In the sprawling landscape of American prosthetics, with its multiple professional organizations, research bodies, and accreditation groups, there are thousands of points of interest, but few clear roads toward the future that could bring the most benefit to the patient and the profession. On October 28-30, the Orthocare Innovation’s Foundation brought together more than 100 top thinkers in prosthetics to change that.
Prosthetics 2020: The Future of Physical Restoration, was a highly interactive symposium designed to get all attendees, from clinicians to the heads of major federal departments, talking as equals in small groups. Their shared insights were then integrated into larger group discussions, which led to knowledge points, action items, and standing questions, meant to help develop specific plans and principles that would in turn drive focus, investment, and innovation over the next ten years of prosthetic research and clinical care. The event’s final deliverable will be a publically available document planned for a late January release that details the collected specifics and can serve as a guide for decision-makers across the profession.
This document, said attendee Rob Kistenburg, MPH, CP, FAAOP, “will probably guide a lot of funding decisions and therefore the research activities and the new information that’s going to be generated by our profession until 2020 and likely beyond that.” The profession’s vision, he continued, previously has been somewhat fragmented, and considering the amount of funding provided in the wake of the current Middle East conflicts, “there needs to be a coordinated effort, and it’s better that the effort be coordinated from within the profession rather than be dictated by those from without – and not just within the profession of prosthetics; all of the groups that are involved with the research associated with it, so the engineers, prosthetists, and so forth.”
Attendees, who included invitees from the National Institute of Health (NIH), the Department of Defense (DoD), the Rehabilitation Institute of Chicago (RIC), and a multitude of private and franchise practices – were assigned to one of two parallel tracks – research or clinical – with the option to switch tracks during breaks. Within each track, attendees join moderated breakout groups of six to eight people to discuss a single, broad topic. Discussions in the technology track focused on potential new development directions for two time periods – the two-to five-year period, and the next ten years. Clinical discussions explored the ways clinical care might adapt to technological changes and social forces over the same periods.
In the 32 breakout sessions, major themes quickly emerged. The need for clinical data to support reimbursement topped the list. Corresponding action items included development of a national database of patients and clinicians to help researchers find suitable subjects, compensation for clinicians who participate in research, increased opportunities for O&P research funding, and a how-to toolkit to help clinicians perform research. In the education sessions, ideas for implementing new technologies included implementing intensive government-funded classes akin to the highly-successful suction-socket schools of 1948-1950. Technological proposals included more “smart” devices that would record patient outcomes data in the course of daily use and upload it automatically into practice-management software and potentially to the proposed national database. In clinical care, proposed efforts to increase patient compliance included reducing device noise and implementing – perhaps even mandating by 2020 – emotional and educational counseling after limb loss.
Orthocare Innovations’ Chief Technology Officer, David Boone, CP, MPH, PhD, and Chief Scientific Officer, Stuart Harshbarger, led the event, but emphasized that the effort was in no way about Orthocare. “This discussion is…about bringing the community together and having people from across the nation be able to contribute to the excitement and energy that…is contagious across the field,” Harshbarger said.
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