The CoVent-19 Challenge is an open innovation effort founded by Mass General Hospital residents and anesthesiologists to close the gap between available resources and ventilator shortages around the world. Out of more than 200 submissions, ours is one of two winning designs selected to continue efforts in manufacturing, and eventually, validation testing and FDA approval. The two-round challenge aimed to present initial concepts and finalize CAD assemblies as part of the first phase, followed by a shortlist of finalist teams delivering functional prototypes in the final phase. The delivery of the final prototype is the result of continual collaboration and engagement with respiratory therapists (RTs), ICU nurses, and doctors who supported and informed the team's goal of delivering a user-friendly, high-precision form factor that is easily assembled and adaptable to multiple healthcare settings.

Our final design, VOX, is a rapidly deployable, pneumatically-driven ventilator that prioritizes modularity, uses off-the-shelf solutions, and is optimized for a Covid-19 healthcare context. VOX costs less than $1,000 to produce and can be assembled in under 4 hours. VOX utilizes the ubiquitous IV pole to enable speedy and simple mounting, height adjustability for user comfort, easy transport, and efficient storage. Its built-in dashboard functionality allows for remote monitoring and operability from a single desktop computer or tablet for up to 4 ventilators, which drastically reduces personal exposure to disease and contamination.

The global COVID-19 pandemic drastically altered our lives and focus around the world, drawing our attention to critical needs in healthcare that had long gone overlooked. As elective and non-essential surgeries were canceled to free up hospital space and resources for patients critically ill with the coronavirus, a group of anesthesiologists at Mass General Hospital (MGH) found themselves in an unprecedented position to help their colleagues address a critical issue looming on the horizon—a global shortage of ventilators. Despite the ramped-up efforts by existing manufacturers on their production cycles, there remained a need for a viable, long-term solution—particularly in areas where standard medical ventilators may be even harder to obtain.

The MGH anesthesiologists and residents developed a challenge guided by the larger medical community to bring an adaptable ventilator design that demonstrates rapid deployment, safety, and cost economy to market: The CoVent19 Challenge. This competition, designed to foster collaboration and innovation, relies on the time-tested truth that coming together across disciplines to create new solutions to a crisis can be key in fostering major breakthroughs.

fuseproject, in partnership with CIONIC, a medical device and technology start-up, and several independent mechanical engineering (ME) consultants, banded together to respond to the open innovation challenge and help close the gap between those in need and available healthcare resources around the world. The two-round challenge aimed to present initial concepts and finalize CAD assemblies as part of the first phase, followed by a shortlist of finalist teams delivering functional prototypes in the final phase. The challenge convened panels of medical and technical experts to guide requirements and review design processes, evaluating each submission for safety, reliability, manufacturability, cost implication, and software/electronic complexity. More than 200 teams from 43 different countries submitted their concepts, and fuseproject/CIONIC/independent MEs were selected as one of seven to build working prototypes for the final round of judging.

Our final design, dubbed VOX, is a rapidly deployable, pneumatically-driven ventilator that prioritizes modularity, uses off-the-shelf solutions, and is optimized for a Covid-19 healthcare context. VOX costs less than $1,000 to produce and can be assembled in under 4 hours.

While ventilator care can be a life-supporting treatment, it can also cause fatal injuries from overstretching or force-inflation. This is a particular area of concern with the usage of plastic bag-valve resuscitators, also called Ambu bags, which have the potential to fluctuate in shape over time and develop variability in its delivery of ventilation. VOX's pneumatic valve ventilation system offers the most reliable, consistent, and safe method of supplying oxygen and is designed around three key principles:

Further, a refined and customizable approach to the UI flow allows VOX to adapt to each unique hospital or medical settings' workflows, processes, and capacities, which allows for flexible use cases from a single manufacturing model. VOX's multi-device dashboard capability means it can be operated remotely, opening up the possibility of a screen-free device that is significantly smaller in volume, faster and more cost-effective to assemble, and easier to sanitize. RTs, ICU nurses, and doctors are able to control the ventilator from a single location if and when in-person patient care is not necessary. Low resource contexts or overburdened hospitals can opt for the no-screen version of VOX and use external mixing—easing overall hospital foot traffic, cost of production, and complexity of patient care processes. VOX is not only a simplified and streamlined ventilator design with robust functionality, but also a product that has the potential to drive new user behaviors that can result in time, cost, and material savings.

Now that the design is complete, the team is creating official assembly instructions to support the final prototype. The UI flow will eventually include onboarding guidance that highlights key features and instructions to drive successful adoption.

The CoVent19 Challenge has partnered with the African Federation for Emergency Medicine (AFEM) which employs over 2,000 emergency medicine clinicians across 26 countries in Africa. In collaboration with AFEM and following regional regulatory approval guidelines, a pilot program will be launched in Nigeria.

Simplified architecture. Ventilators provide an incredible range of capabilities and features. VOX enables the exploration of alternative technologies to tailor functionality based on individual setting needs. Its pneumatic system leverages existing pressurized air systems in place of mechanical actuation, offers a lighter and more manageable form factor, and has built-in overpressure relief.Intelligent manufacturing. The real opportunity behind VOX lies in delivering a product that can be made quickly, by implementing simple manufacturing processes and affordable off-the-shelf components. Production of its 3D printed elements utilizes advanced polyjet printing technologies for abridged assembly and reduced cost. Combining VOX's outer shell and housing, the unit leverages multi-material and multi-color printing to produce the venting, fasteners for assembly, Venturi tubes, and UI details like buttons and icons. All components were specified for critical size and form. Aluminum was selected deliberately for the front and back plates (single bend for the front plate) for durability and protection. The simple assembly of VOX is defined by its minimal use of fasteners, lack of adhesives, and modularization of its production workflow.

Intuitive user experience. VOX utilizes the ubiquitous IV pole to enable speedy and simple mounting, height adjustability for user comfort, easy transport, and efficient storage. Its built-in dashboard functionality allows for remote monitoring and operability from a single desktop computer or tablet for up to 4 ventilators, which drastically reduces personal exposure to disease and contamination. Leveraging existing and familiar user behaviors, VOX is also fully functional from the device itself through a user-friendly touchscreen monitor, oxygen boost & alarm silencing buttons, and rotary dial for intuitive navigation, incremental adjustments, and legibility across generations of healthcare professionals. Simple alert statuses with streamlined management pairs banner messaging with highlighted alerts for quick scanning and comprehension. Volume control and sound signatures are also available by alarm type.