Tools
Patient Assist Devices
Definition/Introduction
Healthcare professionals strive to help their patients recover from illnesses or injuries to regain the ability to function independently. Patient ability levels vary as they represent a standard population, and billions worldwide require assistance when considering the definition of disability. At the intersection of disability and clinical practice, patients can still achieve independent functioning or increase their ability to function through assistive devices. Assistive technology devices (ATDs) are any systems, items, or equipment that assist individuals with disabilities in improving their daily functioning.[1]
ATDs can be high-technology devices such as eye-gaze systems, augmented communication boards, environmental control systems, or simple, low-tech devices such as reachers, walkers, and ramps. These devices are commercially manufactured or customized to a patient's living space. To maximize functional outcomes, patients should be assessed for the need for an ATD, assisted in acquiring the ATD, and given the appropriate training and follow-up to ensure that the assistive device meets their evolving needs.[2][3] Continuous evaluation may be required in cases requiring consultation from segments such as education or social services. In the United States, these consultations typically occur during childhood through local education departments to ensure compliance with ATD standards.
Issues of Concern
Register For Free And Read The Full Article
Search engine and full access to all medical articles- 10 free questions in your specialty
- Free CME/CE Activities
- Free daily question in your email
- Save favorite articles to your dashboard
- Emails offering discounts
Learn more about a Subscription to StatPearls Point-of-Care
Issues of Concern
ATDs facilitate the maintenance of normal living standards, supporting diverse populations ranging from accident survivors to children with autism spectrum disorder to seniors aging in place.[4][5][6] An ATD is a part of the rehabilitation process and can be temporary or lifelong. For example, glasses are considered an ATD and are mandatory for daily function in visually impaired individuals, many of whom are high-functioning.[7][8][9] Because the usefulness of ATDs covers such a broad spectrum, healthcare professionals may face difficulty matching patients with effective devices. Assessment of the individual, their abilities, and their environment can help identify a patient's needs.
Some approaches to ATD assessment and matching include:
- Human, Activity, Assistive Technology model (HAAT model): This practice model evaluates key considerations when selecting ATDs. The HAAT model examines how ATDs are used in conjunction with individuals within the limitations of their environment.
- Assistive Technology Service Method (ATSM): This method is based on the International Classification of Functioning (ICF) model. The process includes assessing an individual, establishing a baseline ability level, and developing a strategy for intervention. The ATSM method may also use the Assistive Device Classification (ATDC) tool to identify ATDs that benefit a patient based on the information gathered.
- Matching Person and Technology (MPT): The MPT tool underscores the importance of considering the patient's context, activity, and personal traits in achieving appropriate matching and utilization of ATDs.[10]
Global Perspectives
Since 2016, the World Health Organization (WHO) has identified a list of priority assistive products based on the needs of nearly 2.5 billion people as of 2022.[WHO. Global Report on Assistive Technology] The compensation structures for assistive technology vary based on country income level, and countries with universal health care likely cover the costs. Several Nordic countries provide assistive technology for free.[11] A significant research constraint is the limited data availability at a population level within several countries.[12] The ethical implications relate to healthcare interpretation as a right, particularly for marginalized populations.[13]
Use Within Clinical Practice
Several ATDs are integrated into clinical practice. However, clinicians do not typically refer to them as such, that is, when providing a patient with crutches for outpatient use or placing a splint on a patient. Interprofessional collaboration could be emphasized between clinicians, physical therapists, and occupational therapists, particularly in sports medicine, orthopedics, and rehabilitation.[14] Designating the devices with the correct jargon could increase access to data for further research in the medical care of patients with disabilities.[15][16]
Clinical Significance
ATDs can positively impact the independence and functioning of individuals across the lifespan.[4][5] The assessment and matching of ATDs for patients are of clinical significance because they lead to better functional outcomes and increased quality of life for patients with disabilities, caregivers, and families.[1][7][6][9] As such, the risks and benefits of ATDs are essential to disclose when a clinician recommends or prescribes any qualifying devices, including whether they are covered by insurance or available free of cost.
Nursing, Allied Health, and Interprofessional Team Interventions
Collaboration between clinicians is essential for delivering patient-centered care, particularly in contexts where health services are often distinct from social services within various healthcare organizations. Occupational therapists, physical therapists, and speech-language pathologists are among the healthcare professionals routinely involved in assessing and matching patients with ATDs. However, they may not work within the same facility; instead, they receive referrals from treating clinicians. Assistive Technology Professionals (ATPs) are trained service providers consulted for activities such as selection, acquisition, and training related to ATDs.[17]
Given the segmented nature of the treatment process, effective communication is crucial to ensure the best patient outcomes. Seamless coordination among these diverse professionals is essential to guarantee that the prescribed assistive technologies align with the individual patient's needs and abilities, facilitating the most effective rehabilitation and functional independence. By fostering collaborative relationships and establishing clear communication channels, healthcare teams can enhance the quality of care delivered to patients requiring assistive technology interventions.
