, "Oh, there's another source of potential solutions. Don't focus on the people who are saying, 'Oh, I'm helpless and I'm doomed and I'm wrecking things.' Go and look for the small subset who have said, 'I'm in a terrible situation and I managed to figure out a way myself nonetheless.'" So, that's my
ending rant and I wish you a good dinner. Bye. Thank you. You're welcome.
