National Seating & Mobility Monthly Minute
Driving Innovative Service Solutions During the Pandemic
The pandemic has elevated the need for innovative service options across the healthcare spectrum, including complex rehab technology. The resulting regulatory changes have opened the door to a broader application of technology-driven solutions that streamline operations to safely continue to serve our clients. While the implementation of many innovative service options is tied to the safe provision of essential CRT services during the COVID-19 outbreak, the need for such innovative service options has been growing for some time. Adopted changes in healthcare brought on by the health crisis, on the heels of an already evolving landscape of care and the shift to consumer-driven healthcare, culminates in a momentum for additional advancements in our industry and the continuation of the innovations our clients will expect post-pandemic.

“Technology and digital engagements must continue to evolve as our clients expect safety, convenience, efficiency, and clarity,” said Bill Mixon NSM CEO.

Removing barriers to client care has long been a focus for NSM. For years, the company has stood alongside industry partners to advocate for federal and state legislation around CRT. This work will continue while also fighting to make regulatory changes made possible due to COVID-19 involving telehealth, CRT home assessments, remote evaluations, contactless signatures, and others permanent.

NSM is also committed to leading the future of technology-driven care for our industry. While having introduced products and operating systems in support of this already, we have recently expedited new service options and partnerships to bring advanced technology to the market, enhance the client experience, and improve outcomes for those we serve.
REMOTE EVALUATION
NSM is prioritizing the utilization of remote evaluation for CRT services, measuring quality of care and outcomes that are essential for the development of industry standards associated with virtual care. Virtual tools supporting seating and wheelchair mobility evaluations have become accepted during the current health crisis. Telehealth provided by therapists teamed with remote evaluations provided by ATPs, not only mitigate exposure to the high-risk community of individuals who rely on CRT, but also allow providers like NSM to support existing referral sources in facilities impacted by COVID-19. Many of these virtual service delivery options have long been discussed as a much-needed option to reach clients who have barriers to in-office appointments. When determined a viable option, these virtual services can also expedite the evaluation process and delivery of equipment
“Telehealth alone opens the door to long-term changes such as eliminating the face-to-face client/physician requirement before therapist appointments and the physical in-home assessment requirement,” Mixon noted
Through strategic partnerships with HIPAA-compliant regional telehealth experts Blue Sky Therapy, Lightning Mobility Evaluations and Spero Rehab, NSM can ensure coverage and access to these essential services for their clients across the country. The company has already seen a steady increase in remote evaluation appointments with 20 percent of new equipment evaluations conducted remotely.
REMOTE SERVICE SUPPORT
NSM has launched a Remote Service Support (RSS) initiative building on the successful foundation of the Remote Evaluation initiative launched last year incorporating verbal and video diagnostics, connected chair integration and a multi-point inspection checklist to remotely evaluate repair client service issues. The RSS advanced support model includes the creation of the NSM RSS center employing Remote Service Technicians (RSTs) a newly created role, to receive and evaluate nationwide client service and repair request calls. The program further enhances the company’s ability to virtually keep clients moving with as little down time as possible
“Our remote service support service options empower our technicians to review and many times resolve service requests without ever having an in-person evaluation,” said Mixon. “This offering, teamed with the connected chair and video diagnostics, further open up the utilization and efficacy of remote service options.”
STATE-OF-THE-ART TECHNOLOGY
While implementing alternative service options, NSM has also continued to explore other advancements to further improve the client experience. Most recently, the company announced the exclusive launch of Complex Rehab Systems (CRS) advanced technology developed over the last four years by wheelchair manufacturer Ki Mobility in collaboration with NSM Assistive Technology Professionals (ATPs). The state-of-the-art digital mapping technology provides ATPs the ability to capture a 3D scan of the client providing unlimited measure points saved as an electronic record for reference by the clinical team. The software strengthens clinical collaboration and limits re-work, cost and cycle-time in the order process. It also supports current client protection measures such as social distancing during seating evaluations
“Collaborative partnerships with other industry experts support our commitment to discover new technologies to improve outcomes and independence for those with mobility needs,” said Mixon.
CONCLUSION
NSM has always been committed to driving the future of technology-driven care for the industry. The pandemic has facilitated the acceptance of innovative solutions to ensure continuity of the services the company provides, all of which benefit those in need of mobility solutions in a number of ways. While NSM continues to offer alternate delivery and evaluation methods allowing the team to safely serve clients during the pandemic, they are simultaneously joining forces with others in the industry to advocate for the post-pandemic acceptance of these innovative service options.
“Once the pandemic subsides, the industry must align to take the progress made during COVID-19 into the future,” said Mixon.
NSM will prioritize the progress made thus far with an eye toward the future, exploring new technologies and additional advancements that will continue to take the industry to the next level of care.
A Better Solution for Your Injured Worker's Mobility & Accessibility Needs
National Seating & Mobility understands the mobility and accessibility needs of an individual when they experience a serious work-related injury. When someone sustains a work-related catastrophic injury, their life – and their family’s life – changes immediately and dramatically. Most everything the injured individual used to do without assistance will now require intervention by a caretaker, medically appropriate equipment and possibly even adaptive home and vehicle modification solutions. Our NSM360 National Workers’ Compensation Program helps our clients gain self-reliance and independence in and around their homes and communities. Most importantly, we collaborate with our workers’ compensation partners to ensure a fully integrated solution to meet all the requirements of our injured workers.
Click here to learn more about NSM's Workers' Compensation Program. 
