10 Years: AT Memories
Manufacturers Remember the Decade’s Technology Advances
Invacare Corp.: Benefits Improving by Leaps & Bounds
Our industry has always been driven by new technology, so for me the most exciting and memorable time was the introduction of the Invacare Xterra power wheelchair, center-wheel-drive chair with six wheels on the ground. This innovation led to the Pronto M71, then the TDX 3, 4, and 5, and finally the TDX SP and more innovation to come. The consumer has benefited by leaps and bounds since, with multiple manufacturers developing maneuverable center-wheeldrive chairs, greatly increasing access in the home.
— Mark Sullivan, global VP for power wheelchairs & seating
Motion Concepts: As Much as Things Change, They Stay the Same… and That’s Not Always a Bad Thing
Funding changes, new codes, mergers, contraction and reimbursement cuts cannot deter the passion and determination of the many rehab professionals that put their clients first. Looking at pictures of 10-year old systems, I am struck by how we, as an industry, continue to evolve and improve. Are there other stories? Sure, but I think the spirit of our industry is the story of the last 10 years. At Motion Concepts we would like to think that we embody that spirit and passion. A small, specialized company in 2001, thanks to you we have remained true to our roots and embrace the opportunity to evolve every day, and I think that is a very good thing.
— Brad Peterson, VP sales & education
Beyond Boundaries: Mark Sullivan
Pictures a World of Access
One of Mobility Management’s earliest supporters was Mark Sullivan, the industry veteran who was leading Invacare Corp.’s rehab division when MM was getting started. Mark provided intelligence not only on assistive technology, but also on the history of seating & mobility and its ultimate goals of making the world more accessible to all consumers.
Go forward a decade, and Mark’s work has gone global in scope. A gift ed photographer with a keen eye for both beauty and substance, he’s authored a pair of books: Denied — A Short Guide to Appropriate Mobility for People with Disabilities, and Complex, an e-book that not only examines the seating & mobility assessment and fitting process in detail, but also looks at what happens when interventions are not provided, as is the case in many countries around the world.
With his employer’s blessing, Mark — now Invacare’s global VP for power wheelchairs and seating — continues to advocate for access to technology regardless of geography.
— Laurie Watanabe, editor
Julie Jackson: Evolving to Keep Pace with What Providers Need
With healthcare expenditures under pressure throughout the world, both suppliers and providers will have to find new ways of doing business in order to remain viable in a world of reduced reimbursement. For this reason, Invacare is leveraging its worldwide footprint of product development and supply chain to remove redundancies with an initiative titled One Invacare. The company is leveraging its various centers of excellence, which will result in increased agility, accelerated product introductions through efficient deployment of research and development efforts and reduced complexities.
What does that mean for our providers? Product excellence, product innovation, innovative services and cost-effective products that deliver a total lower cost to the provider, yet will serve their clients in a superior manner.
One key example is the recent integration with Motion Concepts. Invacare acquired Motion Concepts in 2003, but both companies remained separate in operations, product development, sales and marketing. In February 2011, the two entities joined forces to present a superior and uniform product offering. By leveraging Motion Concepts as the center of design excellence for seating platforms, we can accelerate product development, offer easier component interchangeability and overall greater sales support to our customers. The Invacare Matrx Seating Series gives our providers the benefit of ease of ordering, single invoicing and ultimately delivers to our customer base a product offering that is superior clinically and functionally.
Another advantage to our customers with our new structure is the ability to bring the best products from around the world to the local market. Th erefore, proven and trusted European models will be introduced in North America. For example, the MyOn custom manual folding wheelchair is an adapted version of a popular manual chair sold in Europe. Close to 500,000 units have been sold worldwide in the past decade. Th e strength in sales numbers refl ects its proven durability and history. We are excited to bring this product to the U.S. market later this year and have made revisions to better serve the needs of the U.S. clients.
Another example is the introduction of the Single Stage Drive (SSD) motors that reduce the number of motor and gearbox skus by 75 percent. Th e beauty of this motor platform is that it is wholly designed by Invacare, therefore further enhancing overall quality. A key feature to the SSD platform is the universal motor that can be used on either the right or the left side of the chair and also can be replaced independently from the gearbox. Th is reduces complexity and inventory needing to be kept in stock.