References
Bauer SM, Elsaesser LJ, Arthanat S. Assistive technology device classification based upon the World Health Organization's, International Classification of Functioning, Disability and Health (ICF). Disability and rehabilitation. Assistive technology. 2011:6(3):243-59. doi: 10.3109/17483107.2010.529631. Epub [PubMed PMID: 21446850]
Matter R, Harniss M, Oderud T, Borg J, Eide AH. Assistive technology in resource-limited environments: a scoping review. Disability and rehabilitation. Assistive technology. 2017 Feb:12(2):105-114 [PubMed PMID: 27443790]
Level 2 (mid-level) evidenceAndrich R. Writing Good-Quality Assistive Technology Assessment Reports. Studies in health technology and informatics. 2017:242():86-93 [PubMed PMID: 28873782]
Level 2 (mid-level) evidenceLin SC, Gold RS. Assistive technology needs, functional difficulties, and services utilization and coordination of children with developmental disabilities in the United States. Assistive technology : the official journal of RESNA. 2018:30(2):100-106. doi: 10.1080/10400435.2016.1265023. Epub 2017 Jan 31 [PubMed PMID: 28140832]
Garçon L, Khasnabis C, Walker L, Nakatani Y, Lapitan J, Borg J, Ross A, Velazquez Berumen A. Medical and Assistive Health Technology: Meeting the Needs of Aging Populations. The Gerontologist. 2016 Apr:56 Suppl 2():S293-302. doi: 10.1093/geront/gnw005. Epub [PubMed PMID: 26994268]
McSweeney-Feld MH. Assistive Technology and Older Adults in Disasters: Implications for Emergency Management. Disaster medicine and public health preparedness. 2017 Feb:11(1):135-139. doi: 10.1017/dmp.2016.160. Epub 2016 Nov 21 [PubMed PMID: 27866509]
Jutai J, Coulson S, Teasell R, Bayley M, Garland J, Mayo N, Wood-Dauphinee S. Mobility assistive device utilization in a prospective study of patients with first-ever stroke. Archives of physical medicine and rehabilitation. 2007 Oct:88(10):1268-75 [PubMed PMID: 17908568]
de Mello Monteiro CB, Dawes H, Mayo N, Collett J, Magalhães FH. Assistive Technology Innovations in Neurological Conditions. BioMed research international. 2021:2021():6846120. doi: 10.1155/2021/6846120. Epub 2021 Feb 20 [PubMed PMID: 33728341]
Goto H. Versatile Text Extraction System for Text-to-Speech Reading Assistant Camera. Studies in health technology and informatics. 2015:217():392-7 [PubMed PMID: 26294503]
Smith RO, Scherer MJ, Cooper R, Bell D, Hobbs DA, Pettersson C, Seymour N, Borg J, Johnson MJ, Lane JP, Sujatha S, Rao P, Obiedat QM, MacLachlan M, Bauer S. Assistive technology products: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit. Disability and rehabilitation. Assistive technology. 2018 Jul:13(5):473-485. doi: 10.1080/17483107.2018.1473895. Epub 2018 Jun 6 [PubMed PMID: 29873268]
Layton N, Bell D, Borg J, Steel E, Maclachlan M, Tebbutt E, Khasnabis C, Swaminathan S. Assistive technology as a pillar of universal health coverage: qualitative analysis of stakeholder responses to the world health assembly resolution on assistive technology. Disability and rehabilitation. Assistive technology. 2020 Oct:15(7):825-831. doi: 10.1080/17483107.2020.1774929. Epub 2020 Jun 27 [PubMed PMID: 32594831]
Level 2 (mid-level) evidenceDanemayer J, Mitra S, Holloway C, Hussein S. Assistive technology access in longitudinal datasets: a global review. International journal of population data science. 2023:8(1):1901. doi: 10.23889/ijpds.v8i1.1901. Epub 2023 Mar 16 [PubMed PMID: 37636834]
Stramondo JA. The right to assistive technology. Theoretical medicine and bioethics. 2020 Dec:41(5-6):247-271. doi: 10.1007/s11017-020-09527-8. Epub 2020 Oct 6 [PubMed PMID: 33025313]
Dicianno BE, Joseph J, Eckstein S, Zigler CK, Quinby EJ, Schmeler MR, Schein RM, Pearlman J, Cooper RA. The future of the provision process for mobility assistive technology: a survey of providers. Disability and rehabilitation. Assistive technology. 2019 May:14(4):338-345. doi: 10.1080/17483107.2018.1448470. Epub 2018 Mar 20 [PubMed PMID: 29557196]
Level 3 (low-level) evidenceGreenhalgh M, Kulich H, Blaauw E, Turner R, Peterson S, Cooper RA, Songer T. Health Outcomes Used to Determine Facets of Health-related Quality of Life for Post-9/11 Veterans Using Assistive Technology for A Combat-related Mobility Impairment: A Literature Review. Military medicine. 2021 Nov 2:186(11-12):1106-1114. doi: 10.1093/milmed/usab028. Epub [PubMed PMID: 33538791]
Level 2 (mid-level) evidenceTao G, Charm G, Kabacińska K, Miller WC, Robillard JM. Evaluation Tools for Assistive Technologies: A Scoping Review. Archives of physical medicine and rehabilitation. 2020 Jun:101(6):1025-1040. doi: 10.1016/j.apmr.2020.01.008. Epub 2020 Feb 12 [PubMed PMID: 32059944]
Level 2 (mid-level) evidenceLayton NA, Smith RO, Cudd P, Lee S, Okigawa E. From International Assistive Technology Professional Organisations. Disability and rehabilitation. Assistive technology. 2018 Apr:13(3):323-324. doi: 10.1080/17483107.2017.1379102. Epub 2017 Nov 2 [PubMed PMID: 29094628]