Foot Health: Finally, in Motion

Over the past six months, I have had the pleasure of being associated with a company that has a fair shot at changing the foot health industry in a meaningful way. You won’t yet find much  information about the company online as they are currently tightening the latest lines of code, refining presentation and customer experience,before their market launch in the upcoming quarter. Arizona-based RESA Wearables has innovated a way to scan-design-and-produce a pair of high-quality custom foot orthotics (insoles) at a very low cost, all on site at the point of sale in about one hour.

If you have experienced foot pain or any type of foot-related condition, you probably got it already and are either wondering how you can get to be first in line so you can order a pair of insoles for yourself or how to get a chance to invest in the company because it’s easy to understand how it’s going to take the foot care industry by storm.  If you have not experienced foot pain, you may need further explanation: custom foot orthotics are the first line treatment for most foot-related conditions. Right now, production of custom in-soles is controlled by a very fragmented market of orthopedic labs (Hanger, Langer) and specialized shops (Good Feet, Foot Solutions) which have brought limited innovation to the market since the glory days of biomechanics research back in the 60’s and 70’s. It usually takes several doctors’ visits and anywhere from 3-6 weeks to get a pair of custom insoles made, at a retail price of $300 to $1,000 and a manufacturing cost of around $50 per pair. I repeat what I said earlier: RESA’s one-stop process is able to deliver high-accuracy custom insoles within about an hour for a very low cost (retail under $200 per pair and well under $20 production cost) at the point of scan.  A patent application has been submitted to protect it their breakthrough process, which was developed over several years and involves optical and laser scanning, CAD design, 3D printing, materials sciences, big data architecture, artificial intelligence and of course, lots of input from the medical community.

How big is the opportunity? $3.5 billion global insole and inserts market, 77% of US population have experienced foot pain, 21.5 million diabetic patients with lower-appendage neuropathy in the US and Canada alone. Patients with such neuropathy have usually lost the sense of touch in their lower limbs and are at high risk of foot ulcers, due to decreased blood supply to the feet and legs from narrowed and hardened blood vessels (Atherosclerosis), and high blood sugar levels (Hyperglycemia) which prevents normal healing and leads to infection. The numbers are staggering: in 25% of the cases, foot ulcers in diabetic patients lead to amputation. Healthcare costs linked to the treatment of foot ulcers comprise $38 billion, an estimated 33% of the direct healthcare costs associated with the treatment of diabetes and its complications. Studies estimate the healthcare costs associated with individual ulcer episodes from as high as $28,000/year. The lifetime healthcare costs for a person with limb loss are especially dramatic given the estimated five-year mortality rate of between 50% and 74%.

How can foot ulcers be prevented? Yes, to some extent: control your blood glucose and… wear custom foot orthotics.

Nearly all patients with diabetic neuropathy are eligible to Medicare or private insurance reimbursement for foot orthotics.  So why then is only a fraction of them wearing insoles? 2 reasons in our view: poor patient education and complexity in procuring a pair of custom insoles: First, patients need to see a podiatrist (usually referred by a primary care doctor). In the US the need is underserved.  There are only 12,000 active podiatrists which is not nearly enough to handle the growing demand as rates of diabetes continue to grow, according to theAmerican Podiatric Medical Association. If one is fortunate enough to land an appointment, the podiatrist will examine your feet and take a 3-dimensional plaster cast or scan of the foot, using various types of modern or less modern technologies. Then he sends a prescription with the cast/scan to an orthopaedic lab that will design and manufacture a pair of insoles through a rather expensive, time-consuming, waste-generating and labor-intensive process involving CAD designers, facilities costs, and manufacturing labor. Finally, after several weeks the product is shipped to the podiatrist who calls the patients for a fitting appointment. Usually the insole won’t fit perfectly in the first try because so much gets lost in translation between the number of steps and operators involved. The practitioner is then expected to have onsite equipment to further adjustments as required, but that is complicated and difficult to do with any degree of accuracy. All too often it will still not fit, in which case it’s sent back to the lab or another attempt…

RESA Wearables has now figured out how to transform this entire process down to a simple 3 steps (scan-design-print) than can be performed on-location anywhere they deploy their point-of-sale display: big box and specialized retail stores, offices of health practitioners, sporting events, conventions, airports, you name it! The fact that through their revolutionary process RESA is able to produce higher quality, higher accuracy custom insoles in only an hour is truly game-changing.  The fact that the RESA process requires only a single operator with limited training, and has greatly reduced the raw material cost and waste of conventional insoles production, combine to allow for high margins and easy scalability. 

Following the Q2 launch, RESA is preparing to deploy with aggressive growth, and several leading brands, with thousands of operating locations, are already vying to be the first to offer this great service to their customers. Imagine what this means in terms of public education on foot health: taking custom foot health out of the limits of the podiatrist office to main street, helping the public understand the importance of a healthy foot and the common connections between foot issues and many other common conditions, such as back pain, knee pain, poor balance, and bad posture, and offering a practical, affordable solution. This is comparable to what LensCrafters did to the eyewear market. Like Lenscrafters, RESA is poised to become a dominant brand, starting at the physical point of sale and point of care and quickly moving online, with a captive membership base created after scanning millions of feet. RESA will own the technology (patent pending), the product, the data, and will be able to supply a steady stream of new product generation improvements (sandals, flip-flops, and other types of footwear) to its custom footcare and footwear members.

But wait, there’s more: RESA has already started to work on a new generation of “smart insoles”, printed out of conductive material, remotely connected to a smartphone. The conductive insole will operate like a sensor to capture shear force and give early warning to diabetic neuropathy patients of any risk of ulcers or blisters long before they become incurable. This is not science fiction; the company anticipates being able to start testing this incredible new product soon and anticipates having it ready by 2018.

That’s it for today. We’re launching soon. Sorry that I could not post pictures of the technology and the products pre-launch. RESA wants it kept secret until their debut. That will give me an opportunity to blog again.