ParaMedical Technologies


PORTABLE WEIGHING DEVICE FOR THE MOBILITY DISABLED

 

MARKET EVALUATION

Although the number of mobility disabled in America has increased over the past decade significantly more rapidly than has the general population there are no conveniently-operated devices available today for the expeditious weighing of the mobility disabled. This lack is particularly felt at health-care facilities, both hospital and nursing homes, as well by home-care providers and at the residences of wheelchair users. The devices that are available are either awkward: requiring strenuous pushing of wheelchairs onto a platform scales, or demeaning: requiring strapping the occupant into a sling scale and hoisting them up.

The most generally used device for weighing the mobility-disabled at health-care facilities is the platform scale. It is usually placed in a designated weighing room and all non-ambulatory patients are rolled from their rooms to the scale, often requiring elevators in large multi-floor facilities. The wheelchair and occupant are pushed up a set of ramps onto the platform. The process is not only very fatiguing to care-givers but potentially injurious to care-givers. Back strain is the chronic working hazard in nursing, involving the pulling, pushing and holding of patients, tasks which, in addition, have the potential of inflicting injuries on patients, generally by dropping.

That no concerted efforts has been expended to develop a portable weighing device is all the more surprising because injuries to nurses involving back strain constitutes largest category of workers' compensation payments in the health care industry.

The Portable Weighing Device for the Mobility Disabled comprises two modules with electronic weighing platforms that when folded together fit into a light brief-case sized containment. In operation first the caster wheels and then the main wheels rolled onto the platforms. The device is fully automated in computing the total weight and displaying the results.

For the primary market, generally hospitals and nursing homes, the principal market driver for the proprietary Portable Weighing Device will be insurance companies. Those involved in medical insurance are vitally interested in reducing the incidents of back strain to care-givers involved in moving and transferring the mobility disabled for weighing purposes, a principal cause for workman's compensation claims for care-givers in the health-care industry.

For the secondary market, generally home-care providers and group practices, the principal market driver for the proprietary Portable Weighing Device will be treating physicians. The availability of the Portable Weighing Device will induce physicians to insist that home-care providers obtain accurate weighings of the patients entrusted in their care. Unlike the present situation, in this manner physicians can protect themselves from criticism if irregularities in treatment arise.

For the tertiary market, generally home users and medical trial groups, the principal driver for the Portable Weighing Device will be pharmaceutical companies. Medical trial groups are not equipped at present to handle the mobility disabled because portable weighing devices are not available and consequently this important category of patients cannot be adequately monitored.


CONTENTS
I Introduction
II Product Necessity
A. Need
B. Remedy
III Market Research
A. Survey of Health-Care Administrators
Response to Questionnaire
1) Ease of Operation
2) Ease of Access
3) Necessity
Result of Survey
B. Survey of Health Care Workers
Response to Questionnaire
Result of Survey
IIII Marketing Considerations
A. Market Analysis
Primary Market
1) Hospitals and Rehabilitation Centers
2) Nursing Homes
3) Group Practice
Secondary Market
Tertiary Market
B. Competition
C. Sales Considerations
D. Promotion
Primary Market
Secondary Market
Tertiary Market
E. Service
F. Distribution Channels
V Proprietary Concerns
United States Patents
VI Conclusion



I Introduction


ParaMedical Technologies was organized to develop a Portable Weighing Device for the Mobility-Disabled. The proof-of-performance prototype was financed by an investment by the Ben Franklin Partnership. The prototype has been site tested at four health-care facilities in the Philadelphia area and elicited very positive responses from health-care providers. The proprietary rights to the innovative features of the brief-case size Portable Weighing Device are protected by three United States Patents.

The number of mobility-disabled in America is now well over two million of which almost 11/2 million are confined to wheelchairs. Such an ostensibly simple procedure as the routine weighing the mobility-disabled at health-care facilities can be quite involved because the weighing device must accommodate the wheelchair, which generally requires ramps and a heavy platform scale. Regular weighing is particularly important because the treatment of many ailments include strict weight control. Consequently nurses and nurses aids often must roll 50 pound wheelchairs with 200 pound occupants up the ramp of heavy cumbersome platform scales or hoist patients in a sling scale numerous times each day, both time-consuming and very fatiguing efforts, and as for the latter, potentially dangerous. The Portable Weighing Device will reduce the incidents of back strain to care-givers involved in moving and transferring the mobility disabled for weighing purposes, a principal cause for workman's compensation claims for care-givers in the health-care industry, and a major concern of insurance carriers. Significantly, the Portable Weighing Device is in addition a major labor saving device.