One Invacare’s new operating model serves both Invacare and the customer and positions both parties for future success. We are focused on delivering more innovative products that are consumer preferred, clinically superior, easier to service and deliver the total lowest cost for the provider. Th is is an exciting journey!
Julie Jackson, director of Invacare’s rehab business unit, is a member of MM’s editorial advisory board.
The Braun Corp.: Sharing the Mobility Story
Fifty years ago, he was a young man in a wheelchair who needed a way to get to work. Today, Ralph Braun is CEO of The Braun Corp., the largest manufacturer of wheelchair accessible vehicles in the world. In 2005, The Braun Corp. acquired IMS and began converting the Toyota Sienna Rampvan with the BraunAbility lowered floor conversion. Later in 2009, Braun added the Honda Odyssey Entervan to its fleet. Ralph Braun refused to let his disability hold him back, and in the process has brought independence and mobility to thousands. In 2010, he published his autobiography Rise Above, telling the story of how self-reliance, common sense and a refusal to accept the status quo helped him overcome challenges in business and life.
Remembering David T. Williams
Every new industry magazine needs someone to cut through the rhetoric and give a straightforward view of the landscape. Providing just such a policy perspective for Mobility Management was David T. Williams, director of government relations for Invacare Corp. at the time of MM’s launch.
Whether or not you agreed with him, there was no mistaking where Dave stood on an issue.
In a June 2004 column for MM, for instance, he wrote, “Consumers of personal mobility systems (a.k.a., wheelchairs) that include a wheelchair base listed under HCPCS code K0011 feel betrayed by their providers and confused by the Medicare bureaucracy. Clearly, neither the intent nor the rationale behind this ‘clarification’ has been eff ectively communicated to consumers by CMS.”
In 2004, Dave published Battling the Beast Within, a book that unfl inchingly told of his fight against multiple sclerosis. “I won’t pretend to be glad I have MS or that I would not change things if I could,” he wrote. “But in accepting my disease, I have been able to open my mind to new ideas and opportunities that have changed me for the better.”
Dave passed away this summer at age 62, but having him as a resource and cheerleader, especially in our early days, made us better. Thanks, Dave.
— Laurie Watanabe, editor
Altimate Medical: Standing& Delivering
When Altimate Medical Inc. introduced the first EasyStand in 1989, there was a need for a stander with a seat and back that didn’t require the use of a strap. The first design was extremely heavy and crude compared to today’s EasyStand; however, it worked great, and the sit-to-stand concept has never changed. Since then, our standers have improved and expanded with the addition of many options and accessories, making them adaptable to all levels of disability. For over 20 years, the EasyStand product line has been standing people of all ages, sizes and diagnoses around the world.
TiLite: They Feel More Enabled
Our goal at TiLite has always been to make the best manual wheelchairs in the world. Over the last 10 years, we achieved that objective by tailoring the fit of our frames to the individual, maximizing performance and offering stunning design. The result, and the true milestone, is reflected in what we hear from our customers: They say that they feel more enabled. And, they have more choices than ever before. Today’s wheelchair has more in common with a high-end bike than a wheelchair of 10 years ago. TiLite has led the way in this shift, and we’re excited to lead the way in the decades to come.
— Josh Anderson, VP of marketing
Heartway USA: Ending the Compromise
When Heartway launched the Vita S12 in 2009, it received universal plaudits from commentators. Not only was it one of the most technologically advanced scooters ever made, it was also the most striking. Fast forward 18 months, and the feedback from users has been just as effusive. Mobility scooter users have taken to the Vita S S12S sport edition — with a 12-mph top speed, deluxe high-back racing seat in flannel or leather, smoked black headlights and turn signals — with open arms, welcoming the end of the compromise between mobility and elegance.
The Comfort Company: From LTC to Complex Rehab
Just a decade ago, The Comfort Company was an exclusive long-term care manufacturer with products such as the IncrediBack. It offered limited adjustability, a simplistic strapping attachment, and basic design. From that, the company evolved into a complex rehab supplier with state-of-the-art products. The Acta-Back Deep, for example, provides a sleek, lightweight design with enhanced customization and patented hardware. For the past 10 years, The Comfort Company has strived to develop quality and functional products for the high-end rehab consumer. We look forward to our future in the rehab industry.
