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#153 Rehab Tech Abandonment with Christopher Gaskins · OT Potential Podcast | Occupational Therapy CEUs

0:00
SPEAKER_01: On one hand, it truly feels like we are on track for health technology to transform healthcare delivery as we know it.
0:08
SPEAKER_01: But on the other hand, we have to weigh the reality that many health tech solutions end up totally abandoned.
0:15
SPEAKER_01: This is especially true of consumer facing health tech.
0:19
SPEAKER_01: Some of the latest research shows that around 70% of users abandon health tech apps within 100 days.
0:26
SPEAKER_01: Rehabilitation technology does fare better, largely because of the clinician in the loop who prescribes, fits, and supports the technology toward a defined therapeutic goal.
0:37
SPEAKER_01: But abandonment is still real.
0:39
SPEAKER_01: Even with a clinician involved, one study showed roughly 10 to 30% of assistive rehab technology is abandoned.
0:46
SPEAKER_01: Fortunately, new research is emerging on the factors that drive technology adoption.
0:51
SPEAKER_01: And we are seeing new structured frameworks to guide our decision-making process.
0:56
SPEAKER_01: In today's course, we are excited to welcome Chris Gaskins, PhD, an outpatient neurorehab practice owner, whose dissertation examined how cognitive demand shapes the way clients learn and adopt health tech.
1:09
SPEAKER_01: We'll hear how Kritz is thinking about this whole landscape, and most importantly, how he makes decisions with his clients at his own private practice.
1:19
SPEAKER_01: We have a lot to cover today, so let's dive in.
1:25
SPEAKER_01: Welcome to the OT Potential Podcast.
1:28
SPEAKER_01: I'm your host, Sarah Lyon, OTRL, and I wanted to let you know that this podcast may qualify as continuing education for you.
1:36
SPEAKER_01: You are probably listening to this podcast on a free podcast platform.
1:40
SPEAKER_01: But to gain CEU credit, you will need to be a member of the OT Potential Club, our OT continuing education platform.
1:48
SPEAKER_01: You can go to OTpotential.com to learn more.
1:51
SPEAKER_01: Okay, here we go.
1:55
SPEAKER_01: As I mentioned at the top, joining us today is Christopher Gaskins, PhD OTRL C S R S.
2:03
SPEAKER_01: Chris has over 13 years of experience working as an occupational therapist.
2:08
SPEAKER_01: He developed a passion for neurorehabilitation while working at Walter Reed National Military Medical Center from 2011 to 2017.
2:17
SPEAKER_01: As his love for neurorehabilitation deepened, he noticed there was a shortage of neurorehab specialists.
2:24
SPEAKER_01: To address this issue, he created Neurosuite in 2019, a neurorehabilitation company that provides neurorehab, health tech consultation, and neurorehab education and research services.
2:36
SPEAKER_01: Chris earned his bachelor's in exercise science from the University of South Carolina in 2007, his master's in occupational therapy from Howard University in 2010.
2:47
SPEAKER_01: He then went on to earn his PhD in neuroscience and cognitive science from the University of Maryland College Park.
2:53
SPEAKER_01: So without further ado, we will patch Chris into our live studio.
2:57
SPEAKER_01: Welcome to OT Potential, Chris.
2:59
SPEAKER_01: It's so great to have you.
3:00
SPEAKER_00: Hey there.
3:01
SPEAKER_00: Thanks for having me.
3:03
SPEAKER_01: I am so thankful that you're here.
3:06
SPEAKER_01: Technology abandonment, I feel like, is something that comes up just kind of again and again on the podcast.
3:12
SPEAKER_01: We recently talked about caregiving.
3:15
SPEAKER_01: We've talked about um aging in place.
3:18
SPEAKER_01: And there's just like an underlying thread of abandonment statistics and how hard it is to find just like the just right fit.
3:27
SPEAKER_01: So I'm excited to have this time to just talk about this explicitly today.
3:31
SPEAKER_01: I have to say off the bat though, I feel like a little overwhelmed by the topic and almost a little bit discouraged because we'll talk about all the factors that go into finding that just right fit.
3:44
SPEAKER_01: And honestly, it feels overwhelming.
3:46
SPEAKER_01: Like there's so many things about finding the fit for clients.
3:51
SPEAKER_01: And really the only thing that stands out to me that helps is just having a clinician to talk through things with.
3:57
SPEAKER_01: So I'll be so curious to just hear how you are thinking about this and what advice you have for all of us in this really complex topic.
4:06
SPEAKER_01: But before we get to all of that, I just want to hear your story and how it intersects with uh just a passion for rehab tech.
4:16
SPEAKER_01: Like, where did that come for you for you?
4:18
SPEAKER_01: I know as an OT, I was like, keep me away from the technology.
4:22
SPEAKER_01: What drew you to it?
4:25
SPEAKER_00: Yeah, it definitely didn't start out like that.
4:27
SPEAKER_00: I will say that.
4:28
SPEAKER_00: I mean, I can remember being an undergrad at University of South Carolina and taking like an intro to computer science course.
4:34
SPEAKER_00: And that was the first and I believe only course I ever failed throughout my entire career.
4:40
SPEAKER_00: It just did it just didn't resonate.
4:43
SPEAKER_00: But, you know, as an occupational therapist and, you know, working um like in outpatient neuro, you know, rehab, you know, during my time at Waltz Reed, I became like the unofficial kind of rehab or rehab tech liaison.
4:57
SPEAKER_00: And I would interface with a lot of these rehab tech companies and decide if you know this device were appropriate for our clients.
5:04
SPEAKER_00: So that's where the interest uh really began to kind of blossom and and bloom, so to say.
5:11
SPEAKER_00: And I saw firsthand how you know technology can really help a patient along their road to recovery.
5:18
SPEAKER_00: But also if the technology is rolled out in an improper way, if there's like a lack of education or a lack of support or just continuity surround that device, how it can lead to things like abandonment or even um, you know, lack of motivation.
5:32
SPEAKER_00: But really, you know, then from there, uh once again, when I started my PhD program at the University of Maryland, uh kind of had like a rude awakening to the amount of tech I had to use.
5:43
SPEAKER_00: I didn't know I would have to learn to code and do things of that nature.
5:46
SPEAKER_00: Um, but you know, during that experience, it just really showed me one, what the needs are, and then also the importance of simplifying technology, um, however complex and overwhelming it might seem.
6:00
SPEAKER_01: Yeah, obviously, so many of us became therapists because we're so high on the people's skills.
6:06
SPEAKER_01: And I love your story about failing that computer science uh course, because that just totally feels like the stereotype of all of us, where having to get into the details of these technologies can sometimes feel really different than the other skill set that we typically draw on that like high relationship skill set.
6:28
SPEAKER_01: The reason I wanted to talk to you to you specifically about this is I know that you have a background in like mental workload.
6:36
SPEAKER_01: And that is definitely what I think of when I think of rehab tech, both for our clients and for our therapists, is it's just so much to think about.
6:46
SPEAKER_01: I know you have this background, but I honestly don't know much about what that initial dissertation was for you and what research you've kind of explored around workload.