The primary market for the Portable Weighing Device covers institutions such as the 4,500 hospitals and rehabilitation centers with almost one-million beds and the 16,500 state-certified nursing homes with more than 60 residents. This market also includes the 3,500 physician group practices with more than 10 physicians. The primary market would be serviced by Manufacturers Representatives.

The secondary market covers residential home-care use for the mobility-disabled for whom the lack of weight control programs can aggravate life-threatening ailments. This market involves third-party payments through insurance carriers. The tertiary market includes visiting nurses, discretionary mobility-disabled purchasers who desire a weighing device at home, and clinical drug trial groups. There are no commercial devices available suitable for the secondary and tertiary markets. These markets will be serviced by Durable Medical Equipment suppliers.

Figure I-1. Commercial Configuration of Fully-Deployed Portable Weighing Device

Based on market surveys, because of the high perceived value of the Portable Weighing Device by health-care administrators and nursing supervisors involved in institutional acquisitions, it is the contention of ParaMedical Technologies that the Portable Weighing Device for the Mobility Disabled as shown in Figure I-1 will dominate this market for weighing devices.

 

 



II Product Necessity


A. Need

There are no conveniently-operated devices available today for the expeditious weighing of the mobility disabled, particularly the occupants of wheelchairs, whether at health-care facilities or at their residences. The devices that are available are either awkward: requiring heavy pushing of the wheelchair onto a platform scale, or demeaning: requiring strapping the occupant into a sling scale and hoisting them up.

The most generally used device for weighing the mobility-disabled at health-care facilities is the platform scale. It is usually placed in a designated weighing room and all non-ambulatory patients are rolled from their rooms to the scale, often requiring elevators in large multi-floor facilities. The wheelchair and occupant are pushed up a set of ramps onto the platform. The process is not only very fatiguing to care-givers but potentially injurious to care-givers. Back strain is the chronic working hazard in nursing, involving the pulling, pushing and holding of patients, tasks which, in addition, have the potential of inflicting injuries on patients, generally by dropping.

That no concerted efforts has been expended to develop a portable weighing device is all the more surprising because the number of wheelchairs users in America has increased over the past decade significantly more rapidly than has the general population, as is evident from Figure II-1. Whereas the population has increased some ten percent in this period the number of wheelchair users has almost doubled from some 750,000 in 1980 to well over 1,500,000 by 2000.(1)

Figure II-1. Change in Wheelchairs Usage Relative to Population Change

The principal manufacturers of these platform scales are Cardinal Scale, Sunbeam, and Scaletronix. In terms of portability the major limitations of the scales listed in Table II-I are weight and size.(2) Although an electronic suspension promises a significant weight savings at a moderately higher price, both models remain heavy institutional devices and decidedly not portable.

Because of their weight and size commercial platform scales have minimal attraction for care givers, especially in private practice. Unless a physician has a substantial number of non-ambulatory patients, most will forego having a platform scale at their office. They take up an inordinate amount of floor space in relation to their benefits to patients and care-givers. Moreover platform scales are obviously inappropriate for residential use considering their weight and floor space occupied. They lack portability.

Table II-1. Principal Manufacturers of Platform Scales

The annual sale of platform scales by these manufacturers is roughly 2500 units, for annual retail sales of almost $4.8 million.


B. Remedy

The requirements for a portable weighing device for the mobility disabled to be attractive to this market was surveyed by ParaMedical Technologies. The principal requirements for such a device is reliability, simplicity, and portability.

These disparate requirements are very difficult to reconcile. Portability requires light construction while ruggedness requires heavy construction. Simplicity requires an internal complexity necessary for the weighing device to actively guide the operator though the steps necessary for the weighing of a wheelchair occupant.

