Understanding the adoption of digital workflows in orthotic & prosthetic practice from practitioner perspectives: a qualitative descriptive study

Abstract

Background: The implementation of digital technology (DT) in orthotics and prosthetics (O&P) has been slow despite recent research suggesting that the use of DT will continue to grow and become more prevalent within the industry. There is a need to further investigate DT in O&P practice and the current state of its use in the field.Objective: This study aimed to explore the views and experiences of practitioners using DT workflows in their O&P practice. Methods: In this qualitative descriptive study, 10 in-depth, semistructured interviews with O&P practitioners were conducted. A content analysis was performed to analyze the transcripts and identify key themes from the data.Results: The study examined the experiences of practitioners using or trying to use DT in their practices, and three key themes were identified on the implementation of digital practice: 1) technological advancement and scientific evidence; 2) marketplace, economic, and operational factors; and 3) industry mindset shift in embracing DT practice. Conclusion: A collaborative effort involving academia, healthcare institutions, vendors, and individual practitioners will be required to facilitate the widespread adoption of DT in O&P. More work is required to overcome challenges from the technical, logistical, and cultural aspects.

Business practices efficiency: Impact of integrating digital technology on clinical P&O practices

“…This is a known barrier to adopting 3D scanning and digital modification procedures. 3,10,11 Tactile sensing on the residuum by the clinician obtains not only the pressure applied but also the spatial information of the contact area. However, existing hand-held scanners cannot provide clinical data in this form; therefore, the clinician still needs to assess the limb through palpation to get an idea of crucial tissue information under the skin surface.…”

“…Barriers and controversies for adopting digital manufacturing practices remain and must be addressed as regulatory requirements are formed. 10 These include the unrealistic projections and exaggerations of anticipated advancements, getting regulatory approval from the appropriate industry regulators, and the ethics of AM applications in research and practice. Economical purposes, among others, have resulted in testing digital P&O devices in low-income countries or less-resourced settings in the past few years.…”

User perspectives of digital manufacturing for lower-limb prosthetic sockets

“…Thus, the clinician's CAD experience may influence socket outcomes. 17,18 Although recent efforts have attempted to define 3D scanning and CAD best practices, 25,33 more evidence is needed to reach widespread standardization. These are well-known (but mostly unsolved) barriers to improving DT outcomes, thus emphasizing the need for further technological advancements, such as augmenting CAD with haptic feedback or socket fit-predicting algorithms.…”

“…These are well-known (but mostly unsolved) barriers to improving DT outcomes, thus emphasizing the need for further technological advancements, such as augmenting CAD with haptic feedback or socket fit-predicting algorithms. 18,25,27 Although these enhancements may partially automate and provide constancy to the CAD process, prosthetist involvement is still critical to ensure the modifications and resulting prosthesis alignments are appropriate. 5 The adjustability of the 3D printed socket was an indicated concern by participants in this study.…”

“…However, most studies have not reached long-term trials, and more recent studies using current DT are lacking. Clinical and technical barriers to reaching a standard digitized practice are known, such as the upfront cost of 3D printing equipment and the learning curve associated with CAD software, [17][18][19] which is a fundamentally different rectification process compared with manual rectification techniques that have been used since the mid-1950s. 12 Conventional manual techniques are based on handson skills developed through experience and tactile feedback from the limb and are therefore difficult to translate to a computer screen and mouse.…”