O&P Tech Tools: The Potential Gains and Pitfalls

Timely, accurate billing and effective resource management of time, talent, and supplies are essential in running today’s O&P practices. Various technology tools including artificial intelligence (AI), computerized inventory control, automated claims submission and posting systems, and electronic patient health records can help. But they can also introduce risks for errors and system vulnerabilities. We asked experts to weigh in on the tech tools making the biggest impacts, and the pitfalls to be aware of. Having just opened its 40th location in the Midwest, Comprehensive Orthotics and Prosthetics (CPO) understands the need for the efficiencies technology provides. Amit Bhanti, owner and CEO, is constantly looking at growth initiatives and the technologies that can best support them. Bhanti says CPO is fortunate to be able to leverage the size of the organization when implementing new tech tools, making it less cost prohibitive than it might be for smaller practices. The company has taken a strategic approach to vetting and implementing new technologies. Bhanti believes O&P practices will soon catch up with the medical profession at large when it comes to using AI and other technologies to create efficiencies. No longer will practitioners be doing every task in their practice, but instead they will increasingly take advantage of tech tools that free them up to focus solely on patient care. He believes software providers can benefit from focusing more on specialties rather than trying to be one-stop shops. Open software systems and AI-based technologies, including for electronic medical records (EMRs)/electronic health records (EHRs), Bhanti says, will ease this transition for practitioners and software vendors. “More and more O&P EMR software companies are going toward platforms that do everything or try to do everything, but I don’t think they can do everything perfectly,” Bhanti says. “They need to retain the part they are good at but have the ability to integrate with other systems. Interoperability is the key.” To customize solutions that fit its needs, CPO develops several tech solutions in-house. Data is a key area of development, and after vetting platforms from several companies, CPO ultimately opted to create its own. Bhanti focused on developing a tool that allowed it to cut through the noise and get at the data that really matters in O&P. He encourages other practitioners to do the same. CPO’s platform was designed to help practitioners visualize data and draw inferences. Timeliness and the quantity of data are key components, too, and must be actionable in the short term. “If two weeks go by, then your data is only diagnostic,” he adds. “It needs to be prescriptive and automative—give me three things I need to do as the owner of the company, for example. Our data analytics platform is intended to be accessible and useful for every department and every clinician.” Leaning Into AI As in other industries, AI is top of mind for O&P practitioners and clinic managers as it continues to drive tech advancements. When it comes to patient care, AI tools allow for more customized O&P devices, thanks to machine-learning algorithms that can analyze anatomical data to provide optimal fit and comfort. And tools that enable collecting vast amounts of data from wearables and smart devices can allow providers to monitor the performance and usage of devices in real time. Meanwhile, the integration of AI in office software for EHRs promises to enhance the efficiency and precision of healthcare delivery. AI-driven EHR solutions are designed to streamline data entry and management by automating routine tasks, reducing the administrative burden on practitioners, and minimizing errors. These systems can analyze patient data to provide valuable insights, assisting in diagnostics and treatment planning. While these advancements can help move the profession to more intelligent, efficient, and adaptive patient care solutions, the use of AI to handle sensitive personal health information raises concerns about consent, data breaches, and unauthorized access. Concern also remains about what it means for employees and job security. Bhanti does not believe it is something to be feared. “People are worried about AI just like they were worried about computers 40 years ago,” he says. “We thought computers would take over our jobs, but instead, people got upskilled or changed their skillset and computers became integral—they actually created jobs. If you talk about healthcare in general, I think AI is going to be a boon and be really important.” A key benefit of AI from Bhanti’s perspective is its ability to relieve some of the burnout medical professionals experience by enabling them to offload some tasks. “We have workers leaving by the thousands every year in healthcare due to burnout,” he says. “So, while I don’t think AI will replace healthcare workers, I think it will augment what we as clinicians do—take over the redundant and repetitive tasks, and also allow us to deliver more meaningful insights at the time of a visit in real time.” For CPO, AI-based tech has already allowed the organization to retain less profitable areas of care that it would not have otherwise been able to continue offering, specifically foot orthoses. CAD and scanning tools were not enough to keep the services profitable, Bhanti says, so he developed an AI-based scanner that patients can use to scan their own foot. Patients receive a link that turns their phone camera on and any video that is taken generates a 3D model via an AI-based