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We're featuring cool, interesting or impactful things happening in our industry, and kicking things off with a chat with Steven Quach of Kapok Prosthetics & Orthotics about his work in remote communities.
When did you start your digital workflow journey? What made you start? How have you gone about starting?
I started my digital workflow journey in August 2022 when I started Kapok Prosthetics and Orthotics after looking into it for a few years.
It made sense from many perspectives. With the growing number of options of central fabrication services in Australia, starting a small, independent P&O business has never been more accessible. From a logistics and workflow point of view, being able to digitally facilitate device fabrication was the only real option to consider. It allows me to still be in control of the cast/scan modification process without having to deal with the extra labour, cost and anxiety of sending physical plaster models to these services.
I've gone about starting by doing some homework and inquiring with suppliers to make a decision on a scanner and software combination that meets my current needs. These things are likely subject to change as I grow and reflect on the service! I'm currently using a non P&O specific hybrid LED/Infrared scanner which I couldn't be happier with in terms of the scan quality and ease of use.
What are you hoping to achieve by working digitally - for your clients and for your service?
For both the service and clients, I'm hoping to increase efficiency and reproducibility of devices. Some clients who've grown attached to a particular device/its fit have historically asked me if I can make an exact copy. With a digital workflow, this has been the closest we've been able to get in achieving this. Alongside 3D printing, I'm hoping to also be able to provide novel solutions and prototyping in the future.
From an individual development point of view, I'm hoping that working digitally will allow me to better reflect on my modifications using more objective measures. Being able to precisely track the steps of my modification (to the mm) will be of immense value in this process.
What does digital fabrication enable in your orthotics work with remote communities?
Whether in a café by the beach in Darwin or in a roadhouse with poor mobile coverage en route to Kalkarindji, digital fabrication gives me flexibility in where I work. Why is this important in my work?
Of the Australian states and territories, the NT has by far the lowest population density clocking in at 0.18 persons per square km (from the most recent census). Of note, the next least dense is WA with approximately 5x the density. Of further note, Vic is the densest of the states and territories coming in at 150x the density (not a typo) of the NT but I digress. A sizable portion of the NT population live remotely and in my experience, clients who live in these remote communities have poorer outcomes. When you consider the fact that some clients have historically been required to travel 10-12 hours (one-way) by road to attend an hour long review appointment in Darwin, it's easy to see how this is the case.
One of the big visions of Kapok is to be able to provide modern services to Territorians as close to home as possible. To what degree this will be achieved is yet to be determined but I would not dare attempt this if digital fabrication was not an option. The aforementioned flexibility it provides in working location is paramount to being productive in any location I'm in. Day long commutes to certain communities where there may only be 2-4 clients are made slightly more feasible when I can spend any downtime working on digital modifications.
Additionally, being able to replicate previous devices also cuts down on the number of appointments required (and the associated hefty travel expenses) for remote clients meaning more funds can be used for additional therapy.
Any particular stories of impact or case studies you'd like to share?
I've been able to successfully scan a duplicate prosthetic socket on a whim for a client who lives remotely. Their socket was over 6 years old and was well overdue for replacing from wear and tear as cracks could be seen through the lamination. Despite the structural state of the socket, the client reported that it was the best fitting prosthesis they had ever worn.
Although this may not sound like a major accomplishment initially, doing this traditionally would have likely meant an additional trip as I did not have all the materials required on hand. Instead, through scanning the existing socket on the day (and accounting for its thickness), I was able to provide the duplicate socket at the next clinic. For the client, this has meant they've been provided this device 2-3 months sooner had an additional clinic been required - potentially preventing a fall in the period.
Anything else you’d like to share about digital fabrication and / or its potential for the sector, or working in remote communities in particular?
I think that digital fabrication and availability of central fabrication services means that starting a small P&O business (especially in regional or remote areas) has never been more viable! Additionally, as the 3D printing of devices develops and becomes more accessible from a cost point of view, it will almost certainly become a necessary component to every business.
MORE ABOUT KAPOK PROSTHETICS & ORTHOTICS
Established in 2022 to address the gap of services within the Northern Territory (NT), Kapok Prosthetics & Orthotics provides modern and innovative services to the Northern Territory.
Currently, the NT has half the number of locally based Prosthetist/Orthotists per person when compared to the rest of Australia. Their vision is to create more services for Territorians and allow them be seen as close to home as possible.
Through his 5 years of working in the NT, Steven has had the opportunity to work with and hear the stories of clients from every corner of the territory. He has worked from all of the hospitals in the Top End and Central regions in addition to community clinics. Steven has gained an appreciation for the many trials and tribulations associated with urban, rural and remote work and is passionate about making long standing improvements for the NT population.
From listening to clients, Steven understands that access to services can be challenging for many across the NT - irrespective of where they live. He hopes to improve this by providing a quality mobile service that is still able to incorporate the latest developments in the Prosthetics & Orthotics field.
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