Biomedical Engineering Reference
In-Depth Information
local public health system and 12% abandonment in a rehabilitation project. As the authors
explain, such a high rate of abandonment/discontinued use can be traced back to not
focusing on the user and/or the service delivery process did not foresee a needed support
before the device was delivered (Philips and Zhao 1993; Judge 2002; Scherer and Craddock
2002; Lauer et al. 2006).
However, it must be realized that only 5-15% of the population who could benefit from
ATs uses them (WHO 2006). WHO hopes for a wider range of people that would benefit
from such aids to achieve both functional benefits and participation in desired life situa-
tions (WHO 2002). People not receiving the AT that could benefit combined with evidence
of AT abandonment highlights the fact that matching is not occurring. Thus, there is a need
to perform a matching process that carefully follows an assignation model that encourage
centers for technical aid to perform a systematic assessment at each step of the matching
process, including post-delivery support and assistance. The need of an assignation model
is connected with at least two main objectives:
1. Minimization of financial losses, which would allow more people to take advan-
tage of appropriate technologies
2. The provision of assistive solutions that best fit a user's needs, achieving participa-
tion goals
Although a wide number of AT tools and frameworks have been developed, they tend to
focus on AT outcome by, for example, the measurement of user satisfaction and/or perfor-
mance of the assigned assistive technology [e.g. PIADS (Jutai and Day 2002); COPM (Law
et al. 2005); QUEST (Demers et al. 1996); IPPA (Wessels et al. 2002); FIATS (Ryan et al. 2006);
and ATOM (Lauer et al. 2006)]. Thus, standardized procedures and measures for the match
and the assignation of AT at the time of AT selection are still needed. Although some
individuals refer to the ICF as a tool that can assist the professional during the matching
process (Karlsson 2010), Bernd et al. (2009) consider that even the ICF Checklist is a generic
measure not developed for the purpose of assessing and addressing AT needs. A recent
analysis of this issue (Bernd et al. 2009) reports a lack of reliable models and tools that can
be applicable to the process of selecting AT. In fact, most of the studies in this field are lit-
erature reviews or an attempt to develop a valid model of evaluation and do not follow any
experimental design criteria. The only validated instrument that is currently mentioned in
the literature is the Matching Person and Technology (MPT) model (Scherer 1998). Starting
from these considerations, the assistive technology assessment (ATA) process has been
developed with the aim of identifying the optimal process to increase both the quality
of the match of provided/supplied/purchased AT and users' realization of benefit from
its use. Under this perspective, the ATA model is able to identify the steps needed to
achieve the optimal match by involving different professional skills and tools for the fol-
lowing activities: clinical analysis, the AT matching process, environmental analysis, the
assessment of outcome, and evaluation of the match of the user and selected AT over time
(Scherer et al., Early Online). However, the two perspectives adopted by the MPT and the
ATA model are different: The MPT process describes what needs to be measured, whereas
the ATA process shows how a center for technical aid must be structured to allow for the
appropriate match between user/client and AT. Nevertheless, both models share the objec-
tive of promoting the personal well-being of the users/clients by ensuring that the AT fits
with their needs.