Three problems had to be solved before a weighing device for the mobility disabled would be viable.

a) The tilt error associated with wheels on the scale being higher than the wheels on the floor would have to be less than 0.5% of the weight measured.

b) Because the wheelchair and occupant weighing up to 400 pounds tends to push the 20 pound weighing device rather than roll up onto its ramps the ramps must have such a design curvature that the wheel tread contacts the ramps beyond their front edges.

c) The hinge of the scissor mechanism must be so designed that it automatically locks on closure to prevent the halves of the weighing device from springing open and damaging the scissor.

Both Detecto and Health o Meter were queried during the conceptual stages of this project concerning their interest in a portable weighing device. Detecto admitted to pursuing the development of such a device over the past decade and knowledgeably described the obstacles and pitfalls involved, particularly relating to wheelchair tilt and wheel positioning errors on the platforms, which indicated their seriousness in pursuing this matter. The other problems were not considered.(6) Neither company has marketed such a device to date, but both indicated that the market for a commercial portable wheelchair weighing device would be very promising. This is apparent as both companies attempted to elicit technical details concerning any developments in the field of portable weighing devices for the mobility disabled.

Little if any information is presently available concerning the weight distribution of the mobility disabled. Staff members at the School of Health and Rehabilitation Sciences at The University of Pittsburgh suggested that the weight distribution of the disabled population should parallel that of the general population, the latter shown in Figure II-2.(7) Accordingly a portable weighing device with a rated capacity of 350 pounds should handle the roughly 90% of the disabled population weighing less than 300 pounds, plus their wheelchairs.

 

Figure II-2. Weight Distribution of General Population

A prototype processor-controlled Portable Weighing Device was fabricated by ParaMedical Technologies. In operation the weight of the wheelchair is entered into the internal memory of the Weighing Device either using the keypad or by rolling the unoccupied wheelchair across the Device. The caster wheels and then the main wheels of the occupied wheelchair are then rolled across the Weighing Device in the sequence shown in Figure II-3. The weight of the occupant is then displayed.

 

Figure II-3. Weighing Sequence

The prototype was used for site testing at health-care centers in the Philadelphia area. The purpose of this site-test was to ascertain the reaction of nurses and nursing aids to the configuration and operation of the Portable Weighing Device, and particularly the reaction of nursing supervisors directly involved in purchasing decisions. The Portable Weighing Device folded for carrying is shown in Figure II-4.

Figure II-4. Commercial Configuration of Portable Weighing Device Folded



III Market Research


A. Survey of Health Care Workers

Although the laboratory evaluation model of the Portable Weighing Device shown in Figure III-1 operates essentially as would a production model, the appearance and weight of this prototype is evidently not optimized for marketing. Accordingly, the market survey conducted, was by necessity, limited, although highly informative.

Figure III-1. Laboratory Evaluation Model of Portable Weighing Device

Thirty-one care-givers in the listed institutions who generally care for non-ambulatory patients operated the weighing device and answered the formal questionnaire supplied.(8) The questions posed by the questionnaire, and the 31 responses, are as follows:


Response to Questionnaire

1) Ease of Operation

a. Does the control panel layout of the Portable Weighing Device lend itself to ease of operation?

30 Yes, 1 No

b. What suggestions would you make to improve the control panel or ease of operation?

Two respondents suggested a higher control panel to minimize bending, two rechargeable batteries, two that the access ramp should be lower and one that the control panel lettering should be larger. Foot or hand-held controls were suggested by six respondents.

2) Ease of Access

a. Does rolling an occupied wheelchair onto the Portable Weighing Device appear to be a safe operation for the occupant and operator?

27 Yes, 3 No, 1 Unanswered

b. What suggestions would you make to improve access to the device?

Two respondents indicated that wheelchairs might be prone to tip over at ramp, 11 that access ramp should be lower, and one that confused patients may not be able to keep still between weight readings.

c. It is necessary for care givers either to bring patients to a scale or to bring a scale to the patients. Would the Portable Weighing Device be more ( ) equal ( ) or less ( ) convenient to care givers as compared to a platform or hoist scale.

20 more, 1 equal, 10 Unanswered

3) Necessity

a. If the Portable Weighing Device were commercially available at this time as a compact light-weight device would you consider it helpful in performing your duties?

29 Yes, 0 No, 2 Unanswered

b. Platform and lift scales for the mobility-disabled are priced between $1700 and $2500. At half this platform or lift scale price would you recommend to your supervisor the purchase of the Portable Weighing Device for your department?