6:58
SPEAKER_01: Can you tell me a little bit about that?
7:01
SPEAKER_00: Be glad to.
7:02
SPEAKER_00: Um, so we think about the concept called mental uh workload, sometimes often referred to as cognitive workload or cognitive effort.
7:11
SPEAKER_00: It's really if you think about the amount of mental resources that you have to allocate to complete a task.
7:19
SPEAKER_00: Um, so for example, if you think about when we tie our shoes, that's something that we're all uh likely masters at at this point in our lives.
7:26
SPEAKER_00: We've been doing for a long time.
7:28
SPEAKER_00: And you know, that task has reached this level of automasticity, something that we're doing automatically.
7:34
SPEAKER_00: So more than likely, we're not exuding and putting forth like a lot of mental effort because that, you know, that motor pattern, that contact pattern has, you know, been laid down time and time again on a daily basis.
7:46
SPEAKER_00: So we don't really have to think about it a lot.
7:48
SPEAKER_00: We could even, you know, do other things while we're tiring our shoes.
7:51
SPEAKER_00: But at that same time, if we had to do something with our hands that we're a little bit more complex and we're less familiar with, like maybe crocheting, you know, that because of that lack of familiarity and the complexity of that task, our mental workload would be uh a lot higher.
8:08
SPEAKER_00: So that's just on the basic level of the concept of mental workload.
8:12
SPEAKER_00: And particularly with my dissertation, I train individuals on how to use different types of upper limb prosthetic devices.
8:21
SPEAKER_00: So one group of participants learned to use a body-powered kind of mechanically driven uh cable system uh prosthetic device.
8:30
SPEAKER_00: So, you know, depending upon how you move your shoulder, you can open and close a tunnel device and grab things.
8:36
SPEAKER_00: And then some of my participants learn to use what we call a myoelectric device.
8:41
SPEAKER_00: This is a device that can read your muscle activity on your, you know, on your muscle, whether that be like your biceps and triceps or you know, your wrist and you know, for uh wrist and digit flexors or extensors.
8:56
SPEAKER_00: And uh with and with that, we look to see you know how do people progress along training?
9:03
SPEAKER_00: Like how's their training experiences between these two devices and and how do they differ?
9:09
SPEAKER_00: And you know, it the study had a lot of weight to it, significance to it, because with these myelectric devices, they're you know a whole lot more expensive than, you know, so to say, the the body powered devices.
9:21
SPEAKER_00: And you know, this information translates to the real world because oftentimes we think, you know, technology with all the cool bells and whistles, which might come with a higher price tag, is often better.
9:31
SPEAKER_00: But sometimes we have to put the layers back and understand that.
9:34
SPEAKER_00: I won't go through my whole dissertation, but the major finding was that people that learn to use this less technologically advanced device, the body-powered device, again, it's a mechanical system.
9:46
SPEAKER_00: And then we're comparing that to the myoelectric, more technologically advanced system, the motor performance between these two devices or between the two groups learned to use these devices were relatively the same.
9:58
SPEAKER_00: However, when we peel the layers back and we looked at the cognitive workload or mental workload, so we looked at um populations of neurons in the brain, and really, you know, if we look at certain frequencies that neurons kind of communicate with each other, it tells us information such as mental effort and sensory motor integration and things of that nature.
10:21
SPEAKER_00: And then we also looked at the movement quality, as well as we just asked the people, how's your perception of using this device?
10:29
SPEAKER_00: And what we found was that the more technologically advanced device, despite the performance between the two devices being about the same, there is a lot more mental effort being used uh for this more quote unquote technologically advanced device.
10:43
SPEAKER_00: So the moral of the story there and what I take and apply to everyday tech and rehab is that you know, we have to be mindful of how we introduce technology and how we we educate and train, and that sometimes something you know that might have more bells and whistles might require more training or different methods, more multi-sensory training, you know, visual, auditory, so on and so forth, so on and so forth, demonstration.
11:10
SPEAKER_00: So, yeah, while the study was uh, you know, very interesting, but it was a very strong message that parallels quite well into everyday rehab tech when we think about just the concept of mental workload.
11:24
SPEAKER_01: I feel like we could talk about just this dissertation this whole time because it's it's such a good setup into this conversation.
11:33
SPEAKER_01: And I'm just off the bat thinking about like the more high-tech, the more high-end devices that just typically tends to mean a higher marketing dollar, where those are getting pitched to us more aggressively than low-tech things.
11:54
SPEAKER_01: And it's our job as therapists to um kind of weigh things equally, like look at things for our patients um or alongside them, and I ideally to find the simplest solution to their problems.
12:14
SPEAKER_01: When I look at tech abandonment rates, which I was really excited to pull for this episode, when you look broadly at technology, um, looking at uh like consumer-facing health tech devices, which are like your Apple Watch things, um, those get abandoned about 70% of the time.
12:41
SPEAKER_01: I totally relate to that.
12:42
SPEAKER_01: Like I have bought things for myself and then it's I never use it.
12:46
SPEAKER_01: From what I can tell in the rehab tech space, we actually have much better numbers.
12:53
SPEAKER_01: The studies are all pretty small, but from what um a lot of them came in at like 10 to 30 percent of rehab tech is abandoned.
13:03
SPEAKER_01: This isn't perfect data, but that seems to be the trend.
13:06
SPEAKER_01: And my hypothesis is that it it's probably just because there's that clinician in the loop helping you discern the just right fit.
13:16
SPEAKER_01: Hearing those general um abandonment rates of uh the health tech overall and then rehab tech, how do those hit you?
13:26
SPEAKER_01: Does that feel right?
13:27
SPEAKER_01: Honestly, they still feel kind of high to me.
13:30
SPEAKER_01: What hits you there?
13:32
SPEAKER_00: Actually, I wonder if those numbers should be even even higher.
13:35
SPEAKER_00: There is even more abandonment than what we're actually than what we're actually capturing.
13:40
SPEAKER_00: I think understand like the stakes of the use of the of the device are important to consider, you know.
13:45
SPEAKER_00: Whereas if I bought like, you know, a new phone, I mean there might be some features that I may like and you know might that might affect my usability.
13:55
SPEAKER_00: Um, but like if I did not use that phone, like my life more than likely would not be significantly shifted or affected.
14:02
SPEAKER_00: However, for someone that's really trying to go through rehab and really trying to really improve their lifestyle, you know, these devices that are in use, uh, there might be more buy-in because it really does majorly impact their function, like their lifestyle.
14:16
SPEAKER_00: Um, and then to your point, I also think that having a therapist there or someone that can help with the integration of the technology for the client can be also very important.
14:27
SPEAKER_01: Yeah, I think a lot of the research is about total abandonment.
14:33
SPEAKER_01: Like they got the device, they don't use it at all.
14:37
SPEAKER_01: I only found one study.
14:39
SPEAKER_01: It was um in a pediatric journal, I'll link to it.
14:43
SPEAKER_01: It was about AAC devices, and they saw 33% abandonment, which is um kind of in that realm that I mentioned earlier for rehab tech.
14:52
SPEAKER_01: But they included one more metric, was which was that up to 75% of these devices were never used successfully.
