When Patients Become Innovators

Health care consumers are increasingly able to conceive and develop sophisticated medical devices and services to meet their own needs often without any help from companies that produce or sell medical products. This "free" patient-driven innovation process enables people to benefit from important advances that are not commercially available. Commercial producers of medical devices and services can benefit, too. For them, patient do-it-yourself efforts can be free R&D that informs and amplifies in-house development efforts. In this article, the authors examine two examples of free innovation in the medical field: one for managing type 1 diabetes and the other for managing Crohn's disease. They set these cases within the broader context of the "free innovation" movement that has been gaining momentum in an array of industries and apply the general lessons of free innovation to the specific circumstances of medical innovation by patients. They also explore some of the nuanced questions surrounding patient innovation, such as safety concerns and the legal implications of DIY designs. Even in cases where there are significant safety risks, the authors think it would be a mistake to limit patient innovation. When it addresses medical problems unserved by commercial solutions, they argue, we may well see a net gain in safety and quality of life for the whole population of affected patients. And we can expect safety to improve as low-cost clinical trial methods are developed to enable patient communities to test their own innovations.