Monthly Products Showcase
Power assist wheels and power add-ons are designed to help clients who have difficulty with everyday mobility in their manual wheelchair. The benefits of using Power Assist include improving the user’s activity level and independence with mobility related activities of daily living (MRADL’s) and decreasing the risk of overuse injuries. The addition of the power assist device requires less force to propel and reduces the number of pushes needed to go the same distance in a manual wheelchair. The battery-operated motors attach to the wheelchair via a set of wheels or as an add-on to the back of the wheelchair, making it easier to self-propel over difficult terrain such as grass, gravel, carpet, curb cuts, ramps and inclines.
The Medical Engineering & Physics Journal published Effect of power-assisted hand-rim wheelchair propulsion on shoulder load in experienced wheelchair users: A pilot study with an instrumented wheelchair in October 2015. This article compares hand-rim and power-assisted hand rim propulsion while propelling on a treadmill. It concludes that Power-assisted wheelchair propulsion is effective in reducing potential risk factors of shoulder overuse injuries such as: the intensity of shoulder loading, shoulder angles during force generation, shoulder range of motion and intensity of muscle activation. It also states that the prescription of power-assisted wheelchair seems to be indicated for subjects developing overuse injuries due to hand-rim propulsion or subjects with difficulties driving a hand-rim wheelchair primarily due to lack of upper-extremity power.  
There are several different types of power assist wheels on the market today.  
The SmartDrive MX2+ from Permobil is a power assist add on and can be customized for the end-user, allowing adjustments to the tap sensitivity, top speed and more. The user wears a PushTracker wristband to activate the power assist feature and has the added feature of the PushTracker Activity Monitor and a free Smartphone App. The user can track day-to-day propulsion metrics, including push count, coast time and more.
The SmartDrive is lightweight and easy to install. The system weighs only 12.5lbs and attaches to the back of the chair.  It can be fitted on essentially any make and type of wheelchair, including folding, tilt-in-space, one-arm drive, and standing. The SmartDrive has a battery range of 12 miles for users up to 331lbs.  
Contact your local NSM branch or representative to learn more about this product.
The E-Motion from Alber is a set of power assist wheels that are mounted on the wheelchair in place of the manual wheels. The batteries are integrated in the wheel hub and a sensor registers the propelling movement and activates the electrical motors. Even wheelchair users with impaired strength can move around independently with the help of E-Motion. The E-Motion power assist wheels may be indicated for users with neurological dysfunctions, tetraplegia, cardiac insufficiency and shoulder degeneration. Users with unequal arm strength and limited hand/finger function may benefit from E-Motion due to the ability to set the sensitivity of each wheel to the user’s upper extremity/hand strength on that side. The E-Motion wheels also have the option of an Ergonomic Control System (ECS), which is a remote control improving the functionality of the wheels.  With the ECS, the user can switch between 2 assistance levels, monitor battery/diagnostic information and activate rollback delay. Rollback delay prevents the wheelchair from rolling back for 5 seconds between pushes while climbing inclines or ramps. The E-Motion wheels have a weight of 24 lbs/wheel and can accommodate users up to 285lbs.
Contact your local NSM branch or representative to learn more about this product.
The Twion from Alber “expands possibilities and allows the end-user to reach the highest level of independence”. The driving sensor, positioned on the push rim, continuously and precisely determines the correct amount of assistance. The Twion power assist wheels were designed for clients who have paraplegia often with sufficient power and full coordination in both arms, good upper body stability and full hand and finger function. The user can interchange the power assist wheels and non-powered wheels on their manual wheelchair. The weight of each wheel is 13.2lbs with a range of 12.4 miles for users up to 264lbs.  
Contact your local NSM branch or representative to learn more about this product.
NSM Client Spotlight
Luis was diagnosed with Arthrogryposis in utero, a congenital condition causing curvature of the joints. Despite a fateful prognosis, Luis continues to thrive as a successful adult living in the Bronx, New York.
“When I was born, the doctors told my mother that I wouldn’t amount to anything,” said Luis. “They said I would die by three years old, but here I am at 47.”
While severe cases of Arthrogryposis affect fine motor skills, Luis defied his doctors’ expectations and is able to write, sketch and even walk on a limited basis.
“When I was in high school, I requested to be moved out of the special education class,” said Luis. “After moving into the new class, I parked my chair, got out my notebook and got ready to write. The teacher thought I shouldn’t be in that class, so he wrote quickly, covering all three chalkboards. My friend said he had never done that before. It was at that moment that I put my pen in my mouth and started to write.”
Luis has been writing that way ever since. He has authored multiple comic books, available on Amazon, and has two novels currently in process.
“I’ve worked with two or three artists, but have narrowed it down. I write more in a script form with dialogue and a description of what I’m seeing in my mind,” he said. “I sketch it and send it to the artist.”
Not only creatively inclined, Luis is an entertainer at heart, performing his comedy show – Stand-Up Comedy from a Sitting Down P.O.V. – at famed comedy clubs including Broadway Comedy Club and Dangerfield’s in New York City. He’s even started being recognized at local events!
“Last year I went to New York Comicon as a spectator,” said Luis. “I’m standing in the lobby when this guy passed by and said, ‘I’ve seen you before.’ I asked if it was because of my comic books and he said ‘no it’s because I know your comedy and you’re very funny.’ He asked if he could take a picture with me.”
In addition to his artistic endeavors, Luis has worked with young children as a group leader for an after-school program for more than 25 years.
“Now I write lesson plans,” said Luis. “I have the little ones, ages seven and eight. I try to mix it up.”
With a busy schedule to maintain, mobility is imperative. National Seating & Mobility’s the Bronx branch helps him stay on the go.
“Mobility means freedom,” said Luis. “It means the liberty to not be in one place. I can go anywhere I’d like, anytime.”
Determination, perseverance and what he sees as a handful of miracles have shaped Luis into the successful creator he is today.
“I wish I could see those doctors now,” Luis said.
Your feedback is important to us. Click here to tell us what you want to see in upcoming issues.
Let's Get Moving