29 Yes, 0 No, 2 Unanswered

c. At half the platform or lift scale price would you recommend to your supervisor the purchase of more than a single Portable Weighing Device for your department?

12 Yes 15 No 4 Unanswered

d. What reasons would you give to support your recommendations?

Eight respondents were impressed by ease of operation, portability, convenience and compactness, one that the device would reduce back injuries of nurses, and one that it would be useful for patients for whom it is difficult to transfer to a chair scale.


Result of Survey

The survey was decisive, despite its limited extent, because none of the questions elicited responses that indicate seriously divided opinions of the respondents.(9)

The Portable Weighing Device was overwhelmingly regarded as a device capable of aiding care-givers in their duties, despite the wide range in rank of the respondents from supervisors to nursing assistants, and the range of facilities surveyed. Each respondent answered the questions posed with no discernible assistance from other respondents.

Those who operated the Portable Weighing Device were particularly impressed with its portability and its operator guidance system. This microprocessor controlled feature instructs the operator by display message and indicator lights each step required to operate the Portable Weighing Device

There were two important verbal impressions gathered in conducting the survey:


B. Survey of Health-Care Administrators


Response to Questionnaire

The Melior Group, a market research and consulting firm in Philadelphia [(215) 545-0054], was contracted to conduct a qualitative survey of health-care executives from home-care organizations, physicians, hospitals and long-term care facilities to learn the market requirements for weighing devices for the mobility disabled in general and the Portable Weighing Device in particular. Health-care administrators who volunteered to participate in the survey received a gratuity.

The respondent breakdown is as follows:

Hospitals and Long-Term Care Facilities

Home-Care Organizations

When weight-sensitive conditions are present such as multiple sclerosis, severe diabetes, congestive heart failure, or amyotrophic lateral sclerosis, caregivers resort to the following:

  • Supporting patient
  • Simply estimating weight
  • transporting patient to an appropriate facility
  •  
    When administrators were asked about currently available devices for weighing the mobility disabled their purchase-decisions were based primarily on the following:
     
    Table III-1. Basis of Purchase Decisions
     
     
    Purchasing behavior depended primarily on type of health care provider and on price. For home-care organizations purchase department must approve and facilitate purchase. With hospitals a product standardization committee might become involved. For items other than diagnostic equipment such as weighing devices which directly involve healthcare workers, any dissatisfaction with a current devices by workers is seriously considered. Above a specified price the approbation of more senior administrators is usually required. Purchases often must conform to pre-approved venders.
     
    Respondents rated six possible drivers behind the decision to purchase a weighing device for the mobility disabled.
     
    Table III-2. Purchase Drivers
     
     

    Some respondents were non-responsive: percentages do not necessarily add to 100.

     
    Characteristics considered most valuable to administrators for a weighing device for the mobility disabled are shown below.
     
    Table III-3. Value to Purchaser
     

    Some respondents were non-responsive: percentages do not necessarily add to 100.

     

    Administrators obtain information about new products from a variety of sources. The most conspicuous are the following:

    Table III-4. Value to Purchaser

    Some respondents were non-responsive: percentages do not necessarily add to 100.

    Other sources of product information cited were:

    Result of Survey

    Because the actual Portable weighing Device for the Mobility Disabled was not available to the respondents their opinions depended on a verbal description and a drawing of the device.

    Overall, the reaction to the Portable weighing Device for the Mobility Disabled was highly favorable. A drawback mentioned is the weighing limit of 350 pounds; a weight limit of 500 pounds would have been be desirable. However the present limit will cover some 90% of the mobility disabled. In any event disabled persons with higher weights require special heavy, wide wheelchairs and special facilities.

    Respondents were also concerned about how accurate would be the Portable weighing Device for the Mobility Disabled. Accuracy of the device would be on the order of one percent: within normal circadian weigh variations.

    As for obtaining the empty weight of the wheelchair, the unoccupied wheelchair need be only once pushed over the Portable weighing Device for the Mobility Disabled with the device set for Wheelchair rather than Occupant. A tag on the wheelchair would then indicate its weight.

    Several of the comments made by homecare administrators were disingenuous. Rather than answering the questions these comments simple opened the door to a slew of more pertinent questions.

