The Essentials of Assistive Technology Prescription | Ep 1 | Redefining What’s Possible Podcast

Join Sarah Uncle as she interviews Stewart McDonagh, Chief Clinical Officer at ILS, about his unwavering commitment to Assistive Technology (AT). Stewart shares his personal journey as an Occupational Therapist and explains how AT empowers people with disabilities. This episode also dives into the vital role of Assistive Technology Professionals (ATPs), the significance of their credentials, and the power of teamwork between healthcare professionals and ATPs to improve client outcomes.

Key Takeaways:

• Assistive technology is paramount for achieving client independence.
• Comprehensive assessments are crucial for effective AT prescriptions.
• AT professionals require specialised expertise.
• Credentialing for ATPs is vital for maintaining quality assurance.
• Collaboration between healthcare professionals and ATPs is essential for success.
• AT dramatically improves clients' quality of life.
• Personal experiences with AT can fuel professional dedication.
• Understanding client goals is critical for successful AT implementation.
• AT facilitates meaningful communication for individuals with disabilities.
• Positive client outcomes are the shared objective of all professionals.

Transcript

0:02

Welcome to Redefining What's Possible your guide to Assistive Technology in Australia. Join us as we explore practical applications of AT featuring expert interviews and the latest industry insights to enhance your professional development and to improve client outcomes. Welcome to this episode of the Redefining What's Possible podcast. I'm your host, Sarah Uncle, and today I am joined by Stewart McDonagh. Stewart is the Chief Clinical Officer at ILS, and he and I were in the same year at University, at Sydney University, Studying Occupational Therapy just a couple of years ago - maybe 20 years ago. I think we graduated 20 years ago, right, Stew?- You did. It was about 20 years ago.- It was a while ago. He has a wealth of experience as an Occupational Therapist and a wealth of knowledge and expertise in the sector of Assistive Technology. So it is wonderful to have him here today and to learn from him. So, Stew, welcome to the podcast.- Sarah, Thank you very much for having me.- Stew, why are we doing a podcast At ILS?- We're doing a podcast because we are very passionate about assistive technology. As we've alluded to before. We love to share our experience. We're very fortunate to be able to be involved with, you know, clients across the country, and we're very privileged to be able to support some wonderful outcomes for theirs clients to remain independent, active, functional in the community. So this podcast is all about sharing the impact that AT can have on that individual in the community with a disability or medical condition. I guess whilst it's very much geared towards the health professional and maybe building their confidence and competence in the prescription recommendation of assistive technology, ultimately it's there to energise, I guess, the sector around Assistive Technology and continue to support great outcomes for clients in the community.- Let's start by you explaining just how your career began with Occupational Therapy- Coming out of high school, my first real kind of role in the health and disability sector was as a personal carer. So I did work, it- Started before uni. Before- Uni, so I started before uni. Yeah, okay. Just, just coming out of high school. So I, did work in that personal care space, again, with a number of care organisations assisting to support individuals with a disability to remain in their home, and also assisting them to access the community and participate in various social activities, such as going to the movies or going to concerts. That was my first sort of role in the health and disability sector. I did then go on to, as you, as you alluded to before, I did then go on to Study occupational therapy at the University of Sydney. That can't believe it's 20 years ago now, but yes, it was over 20 years ago.- It's a while ago. Was it your experience in that sort of disability support work that inspired you to study Occupational Therapy?- Yeah, absolutely. Working with individuals in the community, it's a very rewarding thing to do. You know, it's great to work with those individuals and their families and to be able to support them, to participate, to engage, to get out and be active in the community. So yes, it was a really rewarding role, I guess, and yeah, that's kind of what led me into Studying Occupational Therapy yeah, over 20 years ago.- So what was your first role once you finished uni?- Yeah, so look, coming out of uni, my first role was in an acute hospital, so in an acute stroke ward. So it was actually a locum position that I did for my first 12 months out of out of university. So dealing with people or individuals that had had a, that had suffered a stroke and, working through the acute management of their condition post that injury. After that, I did then progress into a subacute rehabilitation setting. That's where I kind of worked, for the rest of my time as an Occupational Therapist. So I did work in sort of various subacute settings, both inpatient and outpatient settings, as well as in community settings, kind of specialising in complex neuro rehab and participating in a number of specialty clinics. So just to give you a bit of a flavour, like some of the, some of the clinics that we were involved with in that subacute rehab setting, there was various neuromuscular clinics, like a motor neuron disease clinic, Huntington's disease clinics, spasticity management clinics. Also I was a driver trained OT. So I did participate in a, in a driver assessment clinic as well as an assistive technology clinic. Yeah.- And is that when you first sort of had your taste of assistive technology and- Yeah,- Yeah. Started to develop a passion for that?- Yeah, look, my first taste for assistive technology early in my time in this sector, you know, working as a personal carer, I did obviously get the opportunity to engage with various types of AT and, and see how they support individuals in the community. But yeah, look, working in the at clinic in that subacute setting really did highlight the very profound impact that assistive technology can have on an individual and on their family and carers to support function in the community. So that is absolutely where my passion for assistive technology started.