Page 14 - Mobility Management, June 2018

CRT Trends: Big Data
Quality Assurance & the
Functional Mobility Assessment
The industry knows Complex Rehab Technology improves lives. Proving it does has been decades in the making
You’re probably already familiar with the Functional Mobility Assessment (FMA). It’s a 10-question survey
that asks adults to compare their activities and abilities before and after they started using a new wheelchair. Among the questions are how often they leave their homes, how well they perform transfers, how efficiently they can reach for items, and how effectively their wheel- chairs meet their comfort needs.
We know results we’re getting from the people, self reporting, are between 85 and 90 percent accurate — Mark Schmeler
Participants respond to the questions using scores
on a scale of 1 (Completely Disagree) to 6 (Completely Agree), and they’re asked these questions repeatedly over time — because satisfaction with a wheelchair can change.
Those are the questions in the survey itself. But among the critical industry questions behind the survey is whether consumer satisfaction is impacted by the involvement of an Assistive Technology Professional (ATP) in the equipment provision process.
U.S. Rehab, a division of The VGM Group, has world- wide rights from the University of Pittsburgh “to commer- cialize and collect data with the FMA,” said U.S. Rehab President Greg Packer.
For years, he has been working with Pittsburgh’s
Mark Schmeler, Ph.D., OTR/L, ATP, Associate Professor, Department of Rehabilitation Science & Technology. Schmeler is one of the developers of the FMA and started on the project just a few years after he began working as a clinician.
“It really is almost a 30-year process,” he said, as Pittsburgh announced it would be publishing a paper on FMA outcomes in 2018.
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The Role of Big Data
To understand the need for the FMA and the data that comes from it, you need only to look at the current land- scape of “big data” and the decisions it influences.
“Everything in healthcare, everything in life, everything we buy, everything we do has a metric associated with it,” Schmeler pointed out. “I think that’s becoming even more obvious now: Every time you buy something, or have a conversation with a customer service representa- tive on the phone, or you get out of an Uber or you leave a restaurant, they ask you to rate them.”
That expectation is common in healthcare: “When
you look at medicine, there’s plenty of data that tells
you the drug or pharmaceutical intervention for which people under what circumstances. You’re able to have conversations with your clinicians, practitioners, people who are serving you about ‘What do you think is going
to be the best treatment for me?’ And usually, they’ll say, ‘Studies show that for people in your situation, these are the chances of this outcome versus that outcome.’ That’s been around forever, but it’s really coming to light now.”
What does that mean for complex rehab technology (CRT)?
“We know what we do works,” Schmeler said. “We see it every day. We know we’re good at it. Nobody’s really in this for self promotion; we’re all here to help people with disabilities.”
But a turning point for the home medical equipment industry came in 2003. During that year’s Operation Wheeler Dealer, Medicare began scrutinizing wide- spread and fraudulent provisions of scooters and consumer power chairs for patients who didn’t always need them.
The result was closer scrutiny of CRT, as well.
“Unfortunately, we had an awful situation 10 years ago or so, with companies just ripping off Medicare,” Schmeler said. “If you’re the government, it’s ‘How do
we stop this freight train? Sure, there are people who really need [CRT], but in the big scheme — they have no outcomes. They have limited evidence. They have little
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