— Eric Murphy, VP of marketing
VARILITE: Driving the Industry with Passion & Care
In 2011 we find ourselves taking for granted technology such as Bluetooth, wireless connections and even color screens. Remember when power mobility electronics were monochromatic, and programming was done via dip switch adjustment? Technology has certainly come a long way compared to just a few years ago, but there is still more room for improvement, and certainly reimbursement dictates (to some extent) how far we can cross over consumer technology. There is one thing that has not changed over the years: the people in our industry. Providers, clinicians and manufacturers continue to drive this industry with passion and care. That hasn’t changed, and I doubt it ever will.
— Ming Chang, sales manager
Harmar: A Sharp Focus on Customer Needs
Over the last 10 years, Harmar has grown globally with an expanded portfolio of industry-leading mobility and home accessibility products. With a sharp focus on the needs of our customers and dealer partners, we’ve methodically refined our product lines, expanded our world-class services team, and continue to set the standard for a quality and customer-first focused company.
In 2008, Harmar acquired Summit Lifts to grow our home accessibility product line into what has become the industry’s broadest offering of stairlifts, vertical platform lifts, incline platform lifts, cargo lifts, dumbwaiters, and — new for 2011 — residential elevators.
At the end of 2010, Harmar acquired Freedom Sciences, now Freedom Mobility, to redefine a portfolio of vehicle lifts and turning seats now exclusively available through NMEDA’s distinguished QAP dealer network. Freedom Mobility lifts feature proven capabilities and installation options that have come to be preferred by QAP’s dealer sales teams, installers and customers.
Harmar’s engineering team continues their dedication to differentiating products and designing new ones in response to market demands. In today’s world, that means developing lifts capable of supporting a heavier load (as chairs tend to get bigger) and with a lighter footprint (as vehicles tend to get smaller). With production of nearly 60 diff erent vehicle lift models in Harmar’s global portfolio, we are driven more than ever to assure there is a lift for every customer vehicle and power chair or scooter need.
Just a couple weeks ago, Harmar processed our 200,000th order. This milestone is representative of the trust that our dealer and end-user customers have placed in Harmar and our obligation to challenge the status quo; to push in delivering the industry’s next best product; to service our dealers better than anyone else and assure their long-term success; and to guarantee that our users have the best possible experience with a Harmar product.
Wenzelite RE/hab: Attractively Functional
Wenzelite RE/hab has always been dedicated to assisting patients with special needs. In September 2003, Drive Medical acquired Wenzelite RE/hab, which was focusing on pediatric rehabilitation. Going into pediatric hospitals, schools and other pediatric facilities helped Wenzelite design a line of mobility products that were functional, but also aesthetically pleasing. With this knowledge, combined with the market dynamics of increasingly difficult funding, Wenzelite expanded its focus to products that are used every day by occupational and physical therapists. Now, eight years later, Wenzelite’s product line has increased, but their commitment has remained the same. Wenzelite works closely with therapists and caregivers to keep developing cutting-edge products and lowering costs to providers.
Aquatic Access: Daily Innovation
Aquatic Access is a company that innovates daily. Over the past 10 years, each lift has been designed and built to fit a particular set of customer needs. Since no two disabilities are the same, Aquatic Access has never developed a “cookie-cutter” product.
With a simple basic design that relies on the green power of flowing water, Aquatic Access lifts have been adapted to fit safely and correctly in therapy pools, hot tubs, swimming pools, water parks, on boats and docks, and to meet the stringent requirements of the ADA for public pools. In addition, Aquatic Access has developed a line of bariatric products to accommodate individuals with obesity issues.
— Liz Waters, marketing manager
EZ-ACCESS: Appearance, Installation Ease, Durability
It was about 10 years ago when the EZ-ACCESS Modular ramp system was developed to address the accessibility needs of the residential and commercial markets. We created a whole new concept for designing, ordering and installing the perfect modular ramp system. The expansion into manufacturing and engineering fostered innovation — we were the first to tie manufacturing, distribution, and installation together for a modular ramp line. The economies of scale allowed us to design a system that has become today’s staple of modular ramps. For over a decade, particular attention to appearance, ease of installation and durability has been key to our design.
— Judson Branch, VP of sales
The ROHO Group: Cushion Evolution
Among The ROHO Group’s many product innovations over the past 10 years, the ISOFLO Memory Control released in 2001 revolutionized the shape-fitting capabilities of the Dry Floatation Cushion, Quadtro Select. ISOFLO Memory Control allows the Select Series cushion to act as a single compartment or to lock into four separate sections, maintaining an individual’s required seat position and delivering a high level of stability and skin protection. The patented ISOFLO Memory Control remains the key feature of ROHO’s therapeutic Select Series Cushions.
