“I thought it was a breakthrough innovation and that if they had
the motivation to work with this product, then they could take it far,”
Bhutani said. “For over 150-odd years, we have been keeping babies
warm by warming the air around the baby.” But when mothers hold
their babies close, heat is transferred by conduction rather than
through the air. Putting the baby in a sleeping bag both warms the
baby directly and warms a small amount of air around it. And the fact
that the device could hold its heat for 6 hours without an external
heating source “made it an ideal device for the developing world.”
Early versions of the warmer had many problems. The team origi-
nally tried heating the wax-like material with tubes of hot water run-
ning through the sleeping bag. “It’s not a good idea to have boiling
water near a baby,” Chen said. They changed the design so that a sepa-
rate heater melts the phase-change material.
The team had to learn about how its target audience would actu-
ally use the device. For example, initially the team used a numerical
display to let users know when the temperature was right. But the
mothers didn’t trust Western medicine’s emphasis on numbers, so
the team changed the numerical scale to symbols indicating “OK”
or “not OK.”
Bhutani arranged for team members to talk with focus groups of
nurses, pediatricians, and neonatologists. One high-priority issue
was cleanliness: The warmth means “the baby keeps warm, but so do
the bugs. Infection becomes a huge risk. The design of this was very
important,” Bhutani said. In addition, in many developing countries,
babies don’t wear diapers, so easy cleaning was a must.
By listening to doctors, the team realized doctors need to watch
babies breathe and assess their color. So they added a clear window
in the front of the sleeping bag. They also made the clinical version
compatible with safe access to an intravenous line.
Running through multiple versions quickly is part of the course’s
Embrace began selling its ThermPod to hospitals in India in April
and expects to launch a version for home use later this year.
“prototyping culture,” Patell said. Course leaders teach students skills
such as sewing and welding to facilitate rapid prototypes. “Embrace
is one of the projects that we can point to and say learning to sew was
a big part of what happened.”
The team needed clinical studies to prove Embrace was safe and
effective so that it could be used in hospitals as an incubator alternative. A study in India demonstrated Embrace’s safety and efficacy on
10 infants. A more extensive clinical study of 160 babies is under way.
At Lucile Packard Children’s Hospital, another study is exploring
Embrace as an adjunct to incubators. Babies are taken out of incubators when they’re stable so they can be held. With Embrace used as a
blanket to keep the babies’ backs warm, they could be taken out of the
incubator earlier and get more skin-to-skin time with their mothers.
As Embrace moved from being a student project to an organization with employees — currently about two dozen — the team also
faced management challenges. About three years ago the cofounders
decided they needed a more traditional management structure with
a CEO, and they chose Chen.
“We’d end up getting into these lengthy conversations on practically
everything. It started resembling a parliamentary democracy instead of
a startup,” Murty said. “Jane is really good at synthesizing opinions and
setting direction, so we decided that Jane should be CEO.”
Embrace launched its clinical product, the Embrace ThermPod, in
April with a comedy of errors, Chen said: The wash tags were printed
incorrectly and had to be sewn on by hand, the power went out at the
integration facility, and a driver got a flat tire on the way to deliver
the first unit. The team quickly piled out of the car, got into an auto
rickshaw, and made sure the unit was delivered to its first customer
at Little Flower Hospital. “It was symbolic,” Chen said. “Nothing is
going to stop us from doing this.”
Now, however, “we’ve just gotten to the hard part,” Chen said this
summer. “We’re still in the infancy of what we’re doing.”
Distribution is a major challenge. Reaching the “bottom billion”
— the more than 1 billion people who live on less than $2 a day —
is challenging for several reasons. How will people hear about the
product? How can they save enough money to buy it? “The informal
economy in the developing world works in livestock and gold,” Murty
said. “Most of them don’t have savings accounts.”
Finally, there is the logistical problem of getting the product to
the user in an area that may not have stores or good roads. For many
goods, up to 30% of the cost is the cost of getting it to the user.
“If your product can’t be carried around on a bike, you’re not done
yet,” Patell said. “A big, boxy incubator is not easy to ship, but a fabric
one is.” Embrace also is trying to innovate by using distribution partnerships such as a sales force that General Electric is building to serve
emerging markets.
Ed McKinley, a Stanford undergraduate from the Class of ’74 and a
private investor in groups working on social justice, said the original
thesis was that the product design would have the most impact, but
“I actually think the innovation that they will become known for is
solving the distribution to the bottom billion — if they can solve that.
The real nut to crack here is how do you get very low-cost devices into
the hands that use them in a cost-effective way?”
Bill Meehan, Racoon Partners Lecturer in Strategic Management
at the GSB, has written a case study about Embrace that considers
when it makes sense to invest in an organization like this one. “I think
Embrace is at the vanguard of a movement to create products for the
bottom billion that, because of market failure, would not otherwise
find funding,” Meehan said.
Shortly after the launch, Chen heard from one of her teammates
who had visited a hospital that was using one of the units. A 2-pound
baby had been born to parents from a village outside Bangalore who
had lost two babies previously. The baby, kept in the Embrace device
for 20 days, was gaining weight, and the mother’s face was joyful
as she held her child. Such stories show why Embrace has become
“the poster child” for the idea of designing for extreme affordabil-
ity, Meehan said. Because most people can relate to warming a cold
baby, “the human connection with a baby warmer is profound and
emotional.”
Chen’s long-term goal is not just to sell baby warmers but to create
other products to improve health care for the rural poor. In May, she
spoke about her journey at the GSB’s Women in Management ban-
quet. When she faces a new hurdle requiring one resource or another,
she said, she has learned to tell herself that the worst that can happen
is someone will say no. “And in my case, when that happens, I guilt
them about being a baby-hater,” she said to laughter from the audi-
ence, which later gave her a standing ovation. ●
