Assistive Technology Standards Working Group
The Assistive Technology (AT) Standards Working group is a technical assistance project of the Center on KTDRR to address the emerging requirements of evidence standards affecting the technology transfer of and payment for assistive technologies designed for persons with disabilities. Although the highest level of evidence is produced through randomized controlled trials, that option is often not feasible when establishing accuracy of effectiveness in assistive rehabilitation technologies because often the solutions provided are unique to an individual. This issue must be addressed so that it does not limit access to rehabilitation assistive technologies by those who need them.
The AT Working Group was facilitated by Jim Leahy, co-principal investigator of the Center on Knowledge Translation for Technology Transfer (KT4TT), Center for Assistive Technology in the School of Public Health and Health Professions at the University at Buffalo. Members of the AT Working Group are representatives from clinical practice, industry, third-party payers, and policymakers.
The results of working group activities and efforts from 2012-2014 are shared through a white paper and a webcast to introduce the paper.
AT Working Group White Paper
Clayback, D., Hostak, R., Leahy, J., Minkel, J., Piper, M., Smith, R. O., & Vaarwerk, T. (2014). Standards for assistive technology funding: What are the right criteria? Austin, TX: SEDL, Center on Knowledge Translation for Disability and Rehabilitation Research.
Abstract: Developed by the KTDRR’s Assistive Technology (AT) Working Group, this white paper addresses the issue of the expectation of an evidence-based standard to determine AT product efficacy, and the impact of this standard on the transfer, use, and payment for assistive technologies designed for persons with disabilities. The highest level of evidence is produced through randomized controlled trials; however, that option is rarely feasible when establishing accuracy of effectiveness in assistive rehabilitation technologies because often the solutions provided are unique to an individual. This issue must be addressed so that it does not limit access to rehabilitation assistive technologies by those who need them.
Recommendations set forth by the AT Working Group in the white paper and webcast included conducting an intra-agency Department of Health and Human Services conference with agencies such as the Centers for Medicare & Medicaid Services (CMS) and NIDILRR to consider and define the hierarchy of evidence needed for the determination of AT safety and effectiveness; AT best clinical practices guidelines; the appropriateness and practicality of AT data collection methods; and the creation, utilization and promotion of a national AT usage and outcomes database. The AT working group also recommends that legislative action should be taken to define the types of AT that are designed to meet the long-term needs for persons with disabilities separate from the policies governing Durable Medical Equipment to allow improved recognition and policies, as well as to shift the AT reimbursement model from being purely a medical model to a model that also considers the social and functional context of the AT user.
Members of the AT Working Group represent five key stakeholder groups (AT Consumers, AT Service Providers, AT Researchers and Methodologists, AT Manufacturers/Product Developers, and AT Payers and Policy Makers) that comprise the entire system of manufacture, prescription, application, funding, reimbursement, and efficacy research within each field of AT devices and services.
View webcast that introduces the white paper and the recommendations from the AT Working Group.
Download article published in Vol. 9, Issue 1 (Winter 2015) of Assistive Technology Outcome and Benefits (ATOB): Clayback, D., Hostak, R., Leahy, J., Minkel, J., Piper, M., Smith, R. O., & Vaarwerk, T. (2015). Standards for assistive technology funding: What are the right criteria? Assistive Technology Outcomes and Benefit, 9(1), 38-53.
AT Working Group Members
Donald E. Clayback is Executive Director of the National Coalition for Assistive and Rehab Technology (NCART). NCART is a national association of complex rehab technology (CRT) providers and manufacturers focused on ensuring individuals with disabilities have appropriate access to CRT products and services. In this role, he has responsibility for monitoring, analyzing, reporting, and influencing legislative and regulatory activities. He also serves as Chair of the Separate Benefit Category Steering Committee. Don has over 25 years of experience in the CRT and Home Medical Equipment industry as a provider, consultant, and advocate and is a frequent speaker at state and national conferences.
