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Li L, Miguel M, Phillips C, Verweel L, Wasilewski MB, MacKay C. A qualitative study exploring healthcare professionals' perceptions of lower limb 3D printed sockets. Disabil Rehabil 2024; 46:4033-4039. [PMID: 37766382 DOI: 10.1080/09638288.2023.2258345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/15/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE The purpose of this study was to explore healthcare professionals' (HCPs) perceptions and experiences related to 3D scanning and 3D printing for fabricating lower limb prosthetic sockets. MATERIALS AND METHODS This study used a qualitative descriptive approach. Participants were recruited through HCPs' professional associations, social media posts, and snowball sampling. Purposive sampling was used to attain variation in provider type. One-on-one telephone interviews were conducted using a semi-structured interview guide. Inductive thematic analysis was performed to identify the main themes. RESULTS Three themes were identified: (1) 3D scanning of the residual limb for designing prosthetic sockets is perceived as clean, quick, and convenient; (2) concerns about the strength and safety of 3D printed sockets for long-term use; (3) Adoption of 3D scanning and 3D printing technology for fabricating prosthetic sockets. CONCLUSION We identified perceived benefits and challenges with digital technologies for fabricating prosthetic sockets. To increase adoption, more research demonstrating its efficacy compared to conventional methods, increasing 3D printing material quality, and improving software training programs are needed.Implications for Rehabilitation3D printing and 3D scanning are emerging digital technologies that can be used as alternative methods for prosthetic socket manufacturing in the field of rehabilitation.Our research identified perceived benefits of using digital technologies for fabricating prosthetics sockets (3D scanning is perceived as clean, quick, and convenient) and perceived challenges (concerns about the strength and safety of 3D printed sockets for long-term use and a prolonged learning curve).To increase adoption of these digital technologies, more training should be provided to prosthetists and support provided to integrate new processes into staff workloads.
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Affiliation(s)
- Lynn Li
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Marian Miguel
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Clara Phillips
- West Park Healthcare Centre, Toronto, Canada
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Canada
| | - Lee Verweel
- West Park Healthcare Centre, Toronto, Canada
| | - Marina B Wasilewski
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- St. John's Rehab, Sunnybrook Health Sciences Centre, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Crystal MacKay
- West Park Healthcare Centre, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Dillon MP, Bishop K, Ridgewell E, Clarke L, Kumar S. Describe the population receiving orthotic/prosthetic services using telehealth in Australia, and their experience and satisfaction: a quantitative and qualitative investigation. Disabil Rehabil 2024; 46:1188-1203. [PMID: 37070568 DOI: 10.1080/09638288.2023.2196094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/22/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE Telehealth may help meet the growing demand for orthotic/prosthetic services. Despite the resurgence of telehealth due to COVID-19, there is limited evidence to inform policy and funding decisions, nor guide practitioners. METHODS Participants were adult orthosis/prosthesis users or parents/guardians of child orthosis/prosthesis users. Participants were convenience sampled following an orthotic/prosthetic telehealth service. An online survey included: demographics, Telehealth Usability Questionnaire, and the Orthotic Prosthetic Users Survey - Client Satisfaction with Services. A subsample of participants took part in a semi-structured interview. RESULTS Most participants were tertiary educated, middle-aged, female, and lived in metropolitan or regional centres. Most telehealth services were for routine reviews. Most participants chose to use telehealth given the distance to the orthotic/prosthetic service, irrespective of whether they lived in metropolitan cities or regional areas. Participants were highly satisfied with the telehealth mode and the clinical service they received via telehealth. While orthosis/prosthesis users were highly satisfied with the clinical service received, and the telehealth mode, technical issues affected reliability and detracted from the user experience. Interviews highlighted the importance of high-quality interpersonal communication, agency and control over the decision to use telehealth, and a degree of health literacy from a lived experience of using an orthosis/prosthesis.
