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Ryan Eder's idea for an inclusive workout system, The Access Strength, began as his student thesis project at University of Cincinnati. After The Access Strength took home multiple IDSA awards, including Best in Show, Eder realized that he needed to do more than travel around and share his idea—he needed to take action and bring it to life. Through years of effort and research to bring his realization to market, Eder's company, IncludeFitness, transformed into both a physical and cloud-based platform aimed to turn our healthcare system as we know it upside down.

Here, Eder tells Core77 his story from the very beginning, highlighting the people, places, inspiration and ideas that helped IncludeFitness become the powerful inclusive design model it is today:

During my time as a student at University of Cincinnati, I co-oped at Ziba in Portland. While working at Ziba, I had a realization that my portfolio was a little shallow—it had a lot of flash in renderings and sketches, but there wasn't a lot of depth to my projects. I wanted to focus on something that could provide that depth.

I was working out at a gym on the west side of Cincinnati and happened to see a guy in a wheelchair enter the facility. I had never seen someone in a chair at the gym before, so I sat back and watched him. I noticed that he spent more time transferring in-and-out of his chair and adapting to the equipment than actually exercising. In fact, he had a bag full of homemade accessories attached to the back of his chair to help him adapt to the various equipment.

You could see the frustration on his face from across the room. In my mind, I was thinking, "It's hard enough to go to the gym and work out on a regular basis, let alone if you're dealing with equipment that isn't designed with you in mind."

I wasn't sure if it was a local issue or something bigger, so before I dug in, I decided to call about 200 fitness clubs across the country. I told them that I was a wheelchair user looking to utilize their facility and asked them what they had to offer me. Sadly, no one had anything. I spent a few hours making these phone calls and getting extremely frustrated in the conversations I was having.

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I decided to tackle this for my senior thesis, which was a 10-week project. Really, what I had learned from a variety of sources and inspiration from Patricia Moore's work back in the day, was the value of immersive research. I wanted to understand not just the physical aspects of this, but the cognitive and emotional sides as well.

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I tried to get as immersed as I could in only 10 weeks. I rented wheelchairs, visited local facilities and tested the equipment that they had. I worked very closely with paraplegics and quadriplegics—I even joined the Wheelchair Football League and played every Saturday for a month.

Every person in a chair that I talked to told me they had zero interest in a wheelchair-centered machine. The desire was to have a piece of equipment that could cater to all people, regardless of abilities— if they're standing, seated in a chair—and not be this separate piece of equipment that only certain people could use.

In fact, a majority of the people—from seniors to children, wheelchair users, athletes to fitness novices— felt that typical workout equipment was very hard to use. It was cumbersome, confusing and really wasn't optimized. This quickly set the parameters on defining a system that could cater to everybody and remove the barriers found in fitness for all demographics.

After I graduated, I moved up to Columbus, Ohio and started working as a designer at Priority Designs. About 6 months into the job, the IDSA submissions popped up. I said, "I'm really proud of this work, maybe I'll submit it to the student category." 

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I remember distinctly getting the phone call that said, "Ryan, you've won Gold in the student category." I flipped my lid. I was extremely excited. But it got even better—they said, "Wait, wait, wait. There's more." When I was told that I won "Best in Show," I didn't even fully understand what that meant. In fact, I have emails going back that have me emailing IDSA saying, "In confirming exactly what that meant."

I remember going back to Priority and telling Paul Kolada, the owner, "I was just informed that we won Gold in the student category and Best in Show." He looked at me and said, "This is a big deal." I had no idea what I was getting into—I was a nervous wreck.

Priority helped me build a model, which I needed to have out in San Francisco for the awards. Of course, I didn't really know anybody there because it was my first year in the industry. The awards ended up having a fairy tale ending; we won awards for the student category and Best in Show, and we ultimately won People's Choice at the very end of the conference.

That was truly the biggest inflection point I can ever imagine. Not just my career, but my life. It has really changed everything for me. I'm really grateful for that recognition.

IDSA recognition is really what provided the catalyst to push this idea further. I started getting floods of emails and phone calls from people seeing it in various publications and asking for it. I was invited to go across the country and travel overseas to share this idea. I actually started having this inherent guilt because I was reaping the benefits of these awards but was unable to actually deliver the solution.

I didn't design the system to win awards. I designed it to solve a problem and to help people. I then realized that I could use this as a catalyst to do just that.