Bodypoint: How the Positioning Market Has Changed
We have seen many changes that have infl uenced the positioning market over the last 20 years — reduced number of service providers, declining reimbursement levels, broadening code categories, etc. One of the biggest changes we have experienced is the evolution of standards within the industry. By introducing standards through the accreditation and certification of assistive technology suppliers, today we have raised the bar of professionalism among peers. Standards have been established for products and product testing, all of which continue to evolve to ensure the client gets the product they need. ISO has been a catalyst for these changes due to the dedication and endurance of individuals who recognize the need to propel the industry forward. Knowing the impact that these standards have on the everyday lives of our clients, Bodypoint has been a proud member of the ISO Technical Committee since 2000.
Tekscan: The Relationship of Body & Support Surface
Tekscan Inc. has produced best-in-class interface pressure measurement systems since the mid-1990s, but the company took this technology to a whole new level with the release of the CONFORMat system in 2005. This revolutionary technology addressed the design limitations of other sensors, which tend to fold between soft surfaces. Through years of R&D and collaboration with university researchers, Tekscan developed a flexible sensor that truly conforms to the body, providing clinicians with more accurate information on the relationship between the body and support surface.
Josh Anderson: Aesthetics’ Role in Assistive Technology
Other than the performance of the chair — is it easy to push, is it lightweight? — aesthetics drive the market. It’s incredibly important. It’s no different than buying a car or buying a computer. You look at Apple computers, and they’re just aesthetically better than anything else. People are willing to pay for that.
Just from a consumer standpoint, I wanted to have something for myself that makes me feel more enabled, that makes me feel more confident about myself and less disabled. When I look at my wheelchair, I don’t see the chrome monsters of 20 years ago, or even the ultralightweight chairs of 10 years ago. I see something now that is so closely related to the bike industry because all the components are upgraded. Th e style of the frame, the colors, the whole look of it are all very current.
I think you have a lot of consumers that are much more educated about their equipment and equipment choices because of the Internet. They can go on there and immediately find answers. They can find answers on their smart phone, so there is no waiting anymore. I think social media drives it a lot.
People are still, first and foremost, concerned about performance. Is the chair going to be easy to push? If it’s a new user, performance encompasses function as well: Is the chair going to be able to adapt to their needs? But beyond that, I think aesthetics have become critical to this market, because you know what? You’re using it for prolonged periods of time, and nobody wants to use something that refl ects negatively upon them.
We’ve got issues with funding. Unlike with phones, where I go in and say, “I really like that new iPhone, here’s $200, give me one,” with assistive technology, you’re still having to sell your insurance company on the fact that you need it; the therapist has to believe that this is the most appropriate equipment for you. You still have to convince a dealer that this chair is right for you. It’s different in that the consumer ultimately doesn’t make the final decision, and that’s still a little frustrating.
One of the problems with our industry is that consumers don’t know about the funding issues, because by the time they find out about it, it’s too late. They’ve already been denied.
— Josh Anderson is the VP of marketing for TiLite.
Quantum Rehab: A Decade Later
Quantum Rehab launched in 2001 to deliver complex rehab solutions. Beginning with power bases and quickly moving into Synergy cushions and backs, Quantum rapidly became a trusted name to patients and clinicians.
Quantum’s versatile TRU-Balance Power Positioning Systems debuted in 2003 along with the Litestream manual chair. Q-Logic Drive Controls were then launched to provide smooth interface and enhanced environmental controls.
The Q6 Series of power chairs debuted and continues to evolve with the advanced Q6 Edge launching in 2010.
In 2011, Quantum acquired Kids Up to expand its pediatric solutions. Kids Up products are the latest to follow Quantum’s economically sound, patient-first principle.
Supracor: Pressure Sore Prevention
Since revolutionizing the industry in the mid-1990s with the first completely ventilated wheelchair cushion, Supracor — the inventor of flexible, fusionbonded honeycomb technology — has expanded its innovative line of products for unsurpassed comfort while maintaining healthy skin.