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Affiliation(s)
- Michael P Dillon
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, La Trobe University, Bundoora, Australia
| | - Katie Bishop
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, La Trobe University, Bundoora, Australia
| | - Emily Ridgewell
- Australian Orthotic Prosthetic Association, Camberwell, Australia
| | - Leigh Clarke
- Australian Orthotic Prosthetic Association, Camberwell, Australia
| | - Saravana Kumar
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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Phillips C, Li L, Miguel M, Eshraghi A, Heim W, Dilkas S, Devlin M, Wasilewski M, Verweel L, MacKay C. User perspectives of digital manufacturing for lower-limb prosthetic sockets. Prosthet Orthot Int 2024; 48:100-107. [PMID: 37639567 DOI: 10.1097/pxr.0000000000000259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 06/09/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND There is growing interest to use digital technology (DT) for manufacturing lower-limb prosthetic sockets to improve efficiency and clinical outcomes. However, little is known about how lower-limb prosthesis users perceive DTs, such as 3D scanning and 3D printing. OBJECTIVES This study aimed to provide an understanding of perceptions and experiences with DT for prosthetic socket manufacturing from the perspective of prosthesis users. STUDY DESIGN A qualitative descriptive research study. METHODS Nine lower-limb prosthesis users (mean age 56; 5 female; 4 male) participated in one-on-one semistructured telephone interviews. Inductive thematic analysis was performed to identify a codebook and emerging themes from the interview transcripts. RESULTS Two major themes were identified: (1) expectations and prioritization of 3D printed socket usability and (2) facilitators and barriers to uptake of DT among patients. CONCLUSION DT methods were found to be acceptable and feasible from a patient perspective, although technological advancements are still required, and real-time communication about the process may be vital for ensuring patient engagement. Consideration of these findings may improve patient satisfaction to emerging prosthesis treatment plans and ultimately support widespread adoption of DT as an additional tool for fabricating prosthetic sockets.
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Affiliation(s)
| | - Lynn Li
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Marian Miguel
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | | | | | - Steven Dilkas
- West Park Healthcare Centre, Toronto, Canada
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | - Marina Wasilewski
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- St John's Rehab, Sunnybrook Health Sciences Centre, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Lee Verweel
- West Park Healthcare Centre, Toronto, Canada
| | - Crystal MacKay
- West Park Healthcare Centre, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Canada
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Hovorka C. Leveraging Digital Workflows to Transition the Orthotics and Prosthetics Profession Toward a Client-Centric and Values-Based Care Model. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 2023; 6:42221. [PMID: 38873133 PMCID: PMC11168606 DOI: 10.33137/cpoj.v6i2.42221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Abstract
The orthotics and prosthetics (O&P) profession has a history of responding to market demands in a reactive rather than proactive manner. This has created significant impacts including shrinkage in scope of practice and constraint in remuneration for professional services due to a fee-for-device third party payer system. Rapid changes in technology and healthcare combined with an outdated device-centric reimbursement system are creating unprecedented challenges that threaten sustainability of the O&P profession. Hence, a reassessment of the value of O&P care, and the O&P workflow process is necessary to inform an update to the value proposition and practice model for sustainability. This article reviews key factors contributing to the current state of O&P, and potential solutions involving an update in practitioner competencies, and the care delivery model (from device-centric to client-centric and values-based). Updates could be achieved by leveraging the use of digital workflows that increase efficiencies and enhance the value of clinical outcomes. Eventually, these updates could enable the O&P profession to elevate the value proposition that aligns with its most important stakeholders: client-patients and third-party reimbursement agencies in a rapidly changing technology and healthcare landscape.