    "When we have a mobility-disabled patient that we want to weigh, we just do the best we can... none of our field staff has ever complained about not being able to weight a patient." Homecare Provider

    As far as field staff complaints: Why should your field staff complain for having fewer chores, and if so inclined, to whom should they complain?

    "I guess that sometimes weights are inaccurate, or that the caregiver doesn't bother to weigh the patient even though they are supposed to, but it never caused a problem." Homecare Provider

    As far as lack of weighing never causing problems: how would anyone know? How would the Provider know if none or inaccurate weighing caused problems? Physicians kept ignorant of these practices and patients whose hearts were impaired, perhaps because of fluid retention, are ill equipped to complain about the dereliction of the homecare provider.

    "Weight is not the primary concern for mobility-disabled patient. In 11 years, I can think of only three occasions where we felt it was really important to get a weight on a wheelchair-bound patient, so we took them to a nearby hospital to get the weight." Physician Practice

    If physician practices in general are any indicator, virtually all mobile patients are initially weighed as a matter of course. Why on only three occasions did you have to weigh non-mobile patients. Why are non-mobile patients excluded as a matter of course?

    It is evident from the above few comments that the true driver for the purchase of the Portable weighing Device for the Mobility Disabled by homecare providers must be the insistence of the treating physicians. However without a portable weighing device available the insistence on regular weighings is impractical. In fact if such a device were commercially available, such as the Portable weighing Device for the Mobility Disabled, physicians would insist on homecare providers obtaining accurate weighings of the patients entrusted in their care. In this manner physicians would protect themselves from criticism if irregularities in treatment arose.



    IIII Marketing Considerations


    A. Market Analysis

    The market for Durable Medical Equipment (DME) such as the Portable Weighing Device can be divided into three independent categories: the Primary Market comprising Health Care Providers, the Secondary Market comprising Home Care Users, and the Tertiary Market comprising Specialized Services. These categories each require a different marketing approach and distinct distribution channels.

    The Primary Market comprises Health Care Providers such as hospitals, rehabilitation centers, large physician group practices, and nursing homes. This market is serviced by manufacturers' representatives, each of whom cover specific geographical areas, and are either individuals or operate as a group. They sell directly to institutions and physician's offices in a manner similar to drug industry practice and receive a commission from manufacturers, ordinarily 10% of the sale price.

    The Secondary Market comprises Home Care Users eligible for third-party reimbursements. Home Care Users are serviced directly by DME suppliers. This market is highly elastic inasmuch as the prevalent markups charged by suppliers can range from several hundred percent for items priced less than $100 to less than 15% for items priced over $10,000.

    The Tertiary Market comprises Specialized Services such as drug trial groups, Home Care Services, and those making discretionary purchases. Specialized Services are reached by direct marketing and sales.


    Primary Market

    1) Hospitals and Rehabilitation Centers

    The institutional market for the Portable Weighing Device is driven by

    Risk Control

    Back strain leading to temporary incapacitation arising from overexertion is the principal cause of time lost by care-givers, and is a major driver for increases in workman's compensation premiums for hospitals. Overexertion invariably arises from moving non-ambulatory patients by pushing and pulling, such as moving patients onto and off of platform scales.(10,11) These transfers, often involved in preparing patients for weighing, are a major cause of injuries to patients in hospitals and rehabilitation centers.

    Labor efficiency

    Weighing platform and lifting hoists are generally placed in special rooms to where all of the non-ambulatory patients must be brought, involving elevators for multi-floor facilities. The Portable Weighing Device can be carried to the most convenient locations, reducing staff and time requirements for weighing.

    There are some 4500 general hospitals and rehabilitation centers in the United States with almost one­million beds.(12) Of these some 800 are for-profit facilities. Half of these are controlled by just three companies: Quorum Health Group with 266 facilities, Columbia/HCA Healthcare with 166, and HealthTrust with 116.(13) The average bed occupancy rate of hospitals is on the order of two-thirds. Roughly half the inpatients are non-ambulatory. Accordingly, there are some 330,000 inpatients requiring weighing on special devices on a regular basis. These beds however are not uniformly distributed, as shown in Figure IIII-1.


