Enhancing Provider and Consumer Communications for Better Outcomes

Presenters:
Adrienne Falk Bergen, PT, ATP/S CRTS, Dynamic Medical Equipment, Ltd.

Marka G. Hayes, RESNA Technical Assistance Project

Description

At the 1999 RESNA Conference in Long Beach, CA, Adrienne Bergen and Marka Hayes conducted a session titled "Enhancing Provider and Consumer Communications for Better Outcomes." The new Assistive Technology Act of 1998 seeks to enhance communication between providers of assistive technology and consumers. The session sought to promote discussion that would lead to the identification of activities that might assist in accomplishing this task.

The discussion focused on activities that the Assistive Technology projects, RESNA and the RESNA Technical Assistance project might undertake to enhance communication between providers and consumers. Suggestions that were made are included at the end of this document.

Also included in this document is a model of how relationships and communication between consumers and providers should work that was developed by Adrienne Falk Bergen and Marka Hayes for the RESNA session. The purpose of this document is to present this model and continue the discussion that began at the RESNA session.

Adrienne Falk Bergen PT, ATP/s CRTS, has more than 25 years of experience providing seating and mobility services and devices. Marka Hayes has worked for the RESNA Technical Assistance Project for 4 years and has a longtime interest in improving both access to assistive technology and the delivery of assistive technology devices and services to consumers. Ms. Hayes has Cerebral Palsy and is a consumer of seating and mobility devices and services.

The model presented here applies directly to the procurement of seating and mobility devices, however, the authors believe the process also applies to the procurement of other types of assistive technology.

This figure shows some of the assumptions made in the model. Information is factual data delivered where needed regarding, the venues available for service, rights and responsibilities of the players including the consumer and providers, and all the other topics pictured here.

This figure describes the people, in many cases, who need this information.

This is an overview of the model. Each step will be described in more detail in subsequent pages.

• Step #1: Identify Need for Assistive Technology
  Someone identifies a problem related to:
  • an activity the person is unable to perform or cannot perform adequately
  • discomfort
  • pressure
  • posture
  • the assistive technology in use by the person is no longer suitable or reliable
  During Step #1 information on the regulations pertaining to insurance carriers or other payers regarding the assessment venue or service delivery model is needed from:
  • the insurance carrier
  • medical doctor or clinician
  • supplier
  • state advocates office
  REFERALS SHOULD BE OBTAINED AS NEEDED
  
  
• Step #2: Seek Venue for Problem Solving
  • Retail Model - consumer goes directly to supplier
  • Medical Model - consumer works with entire team at a medical facility
  • Educational Model - consumer works with team in school-based setting
  • Vocational Model - consumer works with vocational rehabilitation counselor
  • Web Search - the consumer researches and purchases products using the Internet
  EACH VENUE HAS BENEFITS WHICH MUST BE BALANCED AGAINST EXPERIENCE AND NEEDS
  
  Sometimes consumers may combine venues.
  
  
• Step #3: Assessment / Evaluation
  • Gather information about:
    • the consumer
    • the environments where the technology will be used
    • funding sources
  • Observe the consumer
    • assess current performance
    • observe posture
    • identify factors limiting performance
  • Perform any necessary assessments
  COLLECT INFORMATION NOW THAT WILL BE ESSENTIAL IN THE NEXT STEPS
  
  
• Step #4: Set Goals and Identify Possible Solutions
  • Use the simplest approach practical - move toward the complex only when necessary
  • Attempt to use generic solution alternatives
  • Modify the environment OR supplement the environment OR use assistive technology OR USE A COMBINATION
  • Modify/repair what exists OR purchase something new
  THE POSSIBLE SOLUTIONS IDENTIFIED SHOULD CLEARLY ADDRESS THE GOALS THAT ARE SET
  
  
• Step #5: Product Trials
  • Try various products in the settings where they will be used
  
  
  
• Step #6: Identify and Specify Intervention Components
  • Discuss the various options available AND the pros and cons of each
  • Select the product(s) and features needed
  • Create specific recommendations
  Identifying and specifying intervention components involves gaining an understanding of what features a product should have in order to effectively meet the consumers needs and goals. For example, a consumer who uses a respirator needs to have a wheelchair that can accommodate this technology. The wheelchair that meets this requirement has this intervention component. The equipment required to attach the respirator equipment to the wheelchair is another intervention component.
  
  
• Step #7: Seek and Obtain Funding
  • Obtain a prescription and a letter of medical or vocational necessity as needed to support the requirements of funding sources Perform follow-up activities to secure funding
  
  
  
• Step #8: Product Provision
  • Supplier orders the assistive technology products, performs the necessary set-up and prepares for delivery
  MAINTAINING EFFECTIVE COMMUNICATION WITH THE PLAYERS IS IMPORTANT
  
  
• Step #9: Delivery and Support
  • Supplier delivers assistive technology according to the instructions of the evaluation team and/or the consumer
  • Supplier provides useful and effective instructions to consumer on product use and maintenance
  • Supplier provides warranty information from each relevant manufacturer to the consumer
  • Supplier provides contact names and procedures for follow-up and repairs to the consumer
  • Clinicians provide training

These suggestions were made by session participants regarding what can be done by assistive technology projects, RESNA and the RESNA Technical Assistance Project to enhance communications between providers and consumers.

• Consumers, case managers, clinicians, vocational counselors, physicians, and teachers need to be educated regarding assistive technology.



• Information about assistive technology can be incorporated into training, possibly via educational training in professional schools. Presentations to parent groups and senior facilities might also be effective.



• Include information about assistive technology in mailings that go out to consumers and potential consumers of assistive technology, SSI checks for example.



• Disseminate brochures related to assistive technology in various public forums, including public libraries, community welcome wagons, real estate offices, etc.



• Present information about assistive technology on-line linked through existing web sites, and accessible through the most popular search engines.



• Develop public service announcements regarding assistive technology, perhaps by having consumers approach local media to do feature stories.

What activities can assistive technology projects, RESNA and RESNA Technical Assistance Project undertake to enhance communications between consumers and providers? If you have comments or suggestions relating to this document, please contact Marka Hayes.

Marka Hayes
RESNA
1700 North Moore Street, Suite 1540
Arlington, VA 22209
Phone: 703-524-6686, extension 308
TDD: 703-524-6639
Fax: 703-524-6630
Email: mhayes@resna.org

The RESNA Technical Assistance Project, Grant #H224A50006, is an activity funded by the National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Department of Education, under the Technology-Related Assistance for Individuals with Disabilities Act of 1988, as amended. The information contained herein does not necessarily reflect the position of NIDRR/ED or RESNA and no official endorsement of the materials should be inferred.

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