What is Complex Rehab Technology ?

CRT (Complex Rehab Technology) is the newest term, developed over the last few years to describe specialty equipment that which is more involved than basic  DME (Durable Medical Equipment). As you may know DME encompasses everything from disposables  to custom wheelchairs and Orthotics/Prosthetics. You may wonder why a new term was created if it is part of DME? 

Invacare Rear Drive Powerchair

For years, DME vendors have been given a bad name, with a few bad companies taken advantage of the system and many times committing fraud.  CRT was born, when Medicare created the Competitive bidding process and they didn't understand the level of involvement with Specialty Seating and Equipment. After much work from the Rehab industry, some specialty equipment was exempt from the competitive program; including ultra light weight wheelchairs, tilt in space wheelchairs, and group 3 powered wheelchairs.  Medicare, who sets precedent for Medical Equipment to all funding sources, accepted that the skill level and expertise in providing this level equipment was above the typical DME provider.

Since that time, NRRTS ( National Registry of Rehab Technology Suppliers ) and NCART ( National Coalition of Assistive and Rehab Technology ), has been lobbying Congress to further separate Complex Rehab equipment from DME.  It is understood that there is a value for this equipment provided and that there needs to be increased safeguards, and education from individuals providing this level of equipment. If  this industry is not protected, and the value shown, it will disappear in the upcoming years.  The average age of Rehab Technicians are late 30's, with most over 40, and few new people learning this trade.

Carey Britton

 With the baby boomers aging, we will need more specialists  involved; helping match proper equipment for seating and mobility needs.  A further issue causing challenge, is that there are fewer physician and therapists specializing in this field; leaving more pressure and expectations on the Seating and Mobility Specialists.   Although the Seating and Mobility Specialist is a critical component in the team that provides and supports these services; the clinician is  the gatekeeper, and we need more clinicians  to step up become community leaders. 

In order to ensure  good outcomes, we continue to progress in this industry with increased credentials, increased education, and increased safeguards to protect patients.  Our industry needs to continue to educate the allied services to become more involved in the team that is required to improve seating, function and overall satisfaction.

This article was written by Carey Britton, Seating and Mobility Specialist at Active Mobility Center. He can be reached for comment at 954-946-5793 or at cbritton@wheelchairguys.com  .

 

Molded Seating at Active Mobility

Each week at Active Mobility Center, the staff presents on products and services to ensure staff properly educated. This week Robert Bowman and Carey Britton provided a joint presentation on Molded Seating Systems.

Molded Seating Systems are very specialized seating where an impression is taken of the patient, and where a seat and back is created that matches this shape. Molded Seating is expensive, custom, and is not for everyone.

We consider Molded Seating when a patient has asymmetrical postures that cannot be supported by off the shelf, planar seating or modular seating.  These patients are seen by a physician and ruled out for a TLSO (body brace) and where less supportive seating will not support and protect the patients posture from further decline/deformity.

There are many factors to consider when deciding on molded seating. After determining that other seating will not accommodate the patients posture; we need to determine the environment the equipment will be used, who the caregivers are, and if there will be any foreseen changes in condition.  For children and individuals who change weight/size, there is concern for molded seating to be outgrown. Additionally if there are multiple caregivers, there is concern that the patient will placed in the seating the same way each time; failure to sit in contours properly can increase pressure, or cause postural issues.

There are several types and brands of molded seating.  The most common is Silhouette, Pindot, OBSS, and Ride Designs. Each has its benefits, and after a thorough evaluation, each can be considered to best meet the goals and needs of the patient.

Molded Seating traditionally was covered in vinyl, however over the years several options and foam densities are now available. Gel, Air and Visco Foam Inserts and overlays can be used to help with pressure, posture and positioning.

Prior to molding a patient, a clinician should be involved to determine the limitations and range in anatomy to determine the best position for the patient for siting, posture, stability and function. 

Please contact Carey J. Britton, seating specialist for Active Mobility Center for any questions or information on Molded Seating or seating/positioning needs. He can be reached at (954) 946-5793 or cbritton@wheelchairguys.com  .