algorithm. This not only allows CPO to eliminate an initial diagnostic office visit, but also to significantly reduce the time it takes to create foot orthoses. Turning a model into a modified shape now takes approximately four minutes. And as a result, practitioners can deliver a patient’s orthoses within a week versus a month. “The cost is so much less; our rural patients don’t have to make a trip, and they can have a fabricated insole already waiting for them when they do come in,” he says. “Even if 20 percent of my insoles don’t fit at that first visit, which has not been the case, I am still profitable.” CPO also developed an AI-based app to assist in Medicare patient cases. Documentation is processed through this system to corroborate physician notes, and a quality score is generated that indicates to the O&P practitioners if it is acceptable, needs to be reviewed, or needs to be completely redone. Scalability and sustainability are big benefits of developing products in house. And while there are still some solutions that are affordable for budget-conscious practitioners, Bhanti says it depends on the practice’s needs and size. He also cautions that many out-of-the-box solutions don’t work well for O&P. Five years ago, he created a shared services division to use CPO’s scale and efficiencies to drive down its administrative costs. Through that division, CPO can also provide its solutions to other practices. When it comes to making tech purchase decisions, Bhanti says it’s important for practices to know where they’re at in their lifecycle and have a plan for getting where they want to be. “Don’t run after the shiny object,” he says. “You need to know your business and then have a strategy and the team to get you there—and that team includes people and technology. Then you can decide if you should buy something or if it is better to build it.” Another consideration in incorporating AI is awareness of AI biases that inevitably occur based on the data used to train the systems. This is particularly important as it relates to minority and underrepresented patient populations. “You have to have a critical thinking mind when you’re using these systems,” Bhanti says. “When we were building the foot scanning algorithms, for example, we discovered we did not have a lot of African Americans in our data set, so we went out and got scans from that population to ensure those are an adequate part of our model.” Losing human interaction with patients is also a concern for practitioners and patients. But Bhanti cites tools like AI note-taking, which allow a practitioner to be more fully present during a visit. “There is a lot of discussion about accountability in case of AI errors, so of course we have to navigate that in a very responsible manner,” he says. “It comes down to being able to trust those AI models we’ve created.” Keeping the Human Element Hanger is also adopting AI-based tools, and clinical documentation is a key area of focus for the company. To better support its patients and staff, Hanger Clinic recently launched an AI documentation support tool, Clinical Assistant for Records and Automation (CARA), across locations in several states. “I see the biggest potential impact of AI for the O&P industry being in the area of clinical documentation,” says Shane Wurdeman, PhD, vice president of Scientific Affairs, Hanger. “As the industry faces a growing demand to support an aging population with increasing healthcare needs, it is critical that clinics have the tools to optimize care and create efficiencies.” CARA was developed to alleviate the growing documentation challenges, giving clinicians more time to spend with patients and ultimately leading to better patient outcomes and higher clinician satisfaction. “As with any newer technology, it must be tested, monitored, and adjusted,” Wurdeman says. “But CARA represents a significant advancement in O&P care, leveraging artificial intelligence to automate records and management tasks.” Wurdeman does not believe AI will negatively impact the human element of the interaction that takes place between clinicians and patients. “AI will not replace the important relationship between a clinician and their patient but can serve as a tool to enhance the patient’s experience and the level of customized O&P care they receive.” Hanger’s Clinical Documentation Specialist Molly McCoy, CPO, echoes that sentiment. She understands firsthand the value of implementing AI-based tools for those tasks. When used correctly, AI’s benefits are apparent in enhancing practitioners’ ability to more fully understand their patients’ needs, she says. She cites AI’s ability to summarize historical medical records, outcomes data, and information from past interactions for practitioners so they can create more effective documentation and ultimately better patient outcomes. “AI creates the potential for more heartfelt interactions by acting as a scribe and writing partner so you can focus on the patient when they’re in front of you,” she says. “Efficiency is certainly part of the benefit, but even more importantly, AI-assisted note writing can empower the patient to be a participant in their care and in the device design process during evaluation and fitting sessions by helping them to focus on the discussion instead of the computer.” In the coming years, McCoy anticipates that AI will help to remove the trial-and-error process of medical necessity arguments in O&P. This could be particularly beneficial when working on medically complex patient cases. For example, for people with multiple comorbidities where gaps in historical