15:00
SPEAKER_01: So about a third were totally abandoned, but then there was a much larger umbrella of they like kind of used them, but they didn't use them totally successfully.
15:11
SPEAKER_01: Only 25% of people got to that um level.
15:17
SPEAKER_01: Those stats that probably rings as true to me.
15:20
SPEAKER_01: Like maybe like a third abandon, a third don't fully use it, and maybe a third adopt it.
15:28
SPEAKER_01: Does that kind of ring true to you?
15:30
SPEAKER_01: I know we're talking in really broad terms here, but I think it's helpful to kind of set expectations for people.
15:36
SPEAKER_00: Yeah, I tend I tend to think of abandonment, I guess, more from a broader perspective.
15:41
SPEAKER_00: So I might even consider those people that didn't use it successfully, that they ultimately, you know, abandoned it.
15:46
SPEAKER_00: Like if it's not being used successfully, you know, then to me, I won't say it's a failed product, but like it's not being used like the full utility.
15:54
SPEAKER_00: But when I when I hear that stat, uh I I really think about just I think about routines.
16:01
SPEAKER_00: Like when you think about like our OT framework, I think about routines.
16:06
SPEAKER_00: And perhaps there may have been a shortcoming in having that device adopted into like that daily routine.
16:13
SPEAKER_00: And I've seen it clinically, like, you know, just as a as an OT going in to work with clients, where you know, there can be proper education, there can be a proper rollout of technology where you can get, you know, you have a therapist training you, you can call customer support, you know, you can do the demo.
16:32
SPEAKER_00: But then what happens, you know, at the month one, you know, month two, month three, like eventually, like, you know, the rehab frequency may slow down.
16:40
SPEAKER_00: That caregiver might be very interested in learning how to help the patient use a product initially, but over time, you know, that focus of interest dies down.
16:51
SPEAKER_00: And I think that's when you kind of have that gradual non-use and then that that device not really stay in in the routine.
17:00
SPEAKER_00: And then um, that's one thing I kind of want to see more like in some of the papers that we looked at, but just this focus on this kind of like continuity of engagement for the technology to succeed.
17:10
SPEAKER_00: Uh, just a proper rollout and initial education, and you know, the first few uses to confirm that the patient knows how to use the device is not enough.
17:19
SPEAKER_00: Like, how can we change like their health routine behavior so that they're consistently using it with ease, the same way they may brush their teeth or you know, fluff their pillow when they go to bed.
17:33
SPEAKER_01: Yeah, I think it's such a challenge to get a hold of a health tech device for so many of our patients.
17:44
SPEAKER_01: And we want to we want like getting it to be the success.
17:50
SPEAKER_01: But when you look at this research, at this reality, that's just step one.
17:55
SPEAKER_01: And that's a very hard step, and you want that to be the celebration, but it is truly just step one of a long process of really integrating it, like you said, into the routine.
18:07
SPEAKER_01: I was excited for this episode to pull some of the frameworks around tech adoption.
18:13
SPEAKER_01: The one I want to highlight is um a public uh access one.
18:19
SPEAKER_01: It's called the rights model, the rehabilitation rehabilitation technology implementation model.
18:26
SPEAKER_01: You can Google it.
18:27
SPEAKER_01: There's a ton of resources around it.
18:31
SPEAKER_01: Um, I'm going to say the general domains of it, and then I'm going to say the thing that makes me feel a little discouraged about it.
18:39
SPEAKER_01: So the overarching domains are uh does this device have evidence that supports effectiveness for the problem you're trying to solve?
18:48
SPEAKER_01: Like that feels like a great thing for us as therapists to keep in mind.
18:52
SPEAKER_01: Like, is this device geared towards the right problem?
18:56
SPEAKER_01: It after evidence, it encourages us to look at the technology, to think about the ease of use, the features of it, access, funding.
19:07
SPEAKER_01: Um, those are all helpful things to think about.
19:09
SPEAKER_01: I'm glad to have that in the framework.
19:11
SPEAKER_01: And then it has uh users, which it divides to service users and staff users, and thinking about the characteristics of both of those sets and if the match is right.
19:24
SPEAKER_01: And then it has um two domains, thinking about kind of like a broader support system, both the team and the organization.
19:32
SPEAKER_01: So those are the six domains.
19:34
SPEAKER_01: The one thing I want to say about it, well, one, it's kind of helpful to think through the domains that we need to think about as therapists.
19:43
SPEAKER_01: They have a guide for us to help you walk through all six domains, and that's 40 pages long.
19:49
SPEAKER_01: I'm like, that is a lot for us to think about.
19:53
SPEAKER_01: I think it's nice to have it spelled out what therapists think about every day, but there's no, I look at that and I'm like, oh, there's no easy answer to finding the right fit.
20:03
SPEAKER_01: What did you think of this framework overall?
20:06
SPEAKER_00: I thought it was comprehensive, um, especially for like a large-scale rollout of technology.
20:11
SPEAKER_00: I I don't view these five things as equal, so to say.
20:17
SPEAKER_00: Just when I when I look at it, I really kind of sit on the the technology and the the usability piece.
20:25
SPEAKER_00: I really, really sit on that because to me that's where to me that that's what really supports that the device will be used, you know, or or essentially like abandoned.
20:38
SPEAKER_00: Just simply put, how easy is it to use?
20:41
SPEAKER_00: Uh, even in um some of the research that we read about this, you know, one one indication was that it's important for like the rehab technology to kind of have the same modeling or presentation as the mainstream technology.
20:56
SPEAKER_00: I think there's something to that.
20:58
SPEAKER_00: Again, when I think about mental effort, if we are using mainstream technology like our iPhone or Android phone, for example, and maybe when we click on a submit button, we're accustomed to seeing that submit button maybe blue or green.
21:13
SPEAKER_00: Simply means, you know, good.
21:15
SPEAKER_00: You know, that's important to be able to carry that over like into the rehab device space.
21:19
SPEAKER_00: If we're using like a rehab app having that same color, or like if we're looking for, you know, took a part of the screen, like if we're looking for the help icon, we typically know to look to the upper right-hand corner.
21:32
SPEAKER_00: So don't put it like over on the left or like, you know, down low.
21:35
SPEAKER_00: So just that that simplicity um and then that continuity of organization from you know everyday technology that we see.
21:44
SPEAKER_00: And if we see that continued in the rehab technology, you know, I think that is that is critical.
21:50
SPEAKER_00: I definitely think overall digital literacy is key.
21:53
SPEAKER_00: Um, but it speaks to the importance again of a simplification of education.
22:00
SPEAKER_00: Again, how that technology is rolled out.
22:02
SPEAKER_00: But then again, how can we keep on reminding or sharing new information with the end user about the technology?
22:11
SPEAKER_00: So maybe it's like an email, or maybe you know, it was somebody from IT actually checking in with the client about the device.
22:17
SPEAKER_00: But again, that continuity of education to me is a lot of times if it's not there, that that leads to abandonment.
22:24
SPEAKER_00: When we look at the broader aspect, you know, the team and organization at the organizational level, again, I think that's key.
