Alternative Healthcare Delivery Models and O&P
New healthcare reimbursement models that lean toward
large organizations, coordinated and standardized care,
and bundling payments are already a reality in the U. S.
Coordinating Care from Amputation through Rehabilitation
They say no man is an island, and that is likely true with regard to healthcare
professionals providing the most effective O&P care. According to the experts The O&P EDGE spoke to, the more members of a patient's healthcare team coordinate with each
other, the better the patient's outcome.
The O&P EDGE asked professionals from several different healthcare settings how
they go about coordinating care from amputation through rehabilitation and how
this improves their ability to care for their patients.
The Influence of Goals on Early Adaptation to Lower-Limb Amputations
In addition to the physical retraining that often accompanies
an acquired disability, there are a number of emotional adjustments
and adaptations that need to occur as well. In many
instances, the goals and aspirations that preceded the injury
or traumatic event are no longer physically possible and may
need to be restructured.
In the world of prosthetic rehabilitation, lower-limb amputation
is typically an acquired event, frequently occurring during
adulthood when goals and expectations are well established.
Pending O&P Legislation Impacts Private Insurance Coverage, Medicare, and Veterans
The current Congress has been criticized for
being unproductive when comparing the number
of bills passed to previous Congresses, but that
has not stopped the O&P profession from seeking
legislative solutions to O&P problems. There
are three important bills pending in Congress
that all members of the O&P community should
be aware of, understand, and support by contacting
and asking their Congressional representatives
to advance this legislation. Each House Resolution
Benefits of International Communication
In our busy lives, there is always an overarching sense of economy with respect to attention, activity, and financial support of professional groups. Many of us ask the question, "Why do I belong to professional groups, and what are they really doing for me?" But the question can also be asked, "What differentiates me from any other clinician?" These are common concerns among professionals who have limited time to develop professional associations, conduct research, or share opinions beyond their local groups. Creating a group of contacts beyond similar contexts provides significant differentiating qualities.
Changing Our Language and Becoming Part of the Coordinated Care Team
The Affordable Care Act (ACA), Accountable Care Organizations
(ACOs), person-centered care, coordinated care—no matter
what you call it, a force is being applied to the American healthcare
system unlike any we've seen in our lifetimes. That force
will have an impact on the system even if it serves simply to
accelerate the pace of change. But what does all this mean to
the O&P community? Before we can address that, we must first
ask ourselves a basic question:
Do you work in an industry or in a profession?
Here are definitions of the two terms from Merriam-Webster:
INDUSTRY: "The process of making products by using machinery and factories.
Are You a Great Technician?
As a judge of the technical fabrication
contest at last year's American Orthotic
& Prosthetic Association (AOPA) World
Congress in Orlando, Florida, I noticed
something I hadn't really thought much
about before: There are some really great
technicians out there.
The task was to fabricate a "prosthosis"-a device to accommodate
a mid-foot amputation-and there were some really
great entries. Some were more for show, some focused on
function, and a few represented what I think a really great
technician can do.
Master's Program Profile Series: California State University, Dominguez Hills (CSUDH)
As evidence-based practice becomes increasingly important, The O&P EDGE is providing a series of articles to explore how the next generation of O&P professionals is being educated in preparation to begin their careers. This series of articles takes a look at the National Commission on Orthotic and Prosthetic Education (NCOPE)-accredited programs currently offering master's degrees in O&P. NCOPE accreditation promotes credibility and gives students, the public, and those within the profession confidence that the program meets the educational standards needed to effectively train an O&P professional.
Wilma Rudolph Courage Award; ADN Hall of Fame Inductees
Stockwell Presented with the Wilma Rudolph Courage Award
Melissa Stockwell, CP, was presented with the Wilma Rudolph Courage Award from the Women's Sports Foundation, at an October 2013 ceremony in New York, New York. She is the first female American soldier to lose a limb in the Iraq war; she lost her left leg due to a roadside bomb. She is a 2008 Paralympian in swimming, and in September 2013, won a silver medal in the Paratriathlon Female Tri-2 division at the World Triathlon Grand Final London, England.
