How Glen’s journey to getting a power wheelchair got much smoother

Glen is in his 50s, and his ability to stand and walk is limited, so he decided it was time to replace his motorized scooter with a more accessible power wheelchair. Without it, he would often be at the mercy of loved ones to get around.

After a long and less-than-ideal experience trying to get a chair at a community durable medical equipment (DME) clinic, Glen was almost ready to give up. Then he was referred to UT Southwestern's Wheelchair Seating and Mobility Clinic under the Department of Physical Medicine & Rehabilitation.

"That was a turning point for me,” Glen said. “Working with Dr. Shah’s team has cut months off my expected wait time for a chair. And the best part – which I wish more areas of medicine could replicate – is that they brought all the people I needed to talk to into the same room, at the same appointment.”

UT Southwestern’s Wheelchair Seating and Mobility Clinic streamlines the process and emphasizes full-circle communication, so patients get the wheelchair or mobility device they need more quickly. The clinic has grown from a few patients per month in 2013 to more than 50 a month today.

We’ve developed a standard of patient service that DME vendors across the country are implementing to connect patients with their ideal chair and reduce wait times. We’ve also advocated for patients and played an instrumental role in the recent expansion of Medicare coverage for seat-elevation systems in power wheelchairs, which can be vital tools to help patients with their daily activities and to live independently.

Glen has called our approach to care, which is based on the following three core methods, life changing. We call it the way things should be done to help patients.

1. Integrating tech and medical expertise

Certified assistive technology providers (ATPs) are specially trained to help people with disabilities find the best device – such as a wheelchair or power chair – and teach them how to use the equipment. ATPs are experts in the technical aspects of mobility devices, such as:

• Manual and power wheelchair measurement and fitting.
• Appropriate cushion selection and seating adjustments.
• Fine-tuning features such as seat elevators, positioning aids, eye-gaze controls, and speech recognition technology.

Most clinics have at least one ATP. UT Southwestern has three, from three different wheelchair companies: National Seating & Mobility, Numotion, and Metroplex-based Healthline. And if patients are already working with a DME company, they are welcome to bring their own ATP.

Our ATPs are trained and vetted to ensure they bring ethics and accountability, along with expertise, to every patient visit. They manage a wide selection of trial wheelchairs, so patients can explore how specific equipment looks and feels, and they offer in-home trials for patients within a five-hour radius of the Metroplex. Patients can also visit our DME warehouse to see the different choices for wheelchairs, cushions, and other valuable features.

Having ATPs in-house reduces the number of appointments patients need. They can see me and their ATP in one visit. The one-stop-shop method lets us:

• Ask high-level and specific questions in one conversation.
• Cover medical, technical, and lifestyle concerns in one discussion.
• Reduce redundancy in topics and paperwork.

“I loved that they were able to bring those multi-appointment experiences into one or two visits,” Glen said. “I was not the middleman in my care anymore.”

2. Communicating clearly with vendors and patients

Getting a new wheelchair can be a lengthy process. It requires careful evaluations and measurements and managing insurance claims. In many clinics, patients and staff are left waiting months for a status update on their order.

At UTSW, we’ve created a communication plan that keeps patients, families, and DME vendors on the same page about each case and order. Our process has been so successful that vendors across the U.S. are using it with their clinical partners. The two-pronged process goes like this:

• UTSW clinicians meet regularly with DME vendor leadership. We talk through each patient’s documentation, so we can identify issues and streamline the process. The same nurse works with the same DME rep to review wheelchairs in progress.
• Our DME vendors keep patients in the loop. Patients can get weekly status updates through an app, text, or phone call. After the chair is delivered, the ATP manages the go-between messages with the DME for repairs and tuneups.

Clear and proactive communication has demystified what happens behind the scenes, and the built-in efficiencies often mean patients can get their chairs weeks sooner than they would through a traditional DME clinic.

“Dr. Shah asked me, ‘What can we do? What are your challenges? What do you need?’ and the ATP jumped in with specifics,” Glen said. “The team narrowed down the overwhelming amount of options to what I needed for work, recreation, and just life.”

3. One cohesive care team

Everyone at our clinic plays an important role in caring for the more than 300 patients we see annually. Our multidisciplinary team of nurses, physical therapists, and ATPs meets each month to better understand patients’ needs, the nuances of ever-changing insurance coverage, and how we can continue to put patients first.

As a doctor who cares for patients living with mobility-limiting conditions such as multiple sclerosis and ALS, I’ve seen the toll ill-fitting wheelchairs can take on patients and caregivers, from pressure ulcers to skeletal deformities such as scoliosis. I’ve witnessed the sadness and isolation of losing mobility to a health condition – and the frustration when it feels as if no one is listening, let alone helping.

A core principle of our clinic is that wheelchairs are so much more than durable medical equipment – they are a necessity that can give people with disabilities a more independent life. And people deserve access to the right wheelchair as quickly as possible.

Glen wanted to share his perspective on how our clinic helped him get the most out of work, play, and dad life.