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Assistive technologies to help individuals in the workplace are developing at a rapid rate, but if the promise of these technologies is to be fully realized then thinking around access, user training, reimbursement, and other barriers needs to catch up. That conclusion echoes throughout a new report from the National Academies of Science, Medicine, and Engineering.  Authors of the study include Physical Therapy (PTJ) Editor-in-Chief Alan Jette, PT, PhD, MPH, FAPTA, and Linda Resnik, PT, PhD, FAPTA, and executive director of the Center on Health Services Training and Research (CoHSTAR).

"The Promise of Assistive Technology to Enhance Activity and Work Participation" is the result of an extensive review of the literature pertaining to assistive products and technologies, a series of public meetings on the topic, and a public teleconference that invited expert comment. The purpose: to develop an analysis of the adult use of assistive technologies including wheeled mobility devices, upper-extremity prostheses, and technologies designed to assist with hearing, speech, and communication.

The report, available to download for free, isn't just an account of what's out there and how far assistive technology has come—it's also an examination of the challenges of putting these technologies to their most widespread and effective use.

"The committee's review of the literature and the expert opinions of its members and others who provided input for this study made clear that appropriate-quality assistive products and technologies … may mitigate the impact of impairments sufficiently to allow people with disabilities to work," authors write. "In some cases, however, environmental and personal factors create barriers to employment despite the impairment-mitigating effects of these products and technologies. In addition, maximal user performance requires that individuals receive the appropriate devices for their needs, proper fitting of and training in the use of the devices, and appropriate follow-up care."

That concept of barriers and training needs colored most the committee's conclusions, which include recommendations that point to the importance of proper fit, ongoing follow-up, better training for providers, and an understanding among employers and others that a device that may be useful to an employee today may become less useful over time.

Authors also addressed the lag-time that can exist between effective technologies and a payer's willingness to provide reimbursement for those technologies.

"The provision of assistive products and technologies … is contingent largely on reimbursement policy rather than patient need," authors write. "In some cases, the products and technologies that are covered by Medicare and other insurers as medically necessary are not those that would best meet the needs of users to enhance their participation in life roles."

Funded by the Foundation for Physical Therapy, CoHSTAR is a multi-institutional, multi-disciplinary center dedicated to advancing health services and health policy research capacity in physical therapy.

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