Billing and Collections Q&A
Running an O&P facility in today's landscape of enhanced scrutiny and changing billing requirements can leave even the most seasoned billing professional feeling frustrated. If you have a billing question or a question about a denial, "Got FAQs?" can help you sift through the confusion and get you the answers you need. This month's column addresses your questions about forms required for a new facility and billing for L-0631 and L-0637.
PFA's 54th Annual Symposium & Exhibition Sets Foot in Boston
Industry Review - Conferences
The Pedorthic Footcare Association's (PFA) 54th Annual Symposium
& Exhibition arrived in Boston, Massachusetts, on October 30,
2013, the same day the Boston Red Sox clinched the World Series
championship down the street at Fenway Park. The PFA's Annual
Symposium & Exhibition is the largest educational and networking
event in the United States that is dedicated to pedorthics.
Held this year at the John B.
Something for Everyone
As The O&P EDGE enters its 12th year, we do so
with a renewed commitment to provide beneficial
information to our O&P professional readers,
their referral sources, and their patients. In
his first of six articles, Peter Thomas, JD, highlights
pending O&P legislation to help keep
our readers abreast of the latest happenings in
Washington DC. In addition to this regular coverage,
I encourage you to visit oandp.
A Coordinated Care Model for an Orthotics Practice
The January issue of The O&P EDGE features an article about coordinated care models from amputation through rehabilitation. In this EDGE Direct exclusive, pediatric specialists Brett Boutin, CO, and Barbara Boutin, CO, who own and operate Orthotic Specialists, Phoenix, Arizona, describe their orthotic model of coordinated care.
The Freedom Agilix™ is a multiaxial, shock-absorbing, flexible foot system designed to manage loading impacts, reduce socket shear forces, and improve comfort while walking on nearly any terrain. The ultra-lightweight design offers low-impact K3 ambulators shockingly comfortable performance at a value like no other. Learn more about the Agilix on our website.
A program designed to help optimize your materials costs.
With the challenges facing O&P care providers, it's becoming more difficult to provide high-quality patient care while managing a business. The SPS Rewards Program ensures you are getting the best value for the products you need to run your business. To learn more and register for the SPS Rewards Program, contact your SPS sales manager.
Finally, a humeral fracture orthosis (HFO) that will fit—because you fabricate it! The innovative, lightweight, and breathable 3D-LITE™ thermoplastic is pre-cut to fabricate an HFO. The 3D-LITE can be softened in three to five minutes using a heat gun or oven, allowing it to be custom molded to your patient's anatomy or easily remolded to assure continued intimate fit as any edema subsides. The kit includes straps and hardware, which are ready for you to attach and position to achieve optimum stabilization. Fabricate your own custom HFO in less than 30 minutes!
The avalon foot provides 12° of controlled ankle motion, allowing the user to safely negotiate stairs, ramps, and environmental obstacles with increased confidence and security.
- Dorsiflexes from midstance to toe off for a smooth rollover.
- Remains dorsiflexed through swing phase for improved toe clearance, to minimize the risk of falls.
- Provides a more natural gait; reduces the need to compensate by hip hiking, circumduction, or lifting the knee to clear the toe during swing phase.
- Biomimetic ankle motion encourages equal loading during ambulation, which leads to less stress and thereby preserves the sound side.
The Compact Double Action Ankle Joint
(Model 725) is supplied fully assembled
and is designed specifically for use with
thermoplastics. The precontoured stainless steel
upright and stirrup reduces fabrication
time, while the low-profile and lightweight
design enhances the clinical application.
The Compact Double Action Ankle Joint,
intended for both small-adult and pediatric
patients, is designed to provide optimal
control in the sagittal plane and increase
Find out why CP's and amputees are
raving about this new low profile
prosthetic foot. Our Flexeon™
fiberglass composite material is 3
times more flexible than carbon
fiber and nearly indestructible. This
translates into fewer repairs, warranty
claims and higher patient satisfaction - all of which are good for
Whether the need is for above or below the knee amputees,
our unique design ensures the most stable, natural K3 mobility
and lifestyle experience for your patients.
