Shopping around: the cost-benefit of emerging rehabilitation technologies
The disability market is benefiting from an expanding range of innovative equipment, fuelled by a combination of technological advances and by crossover into the civilian sector from military aftercare of combat veterans.
The marketing brochures promise life-changing improvements in quality of life. It is inevitably appealing for personal injury claimants and their lawyers to draw up a shopping list of cutting-edge technologies - with a corresponding price tag attached. As a consequence, equipment is currently an inflationary trend when examining the overall cost of claims.
In practice there are recurring questions for compensators being asked to fund breakthrough products, including whether the (usually higher) cost is justified compared to existing options, whether likely to be a short-lived fad or a lifelong commitment, and whether the functional gains deliver savings in relation to other usual heads of loss such as care and accommodation.
One of the highest profile innovations has been the robotic exoskeleton designed to allow paralysed people to re-walk following a spinal injury. The psychological upside is obvious; a recent example reported in the press was a paralysed father of the bride able to walk his daughter down the aisle using an exoskeleton. The manufacturers claim other health benefits such as improved body conditioning and sleep health.
However, the exoskeleton has its limitations. At higher levels of spinal lesion, the user is still likely to require an attendant carer to help put on and take off the suit and to accompany them in case of falls. There are also rival and arguably better options for home exercise, such as FES (functional electrical stimulation) cycling or hand cycling.
The challenge for compensators is to try to identify innovations that both ameliorate the injured person's quality of life and offer a return on investment by minimising inter-dependent heads of loss. Some of the emerging products with that potential are as follows:
- A "hands free" wheelchair which uses the Segway self-balancing technology so that users can control direction of travel by tilting their upper body or even head. It has everyday applications, such as holding an umbrella in the rain, or carrying a hot drink from the kitchen into the living room, when otherwise a carer may be required.
- A smart watch which uses sensors including GPS and accelerometers to collect data about a patient for ongoing remote monitoring of rehabilitation compliance, which in turn could reduce the frequency and expense of therapist-led sessions and maximise independent or carer-facilitated exercises.
Suppliers are also becoming more commercial with their product support and marketing. For example:
- At least one of the exoskeleton suppliers offers a three month rental on a trial basis, following which the costs are deducted from any subsequent purchase.
- It has been commonplace for many years for amputees to seek a compensation award for a spare prosthetic limb as back-up when the main limb is being serviced or repaired. One of the major prosthetic manufacturers, Otto Bock, now offers in-warranty courtesy limbs on many of its products.
- It is now possible to lease adapted vehicles for a short period, including where the level of ultimate recovery is uncertain at the point of hospital discharge and the parties may not know whether an adapted vehicle will be required in the longer term or what wheelchair specification it will need to accommodate.
Disability technology is a growth area with significant financial consequences for claims reserves and potentially lifelong benefits for accident victims. The prudent compensator should therefore critically evaluate the cost-benefit of equipment and be prepared to shop around for the right purchases.