The Pathways to Independence Project and the UW Center for Rehabilitation Engineering and Assistive Technology (UW-CREATe) have joined forces to tackle this growing and costly problem. The collaboration has two primary goals:
- Enhance independence through improvements with DME procurement, maintenance, repair and retirement so that users are not unnecessarily disadvantaged in terms of their health, community living, and employment.
- Reduce costs associated with providing DME.
The team began with intensive analyses of various aspects of the DME procurement, usage, and retirement process, including:
- User experience related to acquisition of DME.
- Development of models for alternative methods for DME purchase, maintenance, repair, and retirement.
- DME design and technology influences on device utility, maintenance, reliability, repair, and overall user satisfaction.
This comprehensive review resulted in the following conclusions about disability and DME:
1) Current practice with DME results in high rates of equipment abandonment by the potential user. For example, a recent study from the National Rehabilitation Research Hospital in Washington, D.C. showed that 29.3% of all devices were completely abandoned. Mobility aids were more frequently abandoned than other categories of devices, and abandonment rates were highest during the first year and after five years of use. Four factors were significantly related to abandonment: 1) lack of consideration of user opinion in selection; 2) easy device procurement; 3) poor device performance; 4) change in user needs or priorities.
2) DME pre-acquisition procedures significantly impact user satisfaction. A recent study found a strong correlation between user perceptions of how informed they were about the equipment prior to purchase and how satisfied they were with the equipment after receiving and using the equipment.
3) Current DME maintenance and repair procedures result in considerable dissatisfaction for users. A separate study showed that users felt the current practice was too complex, that it resulted in lengthy delays in getting repairs, and that it was essential that the system be improved. In addition, providers of DME repair services reported the current reimbursement methods were insufficient to cover the cost of repairs and significantly impacted maintenance and repair quality.
4) There is significant expense associated with fraudulent practice in both procurement and maintenance and repair of DME.
5) Current practice results in increasing costs for DME.