Call today and receive a special introductory discount on
your first two orders.
The Stride4™ Shadow is a lightweight KAFO that combines structural strength and cosmetic appeal with the new Stride4 mechanical stance control orthotic knee joint from Becker Orthopedic.
Stride4 features include:
- Three operation modes: stance control, free motion, and locked with stance phase knee flexion.
- Four-bar linkage mechanism to afford stability and mimic anatomical knee motion.
- Integrated extension assist.
The inherent rigidity of the Stride4 Shadow ensures that optimal joint alignment and function is maintained throughout the gait cycle.
The guide provides information about:
- Terms to know.
- Types of audits.
- Planning ahead.
- The RAC audit process.
- And more!
Ask your Endolite territory manager about getting your guide today.
College Park is known for high-quality and durable foot shells. Now your highest impact patients can have increased durability, and everyone can enjoy walking barefoot safely. The College Park Shelltread™ is made from abrasion-resistant styrene-butadiene rubber with a crosshatch design for enhanced nonskid capability. Easy to install and affordable, they are available in neutral and black for every size and type of College Park foot shell.
College Park Industries
Finally, the elegance of a heeled shoe
specially designed for women with
diabetes. The patent pending forefoot
design provides pressure relief for
all-day comfort, and the BOA® closure
system provides an adjustable, secure
fit. You can find all of the beautiful
styles in Dr. Comfort's Classic Heels
Comfort Collection online.
- Forefoot design acts like a metatarsal bar to help relieve forefoot pressure.
- Adjustable, secure-fitting BOA® closure system.
- PDAC assigned code A-5500.
Other K2 designs are typically stiffer SACH feet or softer K3
designs, but the Fillauer K2 Foot has been engineered from the
ground up specifically for the K2 patient.
Features and benefits include:
- Unique flexible keel/multiaxis design.
- Flexible, impact-reducing design.
- Roll-over shape (ROS) designed for a natural gait.
- Compliant dynamics for comfort and stability.
- Positive-lock foot shell interface for stability.
- Simple, maintenance-free design.
- Foot comes assembled in the foot shell for an easy, out-of-the-box fit.
The new VENUM1 LSO and TLSO
one-size-fits-all line features a
drawstring pulley system that is easy
to use and simple to pull. The sleek
design and lightweight, less bulky
product are features to look for in
this brace. Each VENUM1 has a
built-in anterior panel and removable
posterior panels that can be
retrofitted from a TLSO and break
down to a simple corset.
Features and benefits include:
- 50 percent stronger than conventional triple swivels.
- Simplified design and construction outlasts conventional models.
- Stronger, heat-tempered, stainless steel materials.
- Extra-long ferrule provides "double swage" capability.
- 3/16-in. and 9/32-in. diameter terminals for both standard and heavy-duty cable.
- Use with TRS Python cable for the ultimate in strength and durability.
Features and benefits include:
- All stainless steel construction for stronger, longer-lasting control.
- Lightweight—weighs only 1.5 oz. per hinge.
- Sold in pairs, with an ultrasmall joint head to reduce overall bulk.
- Taller, reversible, stainless steel upright helps to corrugate the plastic strut, reducing the need for thicker plastics.
- AFOs can be fabricated with plastic as thin as 3/32 in.
- Adjustable stops allow movement from 0-30 degrees in both directions or anywhere in between.
- Contourable distal stirrup attachment increases strength connection of the molded footplate and allows for thinner plastic in AFO fabrication.
Coyote Composite is made by melting basalt (volcanic rock),
which is then extruded into a filament and braided to our
proprietary specifications for use in prosthetics and orthotics.
Basalt has applications in fields that demand extremely tough,
lightweight material that retains flexibility, including the aerospace
and hockey equipment industries.
Features and benefits include:
- Noncarcinogenic and nontoxic.
- Less itch than carbon.
- Tough and durable.
- High saturation.
- Cost effective.
- Easy to use for rigid or flexible layups.
- Fully compatible with all prosthetic resins.
