Oh, iBOT — we hardly knew ye.
In mid-December, Independence Technology quietly announced it would stop selling its iBOT Mobility System in January, about six years after the power wheelchair went on the market. After fulfilling its obligatory five years of iBOT parts and service support through 2013, Independence Technology itself — a division of health-care giant Johnson & Johnson — will shut down.

The official announcement from Independence Technology said, “Despite significant, long-term investment by the company and acceptance of the iBOT Mobility System, demand has not proven sufficient to create a sustainable market. A challenging reimbursement environment for innovative assistive technologies has been a factor in limiting demand.”

Of course, Independence Technology’s early decision to bypass the traditional rehab technology supplier network kept iBOT at arm’s length from much of this industry. But more importantly to the iBOT brand, the chair failed to generate the overall sales numbers needed to keep itself alive. What happened?

The Distribution Decision

The first iBOT launched in 2003, soon after Independence Technology launched iGLIDE, a power-assist wheelchair discontinued the following year.
iBOT uses gyroscopic technology developed by inventor Dean Kamen and also seen in the Segway Personal Transporter. That technology enables iBOT to rise and balance on two wheels, thus elevating the seat. And it enabled iBOT to move two wheels up and over the other two, repeatedly, so the chair could climb stairs (albeit with help from its user, who had to grab the stair’s railings and lean appropriately forward or backward to guide iBOT’s movements).

Those abilities fascinated the mainstream media and landed iBOT plenty of coverage. In an October 2003 episode of Dateline NBC, for instance, the narrator proclaims that iBOT was “a device that will force (wheelchair users) to reconsider virtually all the presumed boundaries in (the) world…. The inventor of this new machine claims the impact on all wheelchair users will be nothing short of revolutionary.”
Kamen himself said on Dateline, “This is not a wheelchair. This is an extraordinary machine…. If this thing works and works right, we’re going to liberate millions of people to do things they couldn’t even think of doing before.”

But its technology wasn’t the only thing different about iBOT. Independence Technology decided on an entirely different distribution model — one that cut rehab technology suppliers out of the assessment, distribution and service loop.
The company announced that it would bypass suppliers in favor of teaching clinicians at select rehab facilities to do iBOT assessments and provide consumer training. When repairs were needed, iBOT owners would call a hotline, and Independence Technology would mail replacement parts or dispatch an iBOT technician.

This strategy extended to iBOT’s show presence. Independence Technology did exhibit at clinician-oriented events such as the International Seating Symposium, and was a fixture at the Abilities Expo consumer series. But regular outings to venues like Medtrade? Not so fast.
And that meant that RTS’s who could have been among the closest to iBOT and among its biggest champions were never even part of the process.

A Costly Consumer Power Chair?

Of course, even if RTS’s had been given the chance to spec out iBOTs for their clients, they might not have chosen to.
The iBOT Web site — www.ibotnow.com — lists the chair’s price as $26,100. Some payors, including the VA, did purchase iBOTs. But ultimately, despite its supposedly radical technology, iBOT endured the same funding policies as other power chairs on the market.

For instance, iBOT’s signature abilities — and presumably, ones that contribute heavily to that $26K price tag — are climbing stairs and rising up to balance on two wheels. But Medicare typically does not pay for seat-elevating systems, and does not consider stair-climbing to be a medically necessary function.
iBOT was similarly hurt by Medicare’s “in-the-home” funding policy, which negated all those iBOT demonstrations of clients using the chair to reach top shelves in grocery stores or to gain a height advantage in a basketball game.

Yet another problem: Despite its price tag, iBOT did not offer complex rehab options. It could not provide tilt or recline; required clients to use a traditional hand-controlled joystick and a standard footrest; required clients to sit at an approximate 90° angle without positioning help such as tilt; and could not accommodate respiratory equipment. Independence Technology also required a physician’s clearance from any potential user with severe osteoporosis or osteogenesis imperfecta, because impact from stair-climbing or transitioning out of the balance function might cause bone fractures.
iBOT’s weight capacity — at least 75 lbs., but no more than 250 lbs. — further restricted its pool of potential users.
So, without rehab functions and with its best-known features usually disqualified from funding consideration, iBOT became in essence an adult consumer power chair that cost a lot more than its competitors. It was too costly for those physically able to operate it, and not functional enough for those who qualified for a more complex chair.

The result: an apparent end to Johnson & Johnson’s mobility DME efforts. Said an Independence Technology spokesman in a Mobility Management interview, “The demand just hasn’t been sufficient. We don’t really say what the sales number is, but we tell people it’s in the hundreds, not the thousands.”