information exist, AI tools can quickly retrieve valuable information for the clinician to help them design the most appropriate rehabilitation support plan and change it as the patient changes. “We are integrating medical records, outcomes, and practice workflows with real-time clinical decision support to decrease the clinicians’ cognitive burden during an appointment,” McCoy says. “Additionally, organizing and understanding large amounts of data from such interactions will feed back through AI, so that in the near future we will have real-time clinical decision support and enhanced clinical practice guidelines.” Efficiency Above All OPIE Software supplies its EHRs and workflow, billing, and practice management solutions to more than 1,500 clinical care locations. Founder and CEO Paul Prusakowski, CPO, has been in the business since 1995. When it comes to new tech developments, he says the company is focused on product developments that strike a balance between customer requests and delivering the best value to those customers long term. “The importance of business continuity for users of the original OPIE application (OPIE Classic) requires us to be thoughtful and intentional about deciding which updates will be released and in what order,” he says. “Before we spend a lot of time and money on a small feature or enhancement, we evaluate if our resources would be better invested in the new foundation, which will allow for much greater flexibility in the very near future.” OPIE is currently in the process of rolling out the browser-based OPIE Platform designed to allow practitioners to perform all of their processes through a browser by early 2025. The operations management platform includes tools for managing integrated patient engagement, advanced fabrication and materials management, waste reduction, training tools, and more. His advice to practitioners adopting new technology is to document their journey to learn more quickly what’s working well and to establish repeatable and measurable procedures. Like Bhanti, Prusakowski cautions practitioners against chasing the newest technology. “There are risks in racing too quickly to adopt technologies that have not been thoroughly vetted at the risk of significant financial loss,” he says. “For example, AI is only going to become more advanced. I would caution against too much reliance on systems that have not been thoroughly evaluated at the risk of losing long-term value of data for short-term gain of efficiency. O&P’s future relies upon having a good data strategy, and we may never achieve the leverage we need to move forward if we skip critical steps in the short term.” OPIE tools are attractive to practitioners because they are stable, reliable, and robust, with well-defined workflows and processes that have been refined over years of consistent product development, Prusakowski says, and can provide strong administrative and clinical workflows, integrated purchasing and inventory systems, and billing and functions backed by strong reporting and analytics. “The entire practice benefits from the software since it is a complete ecosystem that connects everyone in the organization with a compliant and easily manageable complete management process,” he says. Although OPIE has not released any AI-enhanced services, they have been investing in the infrastructure to support multiple AI enhancements that the company says will bring significant operational efficiencies to the field. Prusakowski is also keeping an eye on tech advances in the areas of computer vision, humanoid robotics, and new modes of fabrication. “Using advanced digital techniques is rapidly changing the capabilities of practitioners to offer services and socket styles that were previously unavailable,” he says. “The ability for a clinician to imagine solutions to patient problems that go beyond the limitations of our conventional materials, shapes, and techniques allows for more creative patient care in shorter periods of time and in more cost-effective ways.” Protecting Data and Privacy Regardless of the type of technology behind O&P advancements, robust cybersecurity measures and transparent data policies are critical to build trust and safeguard sensitive information in an increasingly digital and automated healthcare environment. While all of these tools lend to a progression toward more intelligent, efficient, and adaptive patient care solutions, vendors must uphold their legal and ethical responsibilities to protect patient privacy and data integrity. Bhanti says practitioners can better safeguard themselves by opting for solutions with Health Information Trust Alliance (HITRUST) or System and Organization Controls (SOC 2) certification. “We continue to take a cautious approach to every step we take and not jump quickly into technology integrations or partnerships without thorough analysis, testing, and monitoring,” Prusakowski says. “Advanced authentication protocols are required between any services we integrate with, and all of our systems are continuously monitored to prevent breach.” As O&P practitioners continue to vet new technology and weigh the benefits and risks, only time will tell which of these tools truly improve patient outcomes and practitioner satisfaction, and which pose legitimate risks. As technology of all types marches on, the industry will need to be diligent to put the needed safeguards in place to manage the security and integrity of the profession. Tara McMeekin is a writer and editor based in Colorado.

O&P Tech Tools: The Potential Gains and Pitfalls

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