    Figure IIII-1. Distribution of Beds Among General Hospitals

    The potential market would be one unit per hospital for the 1800 hospitals with less than 100 beds, regardless of the number of non-ambulatory patients. For larger hospitals the picture is decidedly different. These facilities have either a platform or a potentially dangerous hoist scale on each floor, generally at a special site, or all non-ambulatory patients are moved to the floor with the scale. In contrast, as evident from our Survey, nursing supervisors were enthusiastic about placing the Portable Weighing Device in the hallway adjacent the central nursing station until the day shift's weighing requirements were completed. Almost all 11 of the supervisory respondents thought that each department dealing with the mobility disabled would want one Weighing Device.

    The major disagreement between the respondents of the survey concerned the number of Portable Weighing Devices per department: most thought one, but several more than one. Apparently each department takes a proprietary view of their DME. With this thought in mind a very conservative estimation was made that potentially one Portable Weighing Devices would be desired for each 50 beds.(14) Hence the potential hospital market would be some 20,000 units.(15)

    2) Nursing Homes

    Non-ambulatory residents of nursing and retirement homes require only periodic weighing, either fortnightly or monthly. Therefore a single Portable Weighing Device per unit would constitute the potential market. The survey indicated however, regardless of the frequency of weighing, the Portable Weighing Device was considered a positive aid to those doing the weighing in terms of utility and labor saving, a view shared by the nursing-home supervisor.

    There are almost 16,500 state-certified nursing homes in the United States, 70% of which have more than 60 residents.(16) The potential nursing home market would be one unit for each of these larger facilities.

    3) Group Practice

    Of the almost quarter million physicians in private practice in the United States, roughly 200,000 are in group practices. Seventy percent of these physicians are in the 3500 groups with 10 physicians or more.(17) These larger groups would be most likely to attract mobility-disabled patients because they can provide multiple medical specialties and consequently would be most likely to acquire a Portable Weighing Device. These would constitute the potential market.

    For the primary market as a whole the principal sales driver is the reduction of back-related disability of care-givers. Because the Portable Weighing Device is designed to replace existing platform scales, the reduction in workman's compensation claims and lost time will primarily drive the sales of the Weighing Device.


    Secondary Market

    Home-care users eligible for third-party payments constitute this market. The Portable Weighing Device must be prescribed by a physician. Medicare are very strict concerning support for home-care appliances unless their utilization has a direct bearing on controlling a critical medical disorder such as congestive heart Disease or edema for which weight control must be maintained. Non-ambulatory persons requiring dialysis or suffering from spinal injuries are susceptible to fluid retention which can be dangerously exacerbated by uncontrolled weight variations.

    The number of non-institutionalized persons with these ailments between the ages of 65 and 74 years comprises roughly 1,230,000.(18) Applying to this figure the same fraction of persons in the general population who are non-ambulatory: some 0.3%, then approximately 37,500 of persons in this age category with these ailments are non-ambulatory.(19) Conservatively perhaps 10% of these will be be inclined to purchase a weighing device for home use: perhaps 3,750 individuals: the potential market.

    A Certificate of Medical Necessity would be proper inasmuch as these disorders can be ameliorated or controlled by proper dieting managed by scheduled use of the Portable Weighing Device. Third-party payment through Medicare is administered by the Health Care Financing Administration of the Department of Health and Human Services using independent carriers. Manufacturers have no contractual relationship with Medicare.

    Only DME suppliers who volunteer to participate in the Medicare program can be reimbursed by Medicare.(20) Any DME, such as the Portable Weighing Device, submitted for approval for reimbursement must have been on the commercial market for at least six months.

    In return the participating supplier must accept Medicare's approved reimbursement as payment in full for any DME required by the beneficiary. To be eligible for any Medicare reimbursable DME beneficiaries must present to their supplier a Certificate of Medical Necessity prescribed by their treating physician.

    A copy of the Certificate is submitted by suppliers with their bill to Medicare, or to a private carrier on behalf of Medicare. Even though no regulatory requirements are involved in the marketing of the Mobility-Disabled Portable Weighing Device because it is a non-contact, non-invasive appliance, the Certificate of Medical Necessity from a treating physician is required.(21)

    The format of a Certificate of Medical Necessity is quite specific.

    The general description of the portable weighing device in the Certificate of Medical Necessity must be augmented by a specific description by the supplier to accompany his bill. Under these circumstances close liaison is required between the manufacturer and DME supplier for Medicare approval of a DME. Medicaid approval generally follows Medicare approval.