- Because of its superior saturation, Coyote Composite finishes as good as, or better than, carbon laminations.
Until now, all advanced vacuum systems have required a sleeve to maintain vacuum. The problem is that sleeves are bulky; they bunch behind the knee, restricting range of motion. They can also puncture, leading to a loss of vacuum.
Enter Unity™. Building on established Seal-In® technology, the Unity Sleeveless Vacuum system by Össur® is the first advanced vacuum solution to generate 15-22 in Hg of vacuum without a sleeve.
Visit www.ossur.com/unity to learn how to get certified and check out the entire line of Unity-compatible Flex-Foot feet including low-profile and microprocessor solutions.
Kinterra™ combines hydraulics and carbon-fiber technology to provide K3 ambulators with 12° of motion and an exceptionally normal walking gait-regardless of surface angle or speed. The result is rock-solid stability and the confidence for users to choose a new path.
Kinterra's articulating ankle provides:
- Improved stability and safety, especially on slopes and varied terrain.
- Reduced socket pressure for healthier residual limbs.
- Enhanced comfort while sitting or squatting.
- Increased ground contact and a more symmetrical gait.
See the Kinterra in action on our website.
Available on all Custom Origin Liners for greater freedom of movement.
Evolution Industries Inc.
The 1C30 Trias® is an extraordinary prosthetic foot-a combination of creative design and innovative, lightweight technology. Interconnected, dual-spring elements provide dampening at heel strike and enable a physiological rollover with excellent energy return. The result is movement similar to a natural foot.
- Dual carbon forefoot and heel springs for easy rollover.
- Adapts to various walking speeds and uneven terrain.
- Lightweight carbon construction in an attractive design.
- Functional foot shell in normal and slim versions, two colors, and two heel heights.
- New look as part of the TriAngular foot family.
Join the celebration at
and visit the anniversary
page on our website.
American Board for Certification/ABC
Hersco has a new line of Tri Lam
custom foot orthotics with several
material choices. Tri Lam technology
layers materials of different
durometers, giving the practitioner
the ability to vary thickness and shock
absorption. Hersco Tri Lams include
Plastazote and PPT for accommodative
devices, or more durable Sky for
active patients. You can also choose the base layer of firmer cork
or softer EVA.
More information and pictures are available on our website.
Certified pedorthists are ready to answer any questions you may
have regarding our custom products.
Hersco Ortho Labs
The Freedom DynAdapt™ foot is a
slim-profile, carbon-fiber foot system
with a slender, anatomic design for easy
fit and finish. Its multiaxial function
provides maximum comfort and the
uninterrupted strands of carbon fiber
in the full-length heel provide patients
with effortless rollover and a more
natural gait. The new EnduraCore™
Technology composite laminate delivers up to three times
the fatigue life of a standard laminate in a design that also
returns more energy. The result is a highly durable product that
preserves users' energy so they can do more with confidence.
Accepting Applications Now!
Begin your P&O career at NUPOC! Learn from leaders in the P&O profession! The NUPOC MPO is a 21-month graduate curriculum that prepares you to enter an accredited residency, sit for certification examinations, and become a P&O practitioner.
The online portion of the program includes live and streamed lectures, videoconference discussions, group projects, and case-study sessions that help you learn, apply, and review knowledge.
The on-campus practicum offers supervised opportunities to practice technical and clinical skills with patient models who have neuromusculoskeletal impairments.
Northwestern University Prosthetics-Orthotics Center
Feinberg School of Medicine
Texas Assistive Devices (TAD) has
introduced the N-Abler® III WHO
Soft Brace with Quick Disconnect
Palmer Unit to allow patients with
partial-hand amputation or hand
dysfunction to independently perform
activities such as eating, meal
preparation, grooming, hobby or mechanical work, carpentry,
and sports. The N-Abler system uses patented couplers for flexion
and positional rotation to attach the tools and utensils, with
componentry available for bilateral patients, too. The WHO Soft
Brace comes in four sizes and for right or left use.
Demonstration kits are available.
Contact us for more information, including L-Code
Texas Assistive Devices