Supracor now offers its popular Stimulite Classic, Contoured and Slimline XS cushions, which feature a soft top layer of specially engineered honeycomb, for people who need a higher level of skin protection, positioning and pressure management. In addition, Supracor provides a bariatric cushion for people who weigh up to 650 lbs., a Contoured Pediatric cushion that comfortably positions the child while holding him or her securely in place, and a new Tension Adjustable Back, which ensures a custom fit to improve posture and can accommodate for kyphosis or posterior pelvic tilt.
Stimulite honeycomb provides Total Pressure Management — pressure relief, reduced shearing and ventilation to control heat and moisture — the key to pressure sore prevention.
Darren Jernigan: We Started Policing Ourselves
Seasons come and go, and as years go by, before you know it a decade will pass.
I remember sitting at a table at a NRRTS leadership conference in St. Louis in 2002 next to Karen Cavallo. I was new to the industry, coming from government, and she was launching a new magazine called Mobility Management. I imagine we both have seen a lot of changes over the last 10 years, although from different perspectives. This past decade has had many changes, from technology to funding, staffing and public policy, some good and some bad. Here are a few off the top of my head.
Like it or not, we went from four codes to 64 codes in five categories regarding power mobility. A positive that emerged from this was the term “complex rehab” separating standard power wheelchairs from those power wheelchairs that require expertise to set up in a configuration for people with severe disabilities. Of course, not just anybody can put together these types of wheelchairs, which leads me to another change we saw this past decade… credentialing.
Credentialing swept through many states before the Centers for Medicare & Medicaid Services (CMS) joined in and adopted the policy for complex rehab. A complex rehab technology provider was one of the only professions I knew of in the United States where a person could have their hands all over another person to perform seating and positioning, and not have a license to do so. Credentialing added a level of professionalism to the provider, and frankly, we needed it because we all remember Operation Wheeler-Dealer. Fraud hit the government’s radar screen, and the feds really started cracking down on fly-by-night providers opening up a small shop one day that would be gone the next. So we found providers adopting and following quality standards, being licensed and hiring credentialed employees. We started policing ourselves, and things have turned around.
Of course, the 800-lb. gorilla over the past decade was competitive bidding, which has dominated the DME landscape. Coming, going, passing, repealed, delayed — and while providers have fought the measure kicking and screaming, round 1 has started, and round 2 will be ready to go into eff ect soon. And yes, there is another bill in Congress to repeal the entire policy. Th is issue may be along for the ride well into the next decade, which brings me to the future of the industry.
The future of DME is becoming increasingly more difficult to predict. With 10,000 people turning 65 every day for the next 19 years, the volume is clearly going to be there. With Congress cutting trillions of dollars from the budget, the reimbursement rate may not. As always we will adapt to changes, and whatever the future holds for all of us in this industry, I am certain that Mobility Management will be there to report on it.
Darren Jernigan is government affairs director for Permobil and is the District 11 Councilmember for the city of Nashville, Tenn.
Three Rivers/Out-Front: The Rise of Ergonomic Handrims
Ten years ago, we received a federal grant to develop an ergonomic handrim. Back then, a small round-tube handrim ruled the day. Because it had no ergonomic features, people often grabbed their tire to get a better grip. Our research led to the introduction of the Natural-Fit ergonomic handrim. In contrast to the old roundtube, Natural-Fit users quickly realized extraordinary benefits: The Natural-Fit enhanced performance, eliminated pushing on the tire, eased pain in the hands and wrists, and provided greater control when braking. Today, the Natural-Fit is prescribed by leading clinics everywhere, and we continue to lead the way by offering a variety of ergonomic handrim choices.
Sunrise Medical: Complex-Rehab Focused Organization
Ten years ago, Sunrise Medical’s footprint and brand composition were significantly different than what it is today. In 2001, Sunrise developed, designed, manufactured and distributed products across a very broad range of product segments within the industry. These segments included long-term care (Joerns), respiratory (DeVilbiss), standard HME (Guardian), augmentative and alternative communication devices (Dynavox), adult manual and power mobility (Quickie), pediatric manual mobility (Zippie and KidKart), standard seating (JAY) and standard mobility (Breezy). Over the years, through company sell-offs and acquisitions, we are now a company focused almost solely on complex rehab products and services. Sunrise Medical recently implemented new global branding, and our North American product portfolio includes products marketed under the Quickie, JAY, Zippie and Breezy proprietary brands.
This article originally appeared in the October 2011 issue of Mobility Management.