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We're featuring cool, interesting or impactful things happening in our industry, and kicking things off with a chat with Jarrod Cahir of Therapy Tracks 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’ve always had an interest in digital fabrication and improving quality and access to services. From initially being able to manufacture CAD/CAM orthotics in the Whyalla Hospital High Risk foot clinic, my journey was fast tracked by the pandemic whilst working in the UK, where like everyone we needed to pivot to practice social distancing (the plaster room isn’t the roomiest of places). I was really lucky to be given the time and support, whilst working with enthusiastic colleagues to bounce around ideas and try to think outside the box to continue providing safe service provision as well as using all the extra time looking at available options. There’s a heap of P&O and non industry specific programs and scanners out there and then a matter of getting stuck in and giving it a go.
I think a couple of my early scans featured in an AOPA presentation’s “what not to do in digital fabrication” slide but they each served as a learning experience to try again and work out how to do things differently.
The trickiest part for me was wrapping my head around the digital model and visualising how the end product would look without being able to hold the plaster positive. I think it’s made me much more objective and considerate of every little modification and trimline going into trying to produce a better fitting and more functional product for the end user.
What are you hoping to achieve by working digitally - for your clients and for your service?
Therapy Tracks hope to provide a consistent, objective, evidence based service with our clients at the forefront of everything we do.
Working digitally allows us to fine tune each positive model more for the individual, reliably reproduce our work and goes a small way to assist improving access to services in the remote regions we work in.
What does digital fabrication enable in your orthotics work with remote communities?
Digital fabrication allows us to take our workshop anywhere. We cover a fair bit of ground through the NT and Kimberley, so being able to model straight away whilst travelling improves efficiency and turn around times. In a more practical sense, it also limits lugging around casts at risk of getting squashed; whilst I personally enjoy the flexible work hours spent at the local cafe or with the laptop on the couch, rather than the plaster room.
Any particular stories of impact or case studies you'd like to share?
During the pandemic whilst in London and back in Aus, we could try out Telehealth assessments, facilitated by the clients or multidisciplinary team member with scans from an iPhone or casts being utilised to remotely fabricate orthoses (Pectus Carinatum, scoliosis braces and AFOs). This is something I’m particularly excited to develop further, to reduce the number of times clients must travel to regional centres to access services.
I also have fond memories of directly scanning clients out in the community, like on their front porch and the banks of the dry river bed in Alice Springs to build rapport and make them more comfortable. We got accosted by a pet pig in Bayulu community in Fitzroy Crossing one time whilst doing so.
It’s also provided us with more options for clients with sensory or behavioural issues, where casting has historically been tricky or a complete barrier to accessing orthoses. Parents have been rapt not to go through the trauma of casting and then being able to show the child and send through updates of each stage of the process has allowed them to feel more involved and attached to their end devices.
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 the upside for remote communities is huge; leveraging technologies and using resources that enable people to access services whilst remaining in their community has been demonstrated to improve health outcomes. Then being able to reproduce and tweak devices to match lifestyle or environmental demands in remote communities (and everywhere for that matter) lends itself to better patient-centered care and outcomes.
What would you say to other orthotists considering digital fabrication?
I think it’s important to consider all available options, do your research, don’t be discouraged and learn from mistakes to try different things and see what works best for your clients and clinic. Research and technologies are constantly improving and digital fabrication looks to be another string to the Orthotist’s bow for the foreseeable future.
MORE ABOUT THERAPY TRACKS
Therapy Tracks was started to service remote communities in the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands of Central Australia. From there we expanded to also offer Allied Health Services in and around Broome. As it’s often difficult for people living in remote communities to travel to rural centres for Allied Health Services, we are able to travel to these communities in order to better service clients.
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