The Best in Show award was really the ultimate validation for a senior thesis. I was able to use that, go back to Cincinnati, and connect with Craig Vogel. I actually initially connected with Craig through Patricia Moore—Patty came up to me after the awards, in this blur, and said, "sweetie, we need to do some things." I've always admired her for her work and all of a sudden, she's hugging me and telling me to contact Craig.

So I followed up with Craig, and he invited me to present at the Live Well Collaborative, which is a collaborative he runs out of UC that's really focused on working together with corporations developing solutions for the 50+ demographic. Basically, I went there, shared the story, and said, "Look, I want to help people, but I need help helping people." I didn't know what exactly that meant, I just threw it out there. At the end of that meeting, I actually walked out of the room with $50,000. That came from Proctor & Gamble and CincyTech, which is a Cincinnati-based technology seed stage investor.

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At this point, my thesis was still entirely made up of renderings and concepts. There wasn't a physical representation or mechanical representation of this idea yet. My thesis then became the thesis for mechanical engineering students at UC—together we started to develop these systems and prove their viability. The pictures I have truly look like torture devices—they look like something from the Saw movies that were out a few years ago. They were still very exciting for us because they were the start of proving that this system could work.

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During the first year, we made prototypes individually, and they looked awful. The second year, we actually pulled them together and created one prototype that had everything on one machine—still very much looking like a torture device. Those prototypes were the starting point of how we got off the ground.

I moonlit Include Fitness for 7 years while working full-time at Priority. Priority has been instrumental in supporting Include Fitness—from making a model and going out to San Francisco to giving me the flexibility to work with P&G, UC and CincyTech.

The biggest challenge was always trying to get support. Back then, there wasn't the start-up ecosystem that exists now. It's tremendous what exists now, but back in 2008 and 2009, it was very early for that kind of thing. On top of that, at that time, we were actually only a hardware concept, and hardware requires a lot of capital. When you go into the software aspect, there's a scalability and a flexibility to it that you don't always have with hardware.

After we were done with P&G and CincyTech, I came to the realization with the investors I was talking to, that I was not able to raise enough money to make it to the next step without bringing on an experienced CEO. I had never had experience running a company before—I'd had a couple of business classes, but that was it. I received this feedback saying, "you really need to bring someone on that has experience." So I did.

It was still very challenging raising the money. In fact, there was one summer that we drew a line in the sand and said, "Look, if we don't get funding by this date, we're going to have to pull the plug." I had a job lined up in Chicago—I even had an apartment in place. Lo-and-behold, two weeks before the date that we circled, we got a notification saying that a local investor was going to put some significant dollars in. That changed everything.

This is really where Priority got involved even deeper. I raised this money and knew that I wanted to develop The Access Strength at Priority. They have all the resources and capabilities and expertise under one roof, but I also knew that I didn't have enough funding to support myself full-time. I actually became a client of Priority while still working for them, which led to a lot of interesting dynamics. Everybody there was great and excited to work on the project, and it was definitely interesting being a client and employee at the same time.

After a couple of years had gone by, I had let the concept gestate a bit more and thought there was a lot of opportunity for improvement. I started to think that we should redesign everything. It's scary after you win Best in Show from your industry's leading award platform to go back and say, "All right, we're going to change everything about this and hopefully, it gets better." But I felt compelled and had an instinct to reevaluate.

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At its core, The Access Strength's basic principles were still there, but we had a lot of things we felt could be improved upon—whether it be weight selection, the adjustments or something else—so we started from scratch. We came up with some initial ideas and built another prototype that probably looked more like a transformer than a torture device. The machine was symmetrical with different interaction options on each side.

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We would bring people in to test our concepts to find out what worked and what didn't. That gave us enough insight to say, "Okay, we think we have a direction, let's make a 'looks like, works like model.'" We did that, again, all at Priority. Halfway through building The Access Strength, we decided that it didn't make sense to keep this in the studio and limit our audience. We really needed to take it out and show people.

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Being the designer that I am, I got really excited about developing and designing a custom mobile showroom for us to take around the country. Really, it was less about business and more about finding a tangible solution to this idea that people could interact with and react to.