    Tertiary Market

    The discretionary market for home care users is growing. Non-prescription wheelchair sales in 1996 was $50 million, almost 25% of the total market.(22) Among the 1,400,000 non-institutionalized wheelchair users are those who can afford more sophisticated wheelchairs such as ultralights and sport models with prices approaching twice that of basic models. Roughly 50% of these are in the 45-70 year age group: some 700,000 individuals, those most likely to make discretionary purchases, as interpolated from Figure IIII-2.(23)

    If the median income of the 45-70 year age group parallels that of the general population: roughly $30,000, then potential purchasers would be that half of this population with above-median income: 350,000. Conservatively only ten percent of these will be be inclined to purchase a weighing device for home use: perhaps 35,000 individuals.

    Figure IIII-2. Persons with Difficulties in Using Lower Extremities

    The Specialized Services category also includes home care agencies and clinical trial groups. Home care is the fastest growing segment of the health-care industry, increasing three-times as fast as the aggregate industry.(24) Of the 5000 home care agencies almost 600 are Visiting Nurse Associations. The remainder are either profit or non-profit full-service home-care firms.(25) For home-care agencies the treatment of patients with those disorders for which the treating physician specifies a regular weighing schedule the possession of a Portable Weighing Device by would constitute an effective advantage. At present no home-care agency can perform weighings.

    The subjects of clinical trial groups involved in drug testing for pharmaceutical companies must be weighed on every visit. Often subjects of such trials are sufficiently ill that they cannot readily balance themselves without support, although otherwise mobile, and in such cases a wheelchair would simplify weighing. Moreover the lack of portable weighting devices constitutes a major difficulty for trial groups testing mobility disabled subjects with drugs to treat ailments such as vascular diseases, neurological disorders and degenerate joint diseases.

    Consequently the mobility disabled are often neglected as a subject for drug trials. There are perhaps 500 clinical trial groups concurrently active throughout the United States.


    B. Competition

    There are no portable weighing devices presently on the market for the mobility disabled. The nearest product available is the wheelchair ramp scale at $1200. However long ramps and a weight of 26 pounds makes this device awkward. Hence the ramp scale can be hardly considered either portable or a desirable residential appliance.(26) None of the institutional respondents were familiar with the mobile ramp scale. Consequently the principal manufactures listed in Table II-1: Sunbeam, Cardinal and Scale-tronix; are involved essentially with the institutional health market.(27)

    Table IIII-1. Weighing Devices for the Mobility Disabled

    The proprietary protection afforded ParaMedical Technologies by its three United States Patents will hinder potential competitors from entering this market for a number of years, perhaps three or four, as will an additional Patent Application recently filed, because ultimately potential competitors would have to design around the proprietary technology owned by ParaMedical Technologies. Moreover potential competitors have to overcome not only the first mover advantage of ParaMedical Technologies but the potential of future patented innovations in the Weighing Device.

    To maintain this competitive advantage ParaMedical Technologies will be expected to apply for additional patent protection for improvements in the Portable Weighing Device and will completely redesign the Portable Weighing Device at the end of the third operating year to incorporate any such design improvements.


    C. Sales Considerations

    The great advantage enjoyed by ParaMedical Technologies alone among its potential competitors is that there exists for the Portable Weighing Device a Secondary and Tertiary market. Although these ancillary markets are presumably smaller than the Primary Market, their sales potentials are highly significant.

    With an expected three-year useful life in hospital service, it can be assumed that 50% of the Portable Weighing Device sold will be replaced within three years, 50% of the remainder within four years, and so on. This projection is predicated on a market penetration of 15% in all categories by the third operating year and doubling this penetration by the fifth operating year.


    D. Promotion

    It would certainly not be prudent to rely on either manufactureers representitives or DME suppliers for promotion of the Portable Weighing Device. The average dollar percentage of promotion to sales for DME suppliers (SIC 3842) is only 1.3%.(28)

    Primary Market

    The marketing of the Portable Weighing Device to health care providers requires advertising in the principal industry trade magazines, promotion at trade shows, and direct mailings. The primary purpose of this promotion is to acquaint Health Care Providers with the Portable Weighing Device and interest manufacturers' representatives in carrying the Weighing Device. Special emphasis will be made to familiarize workman's compensation carriers with the Portable Weighing Device, suggesting that premiums be lowered for facilities using the Portable Weighing Device.

