Clinician Insights - Series 1, Episode 1
Radii Devices
We use intelligent software to support and empower the fitting of external medical devices, such as prosthetic limbs.
"Fit is more important than looks, and efficiency does not equal comfort"
Welcome to Radii’s Clinician Insights, a series of newsletters focused on O&P practitioners. At Radii, we ensure the users’ voice is at the centre of our development. Through this we can open up discussions with clinicians to further understand the use of digital technologies to support O&P processes.
A massive thank you to Michael Nunnery , CPO, owner at Nunnery Orthotic & Prosthetic Technologies and Mitchell Warner , CPO, owner Ortho Rehab Designs . They are two highly experienced clinicians, who have kindly shared their insights below.
In the first series of Clinician Insights we discussed the direction of the O&P industry and the use of digital technology. In these wide-reaching and fascinating conversations we explored the following topics, which are covered over three episodes:
Please note, these articles were previously published with O&P Edge and on Radii Devices' Substack page.
The Bottom Line
Mike All my patients care about is wanting to put their prosthesis/orthosis on and wanting it to be comfortable. They don’t want to have to come back once/twice a week. I can make a really fancy socket, but if it doesn’t fit it means nothing to the patient.
Can you tell us about your overall experiences using digital technology to support your socket design?
Mitch We find that digital technology is a great asset as far as reducing time to design a device. It gives the options of going back and making easy changes, whereas with plaster it’s going to require a good amount of time to make the same modifications.
Mike I think digital technology, as far as it relates to patient models and modelling, can be very fast and efficient but again it doesn’t mean that it’s comfortable, and that’s the separation for me.
Mike From a practitioners point of view, we are looking at two issues here. The first is scanning properly and accurately. Secondly you have to take that and you need to learn to digitally modify and ask how can I properly digitally modify for the best comfort. There is a learning curve to that, it doesn’t happen instantaneously and you’re going to make mistakes.
What values do you look for when selecting digital technologies?
Mike In my opinion right now in the field there’s too much wanting to make things (prosthesis/orthosis) look really cool. Let’s learn how to use the technology first and foremost to make the patient comfortable. That’s the first thing, because if they’re not comfortable then they’re not coming back, and secondly make it cost-efficient.
Mitch If you are doing it the traditional way, if you do not take a proper corrective cast of the patient’s limb, you’re not going to get an accurate fit. If you do not get a good scan, which is your digital mould, then you will not get an accurate digital mould and you will not get an accurate fit.
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Mike Just because it looks good it doesn’t mean it’s accurate. I’m a fan of investing in a good scanner. I would like to see the O&P field really look at this. You can’t do anything unless you’re scanning. You need a digital model. That’s important.
Mitch For digital corrections we’re looking for accuracy and as for digital software we are looking for modifications that are user-friendly because some applications can be complex and the more complex they are, the bigger the learning curve for the clinicians to get well suited to use it in practice.
What technologies do you think are important moving forward?
Mitch The 3D world opens up new designs, new types of fit and new types of technology that we can’t do traditionally. Also it will allow structural analysis of the device before sending it to the 3D printer.
Mike We could branch out more into gait analysis, biomechanics and components, but what really impacts me is direct patient care and how we’re utilising technology to support this. I just don’t see this going away.
Mitch Well I think that digital technology is going to be constantly evolving, and eventually more practitioners will be 3D printing. Printing a device does not make it stronger or better at this time. It still has to fit properly and have structural integrity. My Son is a Mechanical Engineer and 3D prints all the time. Just even learning from him, what he’s doing and his mechanical perspective, there are so many things you can do in the digital world and then 3D print. This is done in such a short space of time that to build it traditionally would never be as cost-efficient in some applications.
Mike The danger of digital technology is people can say, hey I’ll take a scan, pop that scan via email to a central fab, who’ll do the mods and mail it back, and you’re good to go. Well, the problem with that is, my patients they want to know I’m in charge of this design and their clinical care. If I’m in charge of their clinical care, then I have to have a role as their practitioner in the design; I can’t send it out for someone else to do the digital mods. I can’t have a faceless person whose never seen my patient to do it for me.
Mike I think on the analysis end, I think people are going to start to look at that to say, hey how can we use analysis for our platforms, to have the best benefit for the practitioners.
Next Installments
Thanks for reading! As always please get in touch with any thoughts or feedback and feel free to share with any colleagues or friends who might be interested.
We hope to see you all soon.
Jenny, Josh and the rest of the Radii team