Clinician Insights Series 5, Episode 2
We’re delighted to be continuing Series 5 of Clinician Insights with our guest Cara Negri, BSME, CP and advocate for learning and development in the O&P field. In our first episode, we discussed Cara’s beginnings in the industry and her perspectives on clinical training and education. Cara shared some fantastic insights, and we encourage you to check out the first episode before turning to this one.
In this second and final installment with Cara, we discussed the advantages and potential drawbacks of digital technology in O&P, and looked to the future of the industry to consider how we can all best adapt our practices to support both patients and industry professionals more broadly.
If you’ve not joined us before, this blog series is brought to you by Radii Devices, to open up conversations about digital technology and its role in clinical practice. We hope you enjoy this episode, and to ensure you don’t miss future installments, please subscribe to our Substack!
Now, let’s continue our conversation with Cara.
Jenny: How do you think that clinician training and education could adapt to involve new digital technologies?
Cara: I love the idea of something that is guiding me towards an evidence-based approach to modifications, supporting me subjectively and coming up with what I think is going to be appropriate for a patient. At the end of the day, we have a lot of demand, and we've got to be able to keep up with it. The less time I take modifying, the more I'm able to spend either with the patient, or on researching what knee sleeve might be better for them, or what foot might be appropriate, because there's so much coming out all the time. It's really hard to keep up to speed with all of the different technologies and not get in that rut of doing the same thing for every single patient.
I'm a continuous learner and love the idea of always getting out of my comfort zone and learning new things. I think that there's always something to be learned to improve my skillset. It can be hard to take the time to sit down and learn something different and new, but I do think it's something we should consider and model to other healthcare practitioners, to show that practicing and refining our skills is important.
Jenny: What do you think are other barriers to using digital technologies?
Cara: I do think we have to consider the cost analysis of it. Some of the insurance companies are definitely not paying us as much as they used to. How much is that going to affect our decision-making for the future? Are the costs of the additive manufacturing being covered now?
However, if I spend less time modifying, then I can spend more time either writing an appeal letter for someone to get coverage, or making sure that I'm doing a really good job at justifying why someone needs something. Of course, modification time isn’t paid for in the US anyway, so using something like riiForm that gets us to a good place without having to actually do as much manual labor, then I think that those costs really do outweigh the cost of the software.
Also, sometimes residents don’t want to partake in digital. I think I had one resident say to me, “I think I can learn that in the future”. But in order for us all to get out of our comfort zone, we need to make sure that we're not just doing what we know because it's easier.
Jenny: What strengths have you found from integrating digital technologies into your workflow and what benefits do you think they could offer in the future?
Cara: My four motivators for going digital are: flexible work, the data aspect, environmental benefits and protecting ourselves.
Even if I go home, I can modify from my computer in my bed, with my dog next to me. I don't mind being here at the office, but if I don't have to come here on a Saturday or Sunday to modify and can make tweaks from anywhere, that’s great. Being able to review my resident’s modifications from anywhere is also fantastic.
There's a lot of strengths in the data. With the comparison tool in riiForm, I was able to look at someone's scan from a year or two ago, then look at their scan now, and see actual evidence of limb changes that we don't always see circumferentially.
The amount of waste that our profession creates is something that I consider. So I love digital workflows, because I'm not producing as much waste. I'm also not pouring or inhaling plaster, or exposing my body to these harsh chemicals. We don’t need to be putting our bodies through that. I smashed my finger recently and broke it with an open fracture busting out a mould. I was already on my digital workflow journey, but being without a finger for a month was enough to seal to deal that we need to make the shift.
It’s almost the same as when I started using a Mac versus a PC. You just have to stop and force yourself to learn the new way and not have the traditional tools in front of you that make it easy for you to just do it that way. Make it difficult for yourself to do it the old way, so that you have to learn the new way. My finger is doing really well now, I can use it quite a bit.
Jenny: I’m glad your finger is doing better! When you are looking at new digital technologies, how do you decide which ones to use?
Cara: I feel like I'm quite technologically savvy, I like the challenge of learning something new and typically won’t just throw my hands up and give up. On the other hand, having a learning curve that's too steep can definitely cause a little resistance to getting through that push of that new technology. I’m not going to remember everything from training sessions, so having an intuitive design so it’s easier for me to figure out things on my own is really important.
Jenny: Looking ahead, where do you see the prosthetics industry going?
Cara: The more evidence that we can apply to each patient is going to be what elevates our field, I think. I really believe in evidence-based practices, so the more evidence that we can have to guide our decision-making, the better.
Students that are coming out now are having much more of a body of research. What does the evidence say about how I could be treating this patient? I really hope that we continue to see ourselves as medical professionals and that the insurance companies value and see the care that we provide for people, versus just the device that we're providing.
Jenny: How do you think using evidence-based fitting could impact patients in the future?
Cara: We're only going get better outcomes if we're using evidence versus trial and error. I think trial and error is always going to be a part of some of the problem solving that we do for patients, but we can use the evidence to get better and faster outcomes, instead of the patient getting frustrated with the fact that they're not getting the outcome that they are desiring.
I think that that goes hand in hand with physical therapy. The evidence that we have is not going be just that the prosthesis is going fix everything. Physical therapy and taking good care of your body and eating well are also important to consider for better outcomes. There's not nearly enough evidence in that respect. But it is part of my personal passion, nutrition and strength, and I think we need to start opening up those conversations.
Jenny: Thank you Cara, I completely agree. Let’s close with that!
Thank you so much to Cara for her time!
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