James Leahy, BS, is Co-Principal Investigator on the NIDILRR-funded Center on Knowledge Translation for Technology Transfer (KT4TT) at the University at Buffalo. Mr. Leahy leads Project D1, where he generates new product outcomes from original R&D and demonstrates effective technology transfer practices to US Department of Education/National Institute on Disability, Independent Living, and Rehabilitation Research technology grantees. In 1993, Leahy brought 20 years of invention evaluation, product development, and project management experience to the University of Buffalo's Rehabilitation Engineering Research Center on Technology Transfer (T2RERC). Over the years, he has led the T2RERC's Supply Push technology transfer program and created a corporate collaboration program through which the T2RERC partnered with Fortune 500 companies to improve the accessibility and usability of new mainstream products. He is a patent holder and serves as a technology transfer consultant to assistive technology inventors.
Jean Minkel, PT, ATP is a physical therapist and master clinician well recognized for her work in Assistive Technology. She is currently the Senior Vice President, Rehab Services for Independence Care System, a nonprofit, Medicaid long term care program in New York City. Jean is also an independent consultant who provides educational and consulting service to all members of the AT team – consumers, therapists, suppliers, manufacturers and payers. The AT community has recognized Jean for her contributions by awarding to her, the RESNA Fellow award in 1995 and the Sam McFarland Mentor Award in 2012. Prior to entering the private section, Jean was the director of the Seating and Mobility Program at the Center for Rehabilitation Technology at Helen Hayes Hospital in West Haverstaw, NY.
Margaret Piper, PhD, MPH is a Senior Investigator with the Kaiser Permanente Center for Health Research (CHR). She is also a member of the Kaiser Permanente Research Affiliates Evidence-based Practice Center (KPRA EPC) and helps support the work of the US Preventive Services Task Force. Previously, Dr. Piper served as the Director of Genomics Resources at the Blue Cross and Blue Shield Association (BCBSA) Technology Evaluation Center (TEC), an EPC for several years. She was with TEC for over 14 years, producing systematic reviews of medical technology, including topics in autoimmunity and transplantation, oncology, laboratory medicine, and genomics/genetic testing. Dr. Piper authored over 35 TEC Assessments and reports and co-authored 7 EPC systematic review or comparative effectiveness reports.
Roger O. Smith, PhD, OT, FAOTA, RESNA Fellow is Professor of Occupational Sciences & Technology and Director of the Rehabilitation Research Design & Disability (R2D2) Center the University of Wisconsin-Milwaukee. Dr. Smith has combined his academic background in engineering, health sciences, and the social sciences to formulate a research emphasis around technology and design as related people of all levels of ability and disability. Dr. Smith's specific research focuses on the application of assistive technology and universal design, particularly related to improving measurement methodologies that quantify the outcomes of these interventions. Dr. Smith has generated over one hundred publications and one hundred national and international presentations in this rehabilitation area.
Rita Stanley is Vice-President, Government Relations of Sunrise Medical, and has been a driving force behind many of the changes benefiting the industry. Rita began her career with Sunrise Medical in November 1982 as a sales associate in North and South Carolina. She advanced rapidly in her career with a move in 1993 to government relations, ultimately assuming the role of VP of Government Relations in 1998. After almost a quarter century of involvement in the homecare industry, Rita's knowledge of the issues, voluminous contacts in both the public and private sector and "get it done" personality uniquely position Sunrise Medical as a true leader in the homecare industry. Ms. Stanley is currently serving as immediate past president of the National Coalition for Rehab and Assistive Technology (NCART) and a member of the coalition's executive. Rita has served on various industry committees. Rita has always worked closely with clinical groups as well as consumer advocacy groups and is passionately committed to ensuring consumers have access to assistive technology.
Todd Vaarwerk is currently the Director of Advocacy and Public Policy at Western New York Independent Living, Inc. His career spans over 20 years in advocating for the education and empowerment for persons with disabilities. He is a part of the ADA Trainer Network for the Northeast ADA Center at Cornell University, and has served on numerous local, state, and national committees. Todd is a recipient of the Robin Shaikun Advocacy Award from the New York State Independent Living Council.