- And then you moved into the private sector, so how did that come about?- Yeah, look, it's an interesting story. As I said, I was in public health for about about 10 years. Very passionate about assistive technology, very passionate about the outcomes that that assistive technology can support for individuals in the community, so having done 10 years in public health, I was, I was looking for a change and, and looking for a challenge and looking to further grow my skillset in in the area of assistive technology. So I did get an introduction into the founders of, of Independent Living Specialists in Peter and Ian and I did organise the time to, to meet with both Peter and Ian with a view to move into the assistive technology space.- And so how was that first introduction?- Yeah, so look, I might, I might just tell you like a, a quick story. I mentioned before that I did obviously schedule a time to meet with Peter and Ian to discuss this role, but the day before I was due to meet with Peter and Ian, I actually got a call from an old lady, I'll say an elderly lady that lived down the road. Her name was Joan. She knew I was a clinician. She knew I was an Occupational Therapist, and her husband was being discharged the next day from a palliative care ward, from a local palliative care ward. You know, Joan had, you know, contacted me by phone and she was, she was really anxious and she was really stressed about her husband coming home. I mean, she was really anxious and stressed about having to care for him in that home environment. Yeah, there was a, there was all this equipment that was getting delivered to the house the, the following morning that had been organised by the hospital. And she'd asked me just to, to come around and just, just make sure all the equipment was going to do what it needed to do for her to be able to care for her husband. So, look, I did turn up at Joan's house. I was here the next morning, and lo and behold, a big ILS van pulls in the driveway with all of this wonderful assistive technology to install or to deliver into, into Joan's home. And, you know, that was a bed, it was a mattress, it was a hoist, a sling, a commode. All all of these assistive technology items that had, that had been organised by the hospital. So look, yeah, the, the installers came in, they, they did a wonderful job. You know, they, they spent a bit of time with Joan. They were very empathetic towards, you know, the fact that her husband was being discharged from palliative care ward. But that, for me, it was a really positive experience for Joan in, in light of the circumstances, but it was also a very positive experience for me seeing, you know, what a few pieces of AT are able to support for individuals in the community. Yes, the circumstance for, for Joan and her husband wasn't ideal, I guess, given the fact that a husband was palliative, but it did mean that he could come home and, and spend his final months in the family home, you know, surrounded by his family, surrounded by his wife. So it was, for me, that kind of, it was a very meaningful experience, particularly as I was going into a meeting that afternoon with Peter and me to discuss a role in this, in this space.- I mean, the coincidence, right, of what wasn't a coincidence, it feels like it was meant to be the day, it's- Just all, all timing, I know.- Yeah. The day you're having, you know, an informal interview to potentially join ILS, you have that really positive experience of people who work for ILS. I think that's, that's it. Amazing. So tell me about your current role At ILS- Started with ILS, you know, shortly following that meeting with Peter and Ian, I kind of moved into the business as an Assistive Technology Professional, working in complex mobility, so scripting, complex powered and manual wheelchairs, as well as working with clients that had complex postural and pressure considerations. So I did start with ILS as as an Assistive Technology Professional. You know, I've been with ILS for coming up to 10 years now. And as the business has grown, I've been very fortunate, I guess, to have been able to have grown with the business. So I have moved from an ATP up into a Chief Clinical Officer role. So I guess in my current role as Chief Clinical Officer, it is really just to support the functional capability of our Assistive Technology Professionals nationally. Yeah,- Yeah. And it's great with your experience that you've had in your career leading up to this current role. So we've talked a lot using the terminology assistive technology. If we can just backtrack a little bit and just have you explain exactly what is AT for the audience.- Yeah. So assistive technology very simply put, it's just a a piece of equipment that helps an individual do something that they can't normally do. It might help them do it more easily, more safely, more independently, or enable them to do that task with the support of a carer or a family member, again, more independently, more safely. Yeah. That, that's essentially what assistive technology is.- And what is an Assistive Technology Professional? What does that mean? What's that role?- Yeah, so an assistive technology professional is someone that specialises or is an expert in assistive technology products. Generally in our sector, you'll see with assistive technology professionals, they tend to specialise in different areas of assistive technology. And they do that so that they can, I guess, support healthcare professional recommendations by being able to articulate the clinical or the functional application of assistive technology to be able to support their recommendations or their client goals.- So how does ILS specialise our ATPs? Like what does that look like?