22:33
SPEAKER_00: Uh, in particular, something that I'm noticing just on a personal level.
22:36
SPEAKER_00: But when I have an IT issue myself and I'll call customer support, I'm noticing that it's harder to find actual phone numbers to call companies these days.
22:46
SPEAKER_00: And then, two, you kind of have to go through a barricade of 10 minutes of automated messaging and phone trees before you speak to a live person.
22:54
SPEAKER_00: And that's hard for me.
22:55
SPEAKER_00: Um, but imagine someone that might be experiencing cognitive challenges, or maybe they had a brain injury and they're a little bit more impulsive, less of less patience.
23:05
SPEAKER_00: Can you imagine like if they had to go through that?
23:07
SPEAKER_00: So there's a need to be able to have a human on our other end for this IT support for these companies, and also for them to be trained in compassion and empathy, but also just simplicity like of communication and just you know, presenting a little bit of information at a time so that the end user or caregiver can understand.
23:29
SPEAKER_01: This kind of gives us, or we've kind of really quickly painted just like the broad picture of what's going on, where uh, as rehab professionals, we're interfacing with a lot of these um health tech solutions that are being marketed to us are being marketed to our patients.
23:50
SPEAKER_01: But abandonment rate is high or is real.
23:54
SPEAKER_01: It's a real consideration for us.
23:56
SPEAKER_01: It's very hard to adopt technologies into our everyday um life, both when you're going through a rehab experience and just in any time.
24:06
SPEAKER_01: Like I totally struggled to adopt new technologies.
24:10
SPEAKER_01: I want to really focus on what this looks like in your world in your practice.
24:17
SPEAKER_01: Like you own this outpatient neuro uh setting.
24:20
SPEAKER_01: I think a lot of times when we think neuro outpatient, that really brings to mind different health tech devices.
24:27
SPEAKER_01: I just want to kind of walk through your process, um, what common trends are for you, um, and just start at the top.
24:38
SPEAKER_01: Just how when you're seeing patients, when people on your team are seeing patients, how do you even assess if a health tech solution is needed?
24:48
SPEAKER_01: Like what's going through your mind, um, knowing all the things that you know about mental workload and about health tech?
24:55
SPEAKER_00: First thing I look for is caregiver presence and engagement.
24:58
SPEAKER_00: And I think that's probably not looked at enough.
25:01
SPEAKER_00: But is there is one is a caregiver present, um, already engaged?
25:06
SPEAKER_00: Was there appetite for just communication, patience, and also technology?
25:11
SPEAKER_00: What does that look like?
25:13
SPEAKER_00: And then also the clients or patients' knowledge of technology, their openness to it.
25:20
SPEAKER_00: But also just very basic things like if I'm noticing their home, am I noticing that everything tends to be in their phone, like their reminders and their calendar?
25:29
SPEAKER_00: Or am I looking on the refrigerator and I'm seeing, you know, like a calendar there, and that's where they're writing things.
25:34
SPEAKER_00: Am I seeing like uh a notepad and pen, you know, pin nearby all the time?
25:39
SPEAKER_00: That's giving me a lot of good information, letting me know, okay, this person might prefer a you know written pen and paper system as opposed to a uh phone system for different, you know, different tasks.
25:54
SPEAKER_00: And I often will ask clients that, you know, based upon my observation within the first couple of sessions, what you know, what they prefer, if I don't notice that per observation.
26:04
SPEAKER_00: I think that that is uh that's a big thing.
26:07
SPEAKER_00: Um that that is definitely key.
26:10
SPEAKER_00: And then really be able to understand like what their goals are, and then also you know, their their patients.
26:16
SPEAKER_00: So we kind of look at technology like in two layers.
26:18
SPEAKER_00: We look at the technology that's utilized on an everyday basis, like phone use or even computer use, even the point are they looking at emails versus like text messages that tells us how we want to communicate or share information.
26:31
SPEAKER_00: And then we look at higher tech things like actual like robotic devices that they, you know, or hemiocratic patient working on uh regaining use of their or their limb.
26:42
SPEAKER_00: Um, or maybe it's a you know cognitive um tool that can help them strengthen their like executive functioning.
26:49
SPEAKER_00: Maybe it's even like a kind of high-end like orthotic.
26:52
SPEAKER_00: But when we look at that, our approach there is to take the workload off of the caregiver and the patient.
26:59
SPEAKER_00: Um, so I think as clinicians, we have an obligation to kind of sift through the overwhelming amount of technology, and we need to get familiar and you know, help guide the patient like in their decision making.
27:14
SPEAKER_00: So with Neural Suite, we we really focus on being a tech for a company so that we already have kind of good working knowledge of these devices, these higher tech devices coming in into the uh into the consideration for the client.
27:28
SPEAKER_00: And understanding the the payment model, is it subscription model?
27:33
SPEAKER_00: Is this affordable for the client?
27:35
SPEAKER_00: Is it you know covered by insurance?
27:37
SPEAKER_00: You know, what happens if insurance only pays 80% of it?
27:40
SPEAKER_00: You know, there might be like a hardship wave that they can apply for to get the remaining 20% waived.
27:46
SPEAKER_00: But just really understand the layout of that, I think, is is key.
27:51
SPEAKER_00: And then again, with Neural Suite, we take initiative on set up the meetings with the with the vendors of the of the rehab products.
28:00
SPEAKER_00: We'll sit on we'll sit on a virtual call with the client and the company, you know, so they can feel safe and not taken advantage of.
28:07
SPEAKER_00: And that kind of really helps on the procurement process, like of a of a device.
28:15
SPEAKER_01: This is why I was really excited to talk to you specifically, like knowing you come from this more tech forward company.
28:23
SPEAKER_01: You're in the Washington, D.C.
28:25
SPEAKER_01: area.
28:25
SPEAKER_01: I'm in rural Nebraska.
28:27
SPEAKER_01: I honestly, to be frank, didn't interface with any high-tech devices when I was working in outpatient.
28:34
SPEAKER_01: Like it just wasn't my skill set, it wasn't what my patients were looking for.
28:38
SPEAKER_01: So I'm very curious to ask you one, when you assess that the health tech might be the right solution for you, how do you like hone in on the right option of many?
28:53
SPEAKER_01: And I'm curious if you just say aloud like um some of the solutions that you use at Neurosuite that you come back to.
29:02
SPEAKER_01: If you say specific products, we're not endorsing these products, but I'm just curious to get specific about um what health tech solutions you tend to come back to.
29:12
SPEAKER_00: Yeah, it really takes to the OT framework.
29:14
SPEAKER_00: I'm looking at motor and process skills, I'm looking at, you know, the environment, the home environment.
29:20
SPEAKER_00: Um, again, the presence of the caregiver, the aptitude like of the client to be able to take in new technology, you know, how patient they are.
29:29
SPEAKER_00: But really, those process and motor demands help me arrive or help us arrive to our final decision.
29:35
SPEAKER_00: Um, I mean, even just now, we were we we've been in talks with a company for like the last week for a client that you know has significantly weakened grip ability.
29:46
SPEAKER_00: And it's really just you know the grip that's really lacking.