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By the beginning of 2013, we decided to go on a 2-week road show. We traveled 1,300 miles across the eastern half of the US over two weeks. We reached out to some pretty marquis places—our first demo was actually with the late Michael Graves. Then, we went to the Christopher & Dana Reeve Foundation and the Lakeshore Foundation, where they train Para-Olympic athletes—Patty Moore actually helped and came out to DC for this. We were able to set up some demos with the VA Medical Center in DC and the National Rehab Hospital. We received tremendous feedback from a variety of people interacting with the equipment, from end users of various demographics to the providers and technicians.

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That's when we really realized The Access Strength had merit and had improved upon its original form. We would still need to raise money to go to market, but it felt very encouraging. However, this was also during a time, in 2013, when ideas around the notion of digital health, quantified self, the data, and value of data in our lives and the impact it can make were becoming more important. From these concepts, a variety of ideas started to pop up.

I started to float this idea halfway through demo:

On top of The Access Strength, what if you could download exercises that let the machine guide you through your workout—select the weight for you, count your reps, pull in more information, put that information back up in the cloud, and integrate that with healthcare?

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After the dust had settled from the tour, we sat down and started to hash this idea out. We realized we were sitting on a much bigger opportunity than just a piece of equipment. We were really poised to create what is now the IF Platform, a digital health platform that complements The Access Strength and rounds out the full IncludeFitness system.

Through the addition of software, not only could we start addressing the cognitive side of fitness—making sure people understand what to do, how much to do, and keep track of progress—but we could really develop productivity tools to drive efficiencies and lower costs in the healthcare system.

That's really what started giving the system traction. People started realizing the tremendous value proposition IncludeFitness could provide—how you could help people become healthier with better outcomes and lower costs. It shifted our value proposition of our system to, "Let's make sure all demographics have ease of use" to, "We can have a profound impact systemically on the healthcare system through software and not just hardware." We would be able to connect various stakeholders throughout the whole process of delivering care and the continuum of care. The whole IncludeFitness system would really drive a bigger impact overall than just a hardware play.

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Since then, we've actually taken our system to a couple VAs in Cleveland and done live demos. We had 15 therapists come out, and they loved it. Two admin's then tested it out, and the rest was history. It's really exciting to see our platform resonate.

The Access Strength and the IF Platform Today

The Access Strength today

Development is never done, but we're at a point where we're ready to commercialize. In fact, we have the supply chain built, our manufacturer in place and are looking forward to putting systems out there in 2017.

One of the things that's very interesting about our software is how many tremendous opportunities we uncovered during the design process. Through automating documentation, we can save providers a tremendous amount of time so they're able to see more patients on a day-to-day basis. When you look at healthcare, we offer the ability to have high cost facilities collaborate more with lower cost facilities while also tracking compliance and offering better care, but ultimately, lower costs.

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Opportunities have really opened up for us from a market standpoint—we've already sold into inpatient and outpatient facilities, active aging, senior care, community centers, universities and, as I mentioned, VA. We're very excited to start shipping soon.

Coming full circle to IDSA, we weren't sure if we could submit IncludeFitness again or not. We knew that the system had completely changed, but it's still based on a fundamental concept from a whole decade ago.

It was so much more rewarding this go-around. If you think about it, the first time we won was over a 10-week project. It was a concept on paper that had a lot of merit and a lot of potential, but it wasn't realized. I'm 33 now—almost a third of my life has been dedicated to developing this system, this platform.

It's making a lot of hard decisions, a lot of blood, sweat, tears, yelling, inflection points, highs-and-lows—to come back after 10 years of that and to receive that type of validation and recognition for what we've built… you almost can't put into words.

It's very gratifying and very exciting for us, especially because what we've uncovered throughout this process is that we're literally at the tip of the iceberg. There's a lot of facets to someone's health that we can explore.

About three years ago, I transitioned from founder and CCO, Chief Creative Officer, to CEO. It's been fantastic. You get an education that you never imagined you could. The knowledge that comes from understanding the dynamics of building a business and building what we want to build as a world class company is immeasurable. I'm lucky to have tremendous mentors, advisors, board members and everyone helping build IncludeFitness to what it needs.

While I can't go into what our next plans are, our goal is to transform the way we deliver care. Really, that boils down to two main goals: to make it easier for people of all abilities and demographics to be healthy and to optimize the delivery of care—to make sure we have higher quality care with better outcomes at lower costs. We're really poised to do that.

We have some great partners in place, and we're going to start shipping units in 2017. Then, we're going to start expanding on this idea even more and start looking at additional technologies and systems.

Despite taking 10 years to get to this point, this is just the beginning. I can't wait to share what we have coming next.