- Yeah, so ILS you know, the, the assistive technology that ILS provides into the community is very much there to support individuals in the community with a disability and or medical condition. So the way we structure our assistive technology professionals is into various teams of specialisation. The first team that I'll talk about is our home and community care team. So our home and community care teams specialise in what we refer to as light rehab or off the shelf product, or off the shelf assistive technology. So it's less configured product, if that makes sense or not scripted product. And that might include things like a hospital bed, an alternating air mattress, you know, all your patient handling equipment, your mobile shower commodes, your mobility scooters, your assisted lift chairs. That is the portfolio that they, they specialise in and that they facilitate trials of in the community with the support of a, a treating clinician or an allied health professional. Yeah. We've then got a, a team called ILAs Rehab. So ILAs Rehab specialise in configured mobility, so, so scripted power scripted manual wheelchairs, as well as, you know, they work closely with clients that have complex poStewral requirements or complex seated pressure care requirements. Again, that is a portfolio that they're facilitating trial of in the community, in, in collaboration with a, with a health professional. We've then got a paediatric division called ILS kids. So our ILS kids, ATPs, they specialise in early intervention products or paediatric assistive technology, again, in collaboration with a healthcare professional in the community. And then we've got a, a hospital and pressure care division. Those ATPs specialise in the supply of AT, into facilities for, I guess for facility use for like ward setup, again, to support their patients in more of an inpatient or an aged care setting.- Okay. Thank you for explaining all of that. That's okay. And so if I was working with an ILS ATP, what sort of credentialing would I expect them to have?- Yeah, so I guess, maybe more broadly, if you think about an Assistive Technology Professional in Australia, there is no certification requirement to be an Assistive Technology Professional. You know, there is that requirement in other, in other countries such as the us there is a, there is a certification requirement to be an assistive technology professional, but that is not the case in Australia currently. So we do see assistive technology professionals coming from varied backgrounds. So some come into the sector from an allied health background, some from more of a technical or engineering style background. You know, some might just be from the industry. So they might have started in the industry at a, at a showroom or as a service technician, and they've worked up through the business to become an Assistive Technology Professional. Yeah. So there, there is a, there is a bit of a mix in terms of the individuals that, that make up those roles nationally. Having said that the question around credentialing is an interesting one.'cause it is, it is something that, well, personally I'm very, I'm very passionate about. I do see a lot of value in providing a credentialing pathway for assistive technology professionals with a view to, I guess, set a benchmark for the level of care that they're providing to, to the end consumer or the client in the community that is being supported by AT.- And so is ILS doing anything about credentialing when it comes to our ATPs?- Yeah, so we are I mentioned at the moment there's no, there's no clear credentialing pathway for ATPs in Australia. So we have engaged an international assistive technology credentialing body to assist with certifying our ATPs internally. So that is something that we are working through with all of our ATPs across the country to give them a level of certification or recognition of the specialty that they have in their roles as ATPs.- It also allows us to kind of set a bit of a standard for, again, the, the level of specialisation or the level of service or care that our ATPs are providing to our clients in the community. Again, in collaboration with that healthcare professional.- So Stewart, if I'm a healthcare professional and I'm working with an ATP to, you know, prescribe AT, to see my client's goals are met. What can I expect from an A TP?- You can expect that, that ATP has a in-depth knowledge of their relevant product portfolio. So I mentioned that ATPs have a level of specialisation generally across the sector, so you can expect a deep knowledge of that product portfolio in relation to their relevant area of specialisation. Those ATPs should be able to clearly articulate back to you not only product specifications, not only technical options available on that product, but they should be able to also articulate how that product is going to meet your recommendations and meet your client's goals. They should be able to articulate the clinical functional application of that assistive technology to support those goals in the community for, for your client.- So would it be fair to say that as the prescribing clinician, I'm sort of the expert in the client and the client's goals and the ATP is the expert in the equipment?- Yeah,- Absolutely.- Absolutely. So that, that, that ATP should be there to not only support those goals and support your recommendations, but also offer choice and be able to facilitate a trial of those products in, in the relevant environment. So whether it be in the customer's home, whether it be at a workplace, whether it be at a school, that is what the A TP is there to support for you. Okay.- And what does the ATP need from me as a healthcare professional?- Yeah, that's a good question. I guess as a healthcare professional, you know, as you alluded to before, you are the expert in the client. So I guess there is a requirement that you go out and you complete a holistic, client-centered, comprehensive assessment of, of that client and their, relevant circumstance. You work through that assessment process with your, with your client and you and maybe their family and carers and you, you set some functional, some collaborative goals and, maybe articulate, I guess back to the ATP, what it is that you are wanting to achieve through the use of AT. So if I'm an ATP and I'm getting a referral from a healthcare provider, I as the ATP need to clearly understand what it is that you are wanting to support for your client out in the community. What are the goals that you are wanting to achieve through AT, as we move into more complex AT prescriptions such as mobility, so powered or manual, wheelchair prescription, there is a minimum amount of information that you need to provide me as the ATP so that I can make sure that the product that I'm bringing out into the community for you to trial is going to meet your client's requirements. So that might include things like seated measures, like a hip width, a lower leg length, any postural considerations, you know, any pressure care considerations. So I need to know all that, know all that as the ATP before I bring that product out into the community just to make sure that what we are bringing out into the community, what we are making available for your client to trial is actually going to be fit for purpose.