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Affiliation(s)
- C.F Hovorka
- Center for the Intrepid, Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX, USA
- Defense Health Agency, Falls Church, VA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
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Eshraghi A, Phillips C, Heim W. Business practices efficiency: Impact of integrating digital technology on clinical P&O practices. Prosthet Orthot Int 2023; 47:621-624. [PMID: 37395754 DOI: 10.1097/pxr.0000000000000249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 04/23/2023] [Indexed: 07/04/2023]
Abstract
Additive manufacturing (AM) is on the path to transforming the approach to Prosthetics and Orthotics (P&O) manufacturing. Although digitalization of limbs and other body parts is not new to the field, it has not been widely accepted by the industry for various reasons. However, the reliability and precision that AM can attain, and the availability of various materials is improving rapidly. This professional opinion article discusses the ways that AM has changed P&O services, with a specific focus on prosthetic socket manufacturing. Digitalizing P&O services will eventually change the business model used in clinics, which is further explored here.
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Affiliation(s)
- Arezoo Eshraghi
- Prosthetic and Orthotic Services, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Clara Phillips
- Biomedical Engineering Department, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Winfried Heim
- Prosthetic and Orthotic Services, West Park Healthcare Centre, Toronto, Ontario, Canada
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Nigatu AM, Yilma TM, Gezie LD, Gebrewold Y, Gullslett MK, Mengiste SA, Tilahun B. Medical imaging consultation practices and challenges at public hospitals in the Amhara regional state, Northwest Ethiopia: a descriptive phenomenological study. BMC Health Serv Res 2023; 23:787. [PMID: 37488569 PMCID: PMC10367423 DOI: 10.1186/s12913-023-09652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 06/06/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Medical imaging plays a vital role in the accurate diagnosis, treatment and outcome prediction of many diseases and injuries. However, in many African countries, deserving populations do not have access to the proper medical imaging specialists' services. As a result, clinicians continue to struggle to provide medical imaging via consultation. However, little is known about conventional referral consultation practices and their challenges. This study, therefore, aimed to explore the practice and challenges of medical imaging service consultation among health professionals and patients in the context of the Ethiopian public healthcare delivery system. METHODS Descriptive phenomenological study was employed to explore the practice of medical imaging service consultation among health professionals and patients in public hospitals of Amhara region from October 12, 2021 to December 29, 2021. Semi-structured interview guides were prepared separately for key-informant and in-depth interviews. A total of 21 participants (6 hospital managers, 4 medical directors, 4 department heads, 3 medical imaging coordinators and 4 patients) were selected using the maximum variation sampling technique. All interviews were audio-recorded, transcribed verbatim and subjected to inductive thematic analysis using Open Code 4.02 software. RESULTS Six major themes emerged following the thematic analysis: (1) medical image service delivery practices; (2) medical imaging consultation modalities; (3) benefits and drawbacks of the consultation modalities; (4) challenges; (5) challenge mitigation strategies; and (6) future recommendations. Image films, compact disks, and telegram apps were the consultation modalities used by the referring clinicians to send the medical images to radiologists. Frequent failure of imaging machines, delayed equipment maintenance, inadequate infrastructure, shortage of budget, lack of radiologists, and low-quality of printed image films were among the challenges influencing the medical imaging consultation service. CONCLUSIONS This research explored onsite and referral imaging consultation practices. However, there are many challenges encountered by the referring clinicians and the radiologists during the consultation process. These challenges could potentially affect clinicians' ability to provide timely diagnosis and treatment services which would ultimately affects patient health status and service delivery. Virtual consultation via teleradiology and enhancing clinicians' competence through long-term and short-term trainings are recommended to improve the referral consultation practice.