29:50
SPEAKER_00: He still has pretty sufficient elbow flexion extension.
29:53
SPEAKER_00: And when I first started communicating with him and our team started working with him, my mind immediately went to like another product that I think would be great for him to help him.
30:02
SPEAKER_00: However, you know, with this device, it it addresses you know elbow movement and the hand movement.
30:08
SPEAKER_00: So, again, because we're because we want a device that's sufficient, we don't want to add literally extra weight to a client if they don't have a use for like the elbow piece.
30:18
SPEAKER_00: You know, we know that, okay, we know this will work, but it might not be optimal.
30:21
SPEAKER_00: So again, focus on those motor processes and focus on okay, again, what can help out with grip.
30:28
SPEAKER_00: Um, you know, we found like a potential product that might potentially fit.
30:32
SPEAKER_00: But I think just again, sticking to the OT framework, looking at those demands.
30:37
SPEAKER_00: And then importantly, which again, you don't see in the research as much, but in the clinical space, I see it every day.
30:43
SPEAKER_00: Um, understanding that the night that dynamic of the caregiver is not talked about enough.
30:49
SPEAKER_01: Oh, I can totally see how big of an impact that caregiver um involvement is.
30:56
SPEAKER_00: Everything.
30:56
SPEAKER_01: And just like the dynamic of the family unit and the partner, even for myself, I'm like, I'm more likely to adopt when both my husband and I adopt something like um together.
31:09
SPEAKER_01: It's hard to talk about this topic because there's so many different options.
31:13
SPEAKER_01: Can you?
31:14
SPEAKER_01: I just want to drill down to be like, are there common low-tech solutions that you go back to?
31:21
SPEAKER_01: And are there common more high-tech solutions that you go back to just in your work?
31:28
SPEAKER_01: Or do you feel like it's truly case by case?
31:30
SPEAKER_01: Like you assess what's out there on the market and you find the just right fit?
31:35
SPEAKER_01: Um, what's more typical in your work?
31:37
SPEAKER_00: It depends.
31:38
SPEAKER_00: Would you say, are we speaking more on uh devices for cognitive, you know, restoration or cognitive use, or more so from the motor perspective?
31:47
SPEAKER_00: Like I want to learn to use my arm again.
31:50
SPEAKER_01: Which direction do you want to go?
31:51
SPEAKER_01: I'm curious about both those.
31:53
SPEAKER_00: Well, for the cognitive piece, I tend to go low, fairly low tech in just items that are already available in the home.
32:00
SPEAKER_00: So just proper utilization of the phone is such a powerful tool.
32:03
SPEAKER_00: Or, you know, again, either even more low-tech in just the pencil and paper, pen and paper method.
32:10
SPEAKER_00: And we look at organization.
32:11
SPEAKER_00: I literally we literally just gave a talk last week at a community center about uh physical clutter and how that can make it hard to organize, but then also digital clutter and how digital clutter can make it hard to properly you know leverage technology to make your your you know your thinking a little bit easier, your organization a little bit easier.
32:32
SPEAKER_00: So a lot of times, yeah, a low-tech solution for cognitive-based goals, utilizing the phone, cleaning out excess apps that are not utilized, getting rid of redundant apps that are used for the same purpose and not really needed.
32:46
SPEAKER_00: And then once we kind of have it kind of cleaned down, then having the specific goals for different apps.
32:54
SPEAKER_00: So, for example, I might not advise a client to put their appointments in the calendar and put their reminders for smaller tasks in the calendar.
33:03
SPEAKER_00: I might encourage them to, hey, use your reminder app for everyday things you need to remember, like you know, to take out your dog or go to a grocery store versus like your calendar for, you know, staying like appointments.
33:17
SPEAKER_00: Now, when thinking about on the lines of motor control, yeah, there are certain devices I tend to go to depending upon the symptomology.
33:27
SPEAKER_00: So if someone tends to, which I can counter a lot, if we have a client with spasticity, flexor spasticity, and a lot of difficulty being able to open that hand.
33:39
SPEAKER_00: Um, some low-tech devices I will go to will be kind of like an extensor glove, like the Sabo um glove.
33:47
SPEAKER_00: It's a very kind of low-tech affordable device, um, but obviously still comes with pros and cons.
33:54
SPEAKER_00: Uh, because it has like a rubber band police system to keep the hand open.
33:58
SPEAKER_00: It can be very challenging to put on and to kind of keep the hand open if those rubber bands lose elasticity over time.
34:05
SPEAKER_00: So, once again, I need the caregiver.
34:09
SPEAKER_00: Uh, a lot of times it's gonna be too hard for the client to put on themselves, oftentimes they can't.
34:13
SPEAKER_00: But I need a caregiver engage.
34:15
SPEAKER_00: How quickly can I train the caregiver?
34:17
SPEAKER_00: Are they gonna be able to put on this device?
34:18
SPEAKER_00: So they're gonna be able to wear it.
34:21
SPEAKER_00: And then for kind of higher, higher tech needs, um, yeah, I mean, again, not endorse any any company.
34:28
SPEAKER_00: It depends on what the client's issue is.
34:30
SPEAKER_00: But, you know, we might use like the Maya Pro, um, you know, for example, or you know, even like a gamification, you know, software, like we're beginning to explore um Houston, uh, Houston Bionics and their XO rehab device, which is like a motorized kind of robot that helps out with wrist sustention and flexion and supination, things of that nature.
34:52
SPEAKER_00: But again, even with that being said, we're looking beyond just the idea of adoption and we're looking at sustained use.
34:59
SPEAKER_00: And the pathway to sustained use is really just how salient, how important you know, this technology is to the client to be able to achieve their goal and their ability to continue to use the product, and then also again, the presence of that caregiver, um, being a team member and helping kind of facilitate the use of that device.
35:21
SPEAKER_01: Every year I come back to this uh blog post that I wrote about tech tools for OTs.
35:27
SPEAKER_01: And maybe this is where my overwhelm comes from because I make all the categories and then I write like the seven tools that are available in that category from uh, like you said, from cognitive rehab to mobility supports to upper extremity options.
35:48
SPEAKER_01: And I'm truly just thinking about this out loud, but I'm like, oh, it would be really helpful to see those like in some kind of order from like low tech to high tech.
35:58
SPEAKER_01: Um, more important than pricing, even, even though there's there's probably a correlation with pricing, that would be another easy way to do it.
36:06
SPEAKER_01: But there's just truly so many, so many options out there.
36:11
SPEAKER_01: It's hard to find the right fit and a miracle that we find it as often as we do.
36:17
SPEAKER_01: I picture you, knowing you have this background in mental workload and doing the work that you do.
36:24
SPEAKER_01: I picture you as being really good at training and client education.
36:29
SPEAKER_01: What have you learned over the years about like setting people up for success with the new device?
36:36
SPEAKER_00: Uh repetition.
36:38
SPEAKER_00: I guess you probably hear my theme now, but it's continuity of education.
36:42
SPEAKER_00: So not just providing structured education when we introduce a product, but even weeks down the road or a month afterwards.
