Towards Co-Design in Delivering Assistive Technology Interventions: Reconsidering Roles for Consumers, Allied Health Practitioners, and the Support Workforce

Abstract

A complexity of factors, from health and technology innovations to policy redesign to achieve consumer-directed care, are impacting traditional roles for Australian allied health practitioners (AHPs). This pilot study considers roles for AHPs in relation to assistive technology (AT) interventions. Articulating ‘who does what’ may serve a number of purposes including de-professionalization of the discourse; better utilization of support networks and workforces; and alignment with contemporary policy. Yet, a suitable framework to assist with collaborative AT implementation between relevant stakeholders was not identified within the existing literature. This research aimed to develop and pilot an AT collaboration tool which enables AHPs, consumers, their support networks and the support workforce, to navigate policy redesign toward ethical consumer-directed implementation of AT interventions. An AT collaboration tool was developed based upon practice-based knowledge, relevant regulatory and practice evidence and identifies relevant stakeholders, AT service steps and roles, and quality indicators to support competent practice. The tool was piloted in four separate and diverse practice analyses of AT interventions (custom prosthetics, home enteral nutrition, communication devices, and vehicle modifications) considering four allied health professions (prosthetics and orthotics, dietetics, speech pathology, occupational therapy). Pilot testing of the tool supports the feasibility of re-framing AT provision using competency-based and risk-informed approaches and enabling more inclusive roles for consumers and the support workforce. Further testing of the tool is indicated, followed by strategic actions for uptake by individuals, professions and policymakers. The AT collaboration tool has potential to enable AHPs to fulfil ethical obligations for consumer-centered practice, and to facilitate consumer choice, both in Australia and internationally.

How is assistive technology meeting the needs and goals of people with brain impairment? Building evidence to support practice

“…Importantly, research has highlighted that assistive products should be tailored to each individual's needs, and the person who is using the technology (and their key supporters) should be trained in product use (Brandt et al). This demonstrates the importance of assistive servicessometimes referred to as 'soft technology' or 'wrap around' supportsthat must be planned for and implemented, and may include assessment, trial and customisation; training and education on use; and trouble shooting and review of assistive products over time (Waldron & Layton, 2008;Layton, O'Connor, Fitzpatrick, & Carey, 2022).Moving beyond a focus on products, as an example of assistive technology policy and practice changes underway, in Australia there have been recent assistive technology reforms across both disability and aged care that are relevant to people with brain impairment. The introduction of a National Disability Insurance Scheme (NDIS) has opened up more timely access to assistive…”

“…Importantly, research has highlighted that assistive products should be tailored to each individual’s needs, and the person who is using the technology (and their key supporters) should be trained in product use (Brandt et al). This demonstrates the importance of assistive services – sometimes referred to as ‘soft technology’ or ‘wrap around’ supports – that must be planned for and implemented, and may include assessment, trial and customisation; training and education on use; and trouble shooting and review of assistive products over time (Waldron & Layton, 2008; Layton, O'Connor, Fitzpatrick, & Carey, 2022).…”