    Secondary Market

    A DME must be prescribed by a treating physician to enable home-care users to benefit through reimbursement from third parties. Hence physicians must be familiar with the Portable Weighing Device, either from manufacturers representatives or from advertising material directed towards physicians to specifically promote the Portable Weighing Device.

    Tertiary Market

    Discretionary purchasers will be reached through consumer magazines for the handicapped. A strategic alliance with a wheelchair manufacturer who sells and promotes ancillary equipment such as lifts and special steering devices would probably be advantageous. Such a manufacturer would promote the weighing device on a commission basis. Weight clinics and drug trial groups will be approached through appropriate trade journals.

    Alternatively a fee or commission arrangement can be made with a major wheelchair manufacturer to include the Portable Weighing Device in their promotional material directed towards the secondary and tertiary marketing categories. Whether this arrangement would include their inventorying the Portable Weighing Device or even private labeling are marketing matters that would have to be decided.

    The principal manufacturers market through manufacturers representatives who receive 10% of the sales price for each unit they sell. Both Cardinal and Signature Brands also distribute through DME suppliers, offering the suppliers a 25% discount. The Primary Market for the Portable Weighing Device will be serviced exclusively through manufacturers representatives. The DME suppliers will service the Secondary Markets. The Tertiary Market will be reached by Direct Marketing.

    E. Service

    The usual industry policy is a one­year unlimited warranty on platform scales. Because of the opportunity for abuse of the Portable Weighing Device a one­year limited warranty will be offered. The warranty will not be honored if there are obvious indications that the Weighing Device had been mishandled: exhibiting such damage as a cracked case, broken scissor links or deformed platform.

    The Portable Weighing Device is placard limited to loads up to 350 pounds. When subjected to loads greater than 350 pounds the Weighing Device will display only "OVERLOAD", requiring that the load be removed and the Weighing Device reset. If the load exceeds the 390-pound design limit of the Weighing Device the Device will be permanently disabled by an electronic override and "DAMAGED" will be displayed. The warranty will not be honored for any returned Weighing Devices whose display indicates such an extreme overload.

    Malfunctioning of the Weighing Device can be attributed to either electronic or mechanical failure. The Weighing Device will be equipped with a data port permitting a simple electronic diagnosis. If the fault is electronic in origin, the electronics module will be replaced as a unit. If the malfunction is mechanical in origin the Weighing Device will be scrapped and replaced. Inasmuch as the Cost of Goods Sold is roughly one-quarter the selling price of the Weighing Device, disassembling and then reassembling a returned Weighing Device for repair would not be cost-effective.

    A second year limited warranty will be offered at a price equal to the Cost of Goods Sold. The useful life of the Weighing Device is not expected to significantly exceed three years in institutional service because of the severe conditions to which it will be subjected during normal hospital use. Sturdier components to extend the expected useful life of the Weighing Device will entail an increase in unit weight, mitigating against its market acceptance.

    F. Distribution Channels

    All three principal manufacturers listed in Table IIII-3 market through Manufacturers Representatives who receive 10% of the sales price for each unit sold to their account. Both Cardinal and Continental also distribute through Durable Medical Equipment suppliers who stock their goods, offering the suppliers a 25% discount.

    Figure IIII-3. Distribution Channels for Portable Weighing Device for the Mobility disabled

    Consistent with commercial practice, the Portable Weighing Device would be sold exclusively through Manufacturers Representatives or Durable Medical Equipment Suppliers. Goods would be shipped directly only to commercial firms, as shown in Figure VI, where dashed lines indicate product flow. Servicing would be provided exclusively by the manufacturer.



    V Proprietary Concerns

    Proprietary protection is afforded the Portable Weighing Device by the following instruments:

    1995 United States Patent 5,414,225             

    1999 United States Patent 5,994,649

    2001 United States Patent 6,315,095


    VI Conclusion

    The Portable Weighing Device for the Mobility Disabled described herein promises to be a commercially viable product that will meet the weighing needs of a substantial and growing portion of our disabled population.

     


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