36:49
SPEAKER_00: And then uh video has been very effective, not just resting on the laurels of just a verbal education, but complementing that with actual video.
37:00
SPEAKER_00: Like you take a video of the patient using it, take a video, take a video, yep, of the patient using it for the first time.
37:06
SPEAKER_00: The first time we might don and doff that device, capturing all of that in video and pictures that we can refer back to.
37:13
SPEAKER_00: And we then share that with the client.
37:15
SPEAKER_00: Literally did this today, uh, with the client.
37:18
SPEAKER_00: We're teaching her how to use the stable stem micro, which is a neuromuscular electrical stimulation device.
37:23
SPEAKER_00: And yeah, we took pictures of the different like electro configurations, you know, that where the electrode should be placed on her arm.
37:30
SPEAKER_00: And you know, we coupled that with instructions and then also a log.
37:36
SPEAKER_00: Um, so the client can print off their home exercise program that has the pictures of where to put the electrodes, the instructions, but then also they can scan a QR code or click a link and then just enter in.
37:50
SPEAKER_00: Hey, today I did these three electrical stimulation protocols and you know, a free text box for hey, this is an issue that I had.
37:59
SPEAKER_00: And, you know, we get again, we want a closed loop system where, you know, I am now as a clinician now getting that feedback each time they do their homework if they log it.
38:11
SPEAKER_00: So that if I need to step in and call, be like, hey, I saw you had an issue with um you weren't getting like the proper muscle activation.
38:18
SPEAKER_00: Maybe you know your electrodes off half a centimeter, you know, half an inch or so.
38:23
SPEAKER_00: That has been like a extremely, extremely like beneficial model um that definitely hope to formalize uh one day.
38:31
SPEAKER_01: They're logging it electronically so you can track it.
38:34
SPEAKER_01: Is that what you're saying?
38:35
SPEAKER_01: Okay.
38:35
SPEAKER_00: Yeah, the moment they log it uh electronically, then I get a ping to my email.
38:40
SPEAKER_00: This client has submitted their homework, and then y'all can go look periodically and see, you know, via bar charts or pie charts or whatever, exactly what they've done.
38:49
SPEAKER_00: And that's that's been really helpful when a client does that.
38:52
SPEAKER_01: I can totally see the benefit of both the things that you're mentioning.
38:58
SPEAKER_01: One, it's like such a common theme on the podcast that uh human beings are highly visual.
39:03
SPEAKER_01: Like the more visual you can make the instructions, whether it's from a video, whether it's from pictures, those efforts just tend to pay off big time because we're just tend to be visual people.
39:15
SPEAKER_01: And the value of the log, like whether um it's super low-tech and they're writing it, or if you can do an electronic one, those things, those are just tried and true things that tend to work.
39:29
SPEAKER_00: Yeah, critical.
39:31
SPEAKER_00: I I would even like to see this happening, but you know, with technology um and this idea of wearables, and you know, if you have a device that can just track your movement and you know, just automatically capture what the client is doing, now we're removing another layer of complexity from the client.
39:49
SPEAKER_00: So now they don't have to bother to scan the QR code to enter in what they did, but you know, the therapist can then log on to a portal, look at this device, and see, oh, this is the amount of repetitions that they did or the range of motion.
40:02
SPEAKER_00: So I think that's a huge opportunity for tech companies to be able to create technology where we can asynchronously view what our clients are doing, um, or even synchronously.
40:14
SPEAKER_00: And I think that helps a lot um, you know, on the client's usability.
40:19
SPEAKER_01: Yeah, I was really hopeful like five years ago that we would see more of that wearable device cater to rehab specifically, how you're saying.
40:29
SPEAKER_00: Um yeah, it's a noisy problem, so to say.
40:32
SPEAKER_00: Yes, yes, yes.
40:33
SPEAKER_00: Think about uh, you know, electrical signaling, like you know, there's a lot of what we call artifacts and what we call like movement artifacts.
40:40
SPEAKER_00: So, like, you know, if we're trying to measure somebody's movement when they reach for a glass, you know, that movement can be contaminated by a lot.
40:47
SPEAKER_00: And, you know, it's not what we call like a clean signal or like a reliable estimate of their movement.
40:53
SPEAKER_00: I think I think that's the problem that tech companies are still trying to refine and solve.
40:59
SPEAKER_00: I think we're getting there, but that's that's probably part of the reason for like the delay.
41:04
SPEAKER_01: I would say it hasn't happened as quickly as we would help.
41:08
SPEAKER_00: Yeah, yeah.
41:10
SPEAKER_01: We're kind of outlining the ideal scenario where uh you find the solution, you educate, uh, they're using it, you're tracking usage.
41:23
SPEAKER_01: Tell me about the other end of you've found a solution, you've provided education.
41:30
SPEAKER_01: It feels like you're headed towards abandonment.
41:33
SPEAKER_01: What does that look like when that tends to happen?
41:36
SPEAKER_01: I'm going to uh add in a question from the comments here, too.
41:39
SPEAKER_01: Someone was curious about correlation between like the price of the tech and the rate of abandonment.
41:46
SPEAKER_01: Um, I didn't see that anywhere in the research, but I'm just curious anecdotally when you're thinking about what types of things you see abandoned and then what you do about it when you see people headed that way.
41:58
SPEAKER_00: What do I do when I see people hand heading that way?
42:01
SPEAKER_01: Yeah, yes.
42:02
SPEAKER_00: Uh, I mainly have a checkpoint and really explore the why.
42:07
SPEAKER_00: And honestly, a lot of times it has to do with like me as an OT or our neurosuites are our implementation.
42:12
SPEAKER_00: Like maybe we didn't roll it out and provide enough cues or education.
42:16
SPEAKER_00: So we kind of dial that back and kind of re-review.
42:19
SPEAKER_00: Um, and a lot of times it might be the time demand, the temporal demand for the family.
42:26
SPEAKER_00: If, again, the caregivers are essential, like if they're busy and they're working, they may not have, or they might be very tired, and they may not be able to like, you know, put on like a very complicated orthosis.
42:37
SPEAKER_00: So maybe like they might be dealing with our flights themselves, and they can't quite, you know, grab that small outridger, that rubber band and pull it back.
42:44
SPEAKER_00: You know, it's for like an orthodox device.
42:47
SPEAKER_00: It can be multi-multilayer, but we want to discover that why for the potential abandonment, and then we we really address that right away.
42:56
SPEAKER_00: Um, if it's a motivation issue, which happens a lot as well, then we look at again, us as clinicians, and how can we provide more uh realistic but also encouraging feedback?
43:09
SPEAKER_00: Like, how can we capture you know that 10 degree range of motion improvement that they did that's not quite translating to functional gain, but it is still like an improvement.
43:20
SPEAKER_00: But how do we highlight that and show that?
43:22
SPEAKER_00: And again, I think it goes back to this theme of just constantly of communication, you know, so you can find these problems right away and address them, but also so you can kind of keep the client informed on how they're doing in like the bigger picture.
43:37
SPEAKER_00: And then sometimes those things have been implemented, and you know, we're seeing like wavering, you know, motivation or use.
43:45
SPEAKER_00: Sometimes we have to accept things for what they are.
