Rehab News
The Internet and the World Wide Web are studies in contradictions and inconsistencies.
All the information we could ever need is available, but there is so much that
we have trouble finding what we want when we need it. There is a veritable fountain
of information along with a cesspool of misinformation. We can find just about
any product that we want, sometimes at unbelievable prices, but we risk being
ripped off and dissatisfied with follow-up and service.
The same situation exists with products designed to meet the needs of people
with disabilities. There are hundreds of web sites that empower consumesr with
a disabilities to surf the Web to find what is available to meet their needs.
That is in many cases what the owners and authors of the Web site would like
consumers to believe they need.
The consumer can also shop the Web to find the best prices for the products
they use. Getting the best deal seems important to most people. When dealing
with urinary incontinence and other disposable commodity supplies, shopping
for price makes sense. Whether the same holds true for more sophisticated Re/habilitation
Technology products is something that all the stakeholders should examine carefully.
Re/hab Technology is defined by the profession and industry not in terms of
products, but in terms of providing the product as part of a specific process.
The words Re/habilitation and Re/hab are written with the "slash"
to include both the rehabilitation, or changing state, and habilitation, or
maintaining status, resulting from the use of this technology.
Re/habilitation technology services are defined as the application of enabling
technology systems designed to meet the needs of a specific person experiencing
any permanent or long-term loss or abnormality of physical or anatomical structure
or function. These services, prescribed by a physician, primarily address wheeled
mobility, seating and alternative positioning, ambulation support and equipment,
environmental controls and other equipment and services that assist the person
in performing their activities of daily living. Re/habilitation technology services
facilitate and enhance access and independence to improve the person's quality
of life.
Re/habilitation technology services are supplied by a re/habilitation technology
supplier (RTS) working for a Re/habilitation Technology Company (RTC). The process
of providing Re/habilitation Technology services includes, at a minimum, the
RTS working closely with other allied health professionals to: complete a comprehensive
evaluation of the consumer's needs and requirements; specify and select appropriate
technology and products; assemble, fit, adjust and deliver the selected technology
to the consumer; and provide all necessary short and long-term follow-up, training,
re-evaluation, re-adjustments and service.
Given this involved process, which is considered the best practice standards
for providing wheelchairs, cushions, seating systems and other Re/hab Technology,
can this type of equipment and services be sold over the Web?
The answer is a resounding yes and no!
There are consumers with disabilities who have been using a specific type of
product for years and are satisfied with they way it meets their needs. They
want the same product again, and they want to get it right away and at the best
price. They know how to install, set-up and maintain this equipment themselves.
For these consumers, Web shopping may be the way to go.
The people who are at risk shopping on the Web for Re/hab Technology equipment
are first time users of technology; those whose medical or functional status
has changed since the last time they acquired their equipment, and those who
need power wheelchairs and other sophisticated Re/hab Technology equipment requiring
set-up and service.
Is saving money when buying the wrong product or not getting appropriate fit
and function what people really want from the Web? If a person has never used
a particular type of technology before, then they need to be evaluated by a
therapist and a RTS with experience, knowledge and expertise. Such professionals
are certified by the Rehabilitation Engineering and Assistive Technology Society
of North America (RESNA) and the National Registry of Rehabilitation Technology
Suppliers (NRRTS). These professionals will present the consumer with a choice
of products and appropriate services to choose from to meet their needs.
If the consumer's medical or functional status has changed, they also need to
be re-evaluated. There may be other products, sometimes less expensive and more
functional, that will meet their new needs. The therapist and RTS will present
these options.
There are certain products that should not be purchased by consumers over the
Web or in response to other sorts of high-pressure advertising such as television
commercials. The most obvious of these are electric wheelchairs. A consumer
needs to test drive this type of high-ticket product before purchasing. They
need to be sure that they can drive the power wheelchair and that it will fit
into their home and into their lifestyle. These products need to be set up by
a trained technician, have the appropriate batteries installed, which is not
as easy as putting a D cell in a flashlight, and service after the sale is critical.
There is one unwritten guarantee on power wheelchairs - at some point they will
break down and need to be repaired by a skilled technician. The consumer will
have a great deal of trouble getting a product purchased off the Web serviced
by a local company. The Re/hab Technology industry is not at all like the automobile
industry. If you buy a Ford at a dealership in Chicago you will have no trouble
getting service in Omaha because Ford pays the dealership to service cars that
are under warranty. The manufacturers of power wheelchairs do not pay the RTCs
to repair chairs that are under warranty.
All qualified RTCs will gladly provide warranty repairs, adjustments and follow-up
on the products that they sell; however, many will not provide these services
on products sold by other companies. When consumers buy a power wheelchair or
other high-end Re/hab Technology product over the Web or through high-pressure
television advertising, they may be out of luck when it comes to follow-up,
adjustment and service.
What is the bottom line then with purchasing Re/hab Technology over the Web?
Consumer should not order products unless they know exactly what they want and
need. They need to find out about the site's written return policy if the product
does not fit or work the way they expect. They need to find out, in writing,
prior to ordering the product who specifically will provide local set-up, adjustment
and service, and contact the local person to make sure that they will provide
those services.
The consumer should not rely on the site's selection guide that asks for measurements,
diagnosis, symptoms and functional needs to come up with suggested products.
This is the same as having medication prescribed by answering a few medical
questions - maybe not as potentially deadly, but something to avoid. The consumer
who needs help from this type of selection guide, should get it locally from
a qualified therapist and RTS, and then, if they choose, go to the Web to shop
for the product.
Are all web sites selling Re/hab Technology out to make a quick buck at the
consumer's expense? Again a resounding yes and no!
If the owners of Web sites have the best interest of the consumer at heart,
they should do at least two things. First, they should prominently display a
disclaimer similar to this: "Power wheelchairs, custom fitted manual wheelchairs,
seated positioning systems and other Re/hab Technology products have a great
impact on a person's physical condition and functional capabilities. They should
be evaluated for and fit by professionals with specific knowledge, skills and
expertise, such as a RESNA certified ATP or CRTS. If you have never used a particular
type of product before, or if your physical condition or functional capabilities
have changed, we strongly recommend that you consult with a physician, therapist
or other Allied Health professional before proceeding." Second, the site
should provide a list of the local Re/hab Technology companies that are available
for evaluation, product trials, measurement, adjustment, set-up, delivery, follow-up
and service.
When it comes to buying Re/hab Technology over the Web: buyer beware. All the
other stakeholders in the process also need to be wary of this new model for
product delivery. Without appropriate evaluation, fitting, set-up and adjustment,
there will be an increase in consumers who are hurt using their equipment. Besides
the human suffering that this will cause, the potential for increased manufacturers'
product liability exposure is very real. The owners of the web sites are also
exposing themselves to additional liability when they do not follow established
best practice standards in providing products.
Many of these sites claim to bill insurance companies, Medicaid and Medicare.
Without proper evaluation and service, will the cheapest price really be the
most cost-effective solution over the long run? This issue is particularly of
concern in dealing with high-pressure television advertising campaigns selling
scooters and power wheelchairs direct to consumers.Web selling and e-commerce
is a fact of life. It is an industry in its infancy, feeling its way through
various products, trying to find the niche where it belongs. Re/hab Technology
can be sold safely and effectively over the Web, but an alliance between Web-based
sellers and local Re/habilitation Technology companies is critical. Without
this alliance the consumer and all the other stakeholders in the process will
suffer.
Buyer beware! Indeed, everyone beware!
This article originally appeared in the February 2000 issue of HME Business.