- Yeah, it's really important. Sounds like it would be great to have an episode maybe on holistic assessment because it is so important. Absolutely. So maybe absolutely stay tuned. We might do that in a future episode coming up.- Sounds good.- So Stew, when we finish the podcast, we're always going to ask the guest a particular question. So I'm going to ask you that question now. So can you describe a time when you saw AT change somebody's life and how did that change your view of your role in your work?- Yeah, so what, what I might do, I might actually bring us back to a time when I was working in public health and in some of those specialty clinics that I talked about. because they, you know, I did mention working in those clinics. That's kind of where my passion for assistive technology kind of began. So I do, I will talk about a client that I, that I saw in our motor neuron disease clinic. And the reason I'll talk about this gentleman is because it's something that has stuck with me, I guess through my career as an OT, but also through my career as an assistive technology professional. And to this day in my, in my current role, so there's a gentleman named Peter. He presented to a, to our motor neuron disease clinic with a bulbar onset motor neuron disease presentation.- What's bulbar onset? What does that mean?- Yeah, so bulbar onset motor neuron disease is characterised by rapid loss of speech and swallowing as well as rapid loss of motor control. So Peter, for example, his disease progression lasted over a period of about nine months. It's not very long. It's quite a rapid disease progression. I guess with, with Peter in this clinic. Again, he presented, you know, he walked into the clinic. He was in his late thirties. He had three young children under the age of six. He had a wife, he had a beautiful family home, he had a full-time job, kind of doing all of those normal things that we do. So look over, over the course of his disease progression, I worked very closely with Peter. I was very privileged to be able to be very heavily involved with Peter throughout the course of his disease progression and to be involved with his family and children. So look, we prescribed various types of assistive technology for Peter to continue to support him in the community so that he could continue to remain in the community with the support of care workers, with the support of his family. You know, the AT that we provided included power chairs, you know, hospital beds, mattresses, various types of patient handling equipment, various types of bathroom equipment with a view to keep him in the community as as long as possible. But probably the most, the most meaningful piece of assistive technology that we provided for Peter was his augmentative speech device. So that device allowed him to continue to have meaningful conversation with his wife, with his children, also with his carers, right throughout his disease progression. So Peter lost his ability to speak very early on in his disease progression. So using that speech device, he was initially able to communicate using his upper limb, using his hands. But as his disease progressed and he lost motor control, we were able to transition that speech device across to an eye gaze controlled unit. So even with minimal control in his eyes, he was able to continue to have meaningful conversation with his wife, with his children, with his family. So for me that was a very profound and impactful piece of assistive technology that meant a lot to Peter as an individual, as he was moving through his disease progression. But it was also something that was very meaningful to his wife and to his children. You know, being able to communicate with Peter right up until the end of his disease progression. So it's one of those client involvement or engagement that I've had over the years that has just stuck with me, right up to this day. It still has a very profound impact on me personally and it's still something that I'm very cognizant of when I deal with individuals and I recommend or prescribe assistive technology in the community.- Yeah.'cause what a difference that made to his life for that sort of short time. He had the progression of MND- Yes.- To be able to stay at home with his family, to be able to talk to his wife and his children. That is significant. And that makes me passionate about AT as well, just what it can actually really do for somebody. because without AT, he probably would have ended up, you know, in a care home and not being able to communicate.- Correct.- So that's significant. It's a really good story. Thank you for sharing that, Stew.- No, no. Thank you for allowing me to share it.- Yeah. Okay. So if you could sum up what you've sort of talked about today in three key points, what would they be?- Three key points. So if you are a healthcare professional, just make sure you are allowing yourself the, the time to complete a holistic assessment with your client and their family or caregivers in the community. Make sure you're taking the time to set collaborative goals with the client and their family and around any assistive technology recommendations, and make sure that you are engaging with an AT provider or an assistive technology professional that you know has a level of specialisation in that area of assistive technology. Make sure it's someone that you trust and you have a level of rapport with. When you are referring to an assistive technology professional, make sure you are providing the required information to ensure that that trial is going to be a successful trial.- Good advice. Because the truth is, we've all got the same goal, right? We all want positive outcomes.- That's it.- Its for the participant or the client.- We absolutely do. We're all in it together. Thank you so much for joining us on the podcast today and for sharing your expertise. We really appreciate it, Stew.- No, no. Thank you for having me.- And thank you for joining us today, and stay tuned for the next episode. Bye.