43:48
SPEAKER_00: Maybe we did not make the best choice for technology use.
43:52
SPEAKER_00: Maybe the timing is off.
43:54
SPEAKER_00: And I think that's a critical decision that a therapist has to make when you think about the cost benefit analysis.
44:00
SPEAKER_00: Is it worth spending additional time to try to get adoption and sustained use from this device?
44:06
SPEAKER_00: Or, you know, is it better yet just pivoting and switching to like a low-tech device or no device?
44:12
SPEAKER_00: I think that's a critical juncture that a therapist has to make.
44:16
SPEAKER_00: But I think it's important to not get too attached to any technology.
44:19
SPEAKER_00: The goal is not to have the client use the host technology out there.
44:23
SPEAKER_00: The goal is to get them back to function.
44:26
SPEAKER_00: And sometimes that might not involve the newest thing on the block.
44:30
SPEAKER_00: It might just involve, you know, grabbing a cup from your cupboard a hundred times, you know, just repetition.
44:37
SPEAKER_01: Yeah, and truly finding that just right challenge.
44:40
SPEAKER_01: And I'm kind of going to like a personal anecdote in my mind, too, where I'm uh I'm in vision therapy right now, and I have this like these glasses I'm supposed to wear and do exercises, and I'm terrible at it because uh it's hard.
44:55
SPEAKER_01: Like it's hard to do the work, and I don't want to carve out the time of my day to do it.
45:03
SPEAKER_00: And it's good remind, yeah, it's a good reminder for me.
45:05
SPEAKER_01: Like usually we're asking people to do hard things, and it may or may not may not be the tech.
45:11
SPEAKER_01: Like I have the right tech, but it's just hard, it's challenging.
45:15
SPEAKER_00: Yeah, that opens up the door a lot.
45:16
SPEAKER_00: So a lot of times what we'll put in our home activity program forms, we'll we'll put time of day that you did the work morning, afternoon, evening, and night, that's or night, and that's good data because like we're now learning again, it goes back about your routine.
45:33
SPEAKER_00: Like, what's your health and your technology routine like?
45:37
SPEAKER_00: If we're seeing a pattern that you're doing in the morning, then let's focus on that and let's carve out time in the morning for you to do the work because we know that you're more likely to complete it.
45:46
SPEAKER_00: So for you, I would I would inquire about yeah, can we find like a little fraction of time during the day that you're more likely to do it?
45:54
SPEAKER_00: Um, and I would literally want to sit down with you and understand, look at your calendar and look at the time that you maybe you're more alert, more focused, or whatever it might be.
46:02
SPEAKER_00: And um, then I would try to find a time before I would quote unquote abandon those exercises.
46:11
SPEAKER_01: Oh, yes, it truly is just hard.
46:15
SPEAKER_01: It's hard work to do the thing, it's hard work to do, find the right fit.
46:20
SPEAKER_01: Um, but it's amazing when the process does work.
46:24
SPEAKER_01: I wanted to ask about the abandonment of low tech versus high tech and just hear anecdotally like, do you see more people abandoning high-tech things or low tech things?
46:36
SPEAKER_01: Uh, as you look back, do you have things that have a very success rate?
46:41
SPEAKER_00: Yeah, uh, yeah.
46:43
SPEAKER_00: I think, yeah, I think that's valid.
46:45
SPEAKER_00: So I think, yeah, we might experience it again, it depends on a product, but a high-tech device doesn't necessarily mean increased difficulty.
46:53
SPEAKER_00: I mean, you can have yeah, it's again, it's really about the usability of it and the education that's associated with it, the the the educational programming.
47:02
SPEAKER_00: But purely when just thinking about a device and its mechanisms, and again, this is a little nerdy, but going back to like signal processing or like electrical signaling, like if you have a device that is you know rely relying upon like again, electromography, like EMG, picking up on the muscle, the signal of the muscle, just inherently like that has what we call like a lot of potential noise that can contaminate that signal.
47:32
SPEAKER_00: And when you contaminate that signal of the device picking up on our muscle activity, our electrical muscle activity, you know, that leads to a poor device use.
47:44
SPEAKER_00: I saw this firsthand during my dissertation.
47:46
SPEAKER_00: Oh my goodness.
47:48
SPEAKER_00: Like, yeah, like where patients, yeah, patients were using like uh, you know, uh what we call a myeletic device, and that required, you know, EMG reading.
47:58
SPEAKER_00: And I mean, if you sweat a lot, uh, if the electrodes are not clean, if your skin is not clean, uh, maybe you put on some oil or lotion before you did the work, that contaminates the signal, and then that will make using the device extremely frustrating, which will ramp up that abandonment like no other.
48:21
SPEAKER_00: So, yeah, I mean, to these companies, there is a need to constantly explore technologies that can understand how our body engages in the world, but you know, the technology has to be done in such a way that it can be somewhat robust against things that might contaminate that that signal.
48:41
SPEAKER_00: The same thing with EEG, electroencephalography, you know, picking up on um neuroactivity in the brain.
48:48
SPEAKER_00: You have the same challenges, like there's products out there that use that technology, but again, if there's a lot of contaminants that might interfere with that signal, the the client is gonna have a complicated process.
49:01
SPEAKER_00: So a lot of times, and I mean some of my other uh rehab kind of neuro gurus have kind of championed this as well.
49:10
SPEAKER_00: Uh but yeah, sometimes low-tech might be, you know, the the best or sometimes more feasible solution.
49:17
SPEAKER_00: Because I mean, at the end of the day, you know, we want task specificity, task-specific training, and then we need you know repetition as well as other factors.
49:26
SPEAKER_00: If I had to spend 30 minutes to set up a device, I mean that's I'm losing the opportunity to do a hundred sereps, you know, which is important for neuroplasticity.
49:35
SPEAKER_00: So again, it's not always about you know if it's high tech or not, but just you know, how well how well can it be used?
49:45
SPEAKER_00: How can we simplify it?
49:46
SPEAKER_00: Even if it is complex, how can we simplify it?
49:50
SPEAKER_01: Yeah, there's so I mean the theme of just this conversation is there's so many options for us, there's so many considerations.
50:00
SPEAKER_01: I'm honestly like I look at the rates and I'm like proud at the level of adoption that we do have in rehab tech.
50:07
SPEAKER_01: Like it almost feels like a miracle to get the thing integrated into the life in someone's life and being helpful um in that way.
50:16
SPEAKER_01: And it feels like, or I started to feel like half of our job is I don't want to say saying no, but encouraging people to think of what it could look like without tech or a low-tech solution for sustained use.
50:31
SPEAKER_01: Like if that's our goal, um, if usually sustained use is our goal.
50:36
SPEAKER_01: Um, so you're looking at simple or no tech, which is not what our tech companies want to hear.
50:42
SPEAKER_00: Yeah, salience.
50:44
SPEAKER_00: I mean, yeah, I think higher tech technological devices can be a benefit because you know it taps into like our interests and it can be you know something new.
50:54
SPEAKER_00: But just salience and just doing tests that are meaningful and important are just extremely key.