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Affiliation(s)
- Araya Mesfin Nigatu
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
| | - Tesfahun Melese Yilma
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Lemma Derseh Gezie
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Yonathan Gebrewold
- Department of Radiology, College of Medicine, Author's Information, University of Gondar, Gondar, Ethiopia
| | | | | | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Yagos WO, Olok GT, Moro EB, Huck J, Nirmalan M. Use of mobile phones for rehabilitative services among prosthetics users in rural Acholi sub-region of northern Uganda: findings from a qualitative study. BMC Med Inform Decis Mak 2022; 22:263. [PMID: 36207722 PMCID: PMC9547425 DOI: 10.1186/s12911-022-02008-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/15/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Digital technologies such as mobile phones have shown potential as vital tools for use in healthcare and related services. However, little has been done to explore its use for prosthetics rehabilitative services, especially in the Acholi sub-region of northern Uganda. We address this gap by exploring ownership of the mobile phone, knowledge of the use of mobile phone applications, use of mobile phones for prosthetics rehabilitative services and challenges faced in using the mobile phones. Methods A case study design was used. We conducted semi-structured one-on-one interviews with 16 prosthetics users spread in the four districts of Nwoya, Amuru, Omoro, and Gulu of the Acholi sub-region of northern Uganda. We transcribed the data verbatim and explored the contents thematically to derive themes. Results More prosthetics users (63%) owned mobile phones compared to those without (37%). Many who owned and use mobile phones are knowledgeable about applications for calls and messaging (47%). Some prosthetics users are knowledgeable in mobile money applications (21%), call applications only (16%) and, others were able to use the internet (16%). Many of the prosthetics users in this study use mobile phones to seek information, mainly relating to the management of prosthetics and treatment of diseases. Many participants were positive about the benefits of the use of mobile phones for prosthetics rehabilitation and related services. Common challenges affecting the use of mobile phones include the expensive price of airtime, few places for charging mobile phones, lack of electricity and inadequate skills to operate a mobile phone. Conclusion The use of mobile phones can break down barriers created by distance and allow effective communication linkages between prosthetics users and rehabilitation services. Our results suggest that some prosthetics users owned mobile phones and used them to seek information relating to prosthetics rehabilitation services. We believe that promoting the use of the mobile phone for prosthetic rehabilitative services among prosthetics users is necessary and should be considered for practical and policy discussion relating to its use for prosthetics rehabilitation in rural areas.
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Affiliation(s)
- Walter Onen Yagos
- Department of Medical Library, Faculty of Medicine, Gulu University, Gulu City, Uganda.
| | - Geoffrey Tabo Olok
- Department of Computer Science, Faculty of Science, Gulu University, Gulu City, Uganda
| | - Emmanuel Ben Moro
- Department of Surgery, Faculty of Medicine, Gulu University, Gulu City, Uganda
| | - Jonathan Huck
- Department of Geography, School of Environment, Education and Development, University of Manchester, Manchester, UK
| | - Mahesh Nirmalan
- Department of Social Responsibility and Public Engagement, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Ngan CC, Sivasambu H, Kelland K, Ramdial S, Andrysek J. Understanding the adoption of digital workflows in orthotic & prosthetic practice from practitioner perspectives: a qualitative descriptive study. Prosthet Orthot Int 2022; 46:282-289. [PMID: 35315819 DOI: 10.1097/pxr.0000000000000107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 01/04/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND The implementation of digital technology (DT) in orthotics and prosthetics (O&P) has been slow despite recent research suggesting that the use of DT will continue to grow and become more prevalent within the industry. There is a need to further investigate DT in O&P practice and the current state of its use in the field. OBJECTIVE This study aimed to explore the views and experiences of practitioners using DT workflows in their O&P practice. METHODS In this qualitative descriptive study, 10 in-depth, semistructured interviews with O&P practitioners were conducted. A content analysis was performed to analyze the transcripts and identify key themes from the data. RESULTS The study examined the experiences of practitioners using or trying to use DT in their practices, and three key themes were identified on the implementation of digital practice: 1) technological advancement and scientific evidence; 2) marketplace, economic, and operational factors; and 3) industry mindset shift in embracing DT practice. CONCLUSION A collaborative effort involving academia, healthcare institutions, vendors, and individual practitioners will be required to facilitate the widespread adoption of DT in O&P. More work is required to overcome challenges from the technical, logistical, and cultural aspects.
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Affiliation(s)
- Calvin C Ngan
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Harry Sivasambu
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Kerri Kelland
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Sandra Ramdial
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Jan Andrysek
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- University of Toronto, Toronto, Canada
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