50:59
SPEAKER_00: And I mean, it might be fun to play like uh to utilize like gamification software or you know, rehab robotic device, and you know, maybe you know, maybe you're doing like an Atari-based, Nintendo-based like game simulation or whatnot.
51:14
SPEAKER_00: But I mean, does that take precedence over again being able to cut you know your stake or you know, being able to turn like a book, a page in your favorite book?
51:25
SPEAKER_00: So again, these, you know, a low-tech simplified approach, you know, can often can often be, you know, the best.
51:32
SPEAKER_00: Um, but sometimes it can be good to layer, you know, that more of a high-tech solution on top of that just to give an alternative and to kind of break the monotony, and then also just to facilitate more repetitions.
51:44
SPEAKER_00: But again, it has to be done uh carefully with a proper rollout, so to say.
51:53
SPEAKER_01: Zooming out just in our final minutes, I'm like, there is so much energy right now to how like health tech is going to transform healthcare.
52:04
SPEAKER_01: We have all these new solutions coming to the market.
52:08
SPEAKER_01: Like, on one hand, I do truly believe that, but I feel it in tension with the knowledge that we know on the ground is like a lot of this stuff is just gonna get abandoned.
52:19
SPEAKER_01: It's not gonna work.
52:21
SPEAKER_01: How do you think about that tension in your mind and just like where we're going with all of this stuff?
52:26
SPEAKER_00: Yeah.
52:27
SPEAKER_00: When I was reading the Olson paper, you know, they were discussing like they did like a thematic analysis of like several art of articles, and I believe they found like how a person-centered approach can be effective.
52:43
SPEAKER_00: And obviously, we've been hearing that like our you know, all of our OT careers.
52:47
SPEAKER_00: Um, but to me, that idea of a device or technology being person-centered is starting to take on a new capability to me.
52:55
SPEAKER_00: Um, meaning that when I think about technology and also like the use of AI, the the ability to create like customized solutions are really, you know, really unprecedented.
53:13
SPEAKER_00: And I just wonder, like, you know, does this idea of person center, you know, can we as therapists begin to maybe not have to, you know, communicate with these large rehab companies that you know have an out-of- out-of-box solution that might not be customized for your individual patient?
53:31
SPEAKER_00: But actually, could we create something on our own?
53:33
SPEAKER_00: And it that might sound seem far out, but it's really, it's really not.
53:38
SPEAKER_00: I mean, I've I mean, even myself, as well as I've seen others, I mean, what we call like a one-shot, a one-shot prompt, like a one-shot, like you maybe you're using like Claude or a certain model, like Opus of Fable.
53:51
SPEAKER_00: I'm getting a little AI nerdy now, but I mean, you can literally like create like a, you know, like a basic video game.
53:58
SPEAKER_00: I mean, even my buddy that I was doing a neuroscience PhD program with, he sent me like a video and like he somehow created like a pressurized handle that a stroke patient can like squeeze a handle and that registers to a computer game that's kind of similar to like Super Mario Brothers.
54:17
SPEAKER_00: And like he did that like you know pretty easily, which is before like we wouldn't even think anything like that.
54:22
SPEAKER_00: So, all that to say, just as OTs, if you're a little curious out there about technology, and also if you if you're not satisfied with what's out there, don't rule out the ability to um, you know, see if you could kind of create something yourself and see that's something that you know a patient might might be able to use.
54:42
SPEAKER_00: Um, again, not as a medical device that has to be FDA cleared, but just as a you know device that just might promote activity, so to say.
54:49
SPEAKER_00: Um, just I think when we think about a person-centered model and leveraging that with technology, I think we have to start looking, we have to push the envelope a little bit there.
54:58
SPEAKER_01: So I was not expecting this conversation to go in that direction towards those really customized solutions.
55:06
SPEAKER_01: But I know at our one of our local rehab hospitals here in Nebraska, uh, one of our I saw a present or an OT there gave a presentation on uh how much 3D printing she does, uh, which is another extension of what you're talking about.
55:21
SPEAKER_01: Exactly.
55:22
SPEAKER_01: We now have the abilities to create our own custom apps.
55:25
SPEAKER_01: We have the ability to 3D print stuff.
55:28
SPEAKER_01: And I hadn't thought about it at all in this way, but maybe that is the direction where we're all going.
55:33
SPEAKER_01: Because of course, a lot of these out-of-box solutions are getting abandoned because they're not tailored.
55:39
SPEAKER_00: Exactly.
55:40
SPEAKER_01: Is there a reality where that becomes our role as OTs where we get to step into that maker space?
55:49
SPEAKER_01: I mean, that's really mind-blowing.
55:51
SPEAKER_00: Think about the hand therapist.
55:52
SPEAKER_00: Go in, see a client that needs like a customized split, and the hand therapist takes a few looks and just goes and creates it.
55:58
SPEAKER_00: I mean, imagine what if we did that for tech.
56:01
SPEAKER_01: Hmm.
56:02
SPEAKER_00: What to think about?
56:04
SPEAKER_01: Yeah, my mind is blown.
56:05
SPEAKER_01: I wasn't expecting the conversation to go in this way.
56:08
SPEAKER_01: I'm gonna be chewing on it.
56:10
SPEAKER_01: We're down to our final minute.
56:13
SPEAKER_01: Um, I'm just ending with my mind blown, but do you have a more coherent thought to end us on today on this big topic of rehab technology abandonment?
56:24
SPEAKER_00: Yeah, I just think again, we as uh occupational therapists and more importantly, advocates for our patients.
56:32
SPEAKER_00: I think it's our duty to be familiar with what things are available to our patients, and it's overwhelming for them.
56:39
SPEAKER_00: And, you know, they get on out there trying to be the Amazon warrior and trying to find different technologies that might work, and sometimes it does, but a lot of times it's not appropriate.
56:49
SPEAKER_00: So we have to be able to provide that knowledge and guide them along the way.
56:53
SPEAKER_00: So I think it's a duty for us to be familiar with what's out there, and then also be familiar with the process.
56:59
SPEAKER_00: Like does insurance cover it?
57:01
SPEAKER_00: What's the payment model for the patient?
57:03
SPEAKER_00: What's you know, the patient responsibility?
57:05
SPEAKER_00: Because again, it's a lot for them to navigate this on their own.
57:09
SPEAKER_00: Um, so that that would just be my closing thought.
57:14
SPEAKER_01: Well, Chris, you I started this conversation feeling overwhelmed, and I'm so thankful for your simplification down to that partnering, to that advocacy.
57:25
SPEAKER_01: I really, I totally agree.
57:26
SPEAKER_01: I think that's what is needed in this really complex space.
57:30
SPEAKER_01: And I'm so thankful for your time to uh talk about this complex topic today and give me some new things to chew on.
57:37
SPEAKER_01: I just really appreciate you being here.
57:39
SPEAKER_00: Yeah, thanks for having me.
57:41
SPEAKER_00: It was great chat.
57:46
SPEAKER_01: Thank you for joining us on the OT Potential podcast.
57:49
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57:59
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58:06
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58:15
SPEAKER_01: Okay, I want to thank you for joining us today, and we'll see you next time.