Improving patient access to appropriate assistive technology by changing methods and mindsets – Julian Jackson, VisionBridge Posted on 2nd March 2021 There is no doubt that sight loss continues to be a clear and present danger across the UK and globally, bolstered by increasingly ageing populations, poor lifestyle choices and the impact of infections, inherited and systemic disease. So how can assistive technology (AT) help alleviate this situation? Let me first go back a step to 2010 when I lost my sight to a retinal inherited disease retinitis pigmentosa and duly launched the social enterprise VisionBridge (www.visionbridge.org.uk). I had struggled for some years with diminishing sight to read emails, recognise faces, navigate outdoors in glare or low light and generally manage the activities in daily living that we all take for granted. It never occurred to me that technology including vision enhancement, audio-description, navigation, and orientation could be so pivotal in the rehabilitation of patients with vision loss, dual sensory loss or even visual processing challenges. Indeed, progress in eye research from basic discovery science to AT continues to move aside the usual obstacles to maintaining a chosen livelihood and lifestyle, experiencing travel and leisure and access to education and employment opportunities. However, all this progress is being made in the context of a growing number of challenges to eyecare provision and patient rehabilitation in the UK. I would like to bring these to the attention of eye health and allied health professionals, voluntary sector representatives and community based health and social care providers and then work with them to defeat these challenges for the ultimate benefit of their patients and those in their care. For example, low vision care via the NHS in England is extremely varied and in some areas of the country, only basic low vision aids and advice are available. Elsewhere, patients may or may not be directed to the voluntary sector and they are almost never signposted directly to specialist distributors which can offer a much wider range of devices and technology plus the vital ongoing wrap-around patient support required by so many users. Also, in many instances, hospital and eye clinic staff are not sufficiently motivated or incentivised to advise on AT beyond the parameters of what they have, and many are confused by the referral pathway around the voluntary sector, patient support groups and suppliers. Due to workloads and time constraints, many eye health and other healthcare professionals are increasingly relying on information from the internet and social media patient feedback and the charity sector where the quality of advice is patchy and the hands-on training of patients on devices (as opposed to just offering advice) is inconsistent. There is also a degree of resistance amongst some eye health professionals to “recommending a particular assistive technology provider over another”. My discussions with a wide range of healthcare professionals have highlighted how confused they are by the ever-increasing range of AT available, the relevance of a specific device or technology solution to a particular eye condition or disease, the risk of obsolescence and indeed the cost and value of such technologies. Turning to patients and service users, they are neither experiencing optimal access to AT, comprehensive guidance in re-entering the eyecare system, access supported by trained advisors nor provided with a clear route map along the patient pathway. This means that patients’ understanding, and awareness of AT is very low, they receive very little guidance or support when devices or solutions become obsolete or broken and they certainly do not understand how all stakeholders in eyecare complement each other, if at all, along the patient pathway. In light of all this feedback above which could be characterised as roadblocks to optimal patient outcomes, Sight and Sound Technology supported by VisionBridge, has launched a series of online interactive AT sessions. They are designed for anyone interested in exploring how technology can improve patients’ mobility, confidence, independence, and connectivity alongside improving the ability to gain and retain employment, sustain a lifestyle, and remain in mainstream education. VisionBridge and Sight and Sound Technology are helping to put AT on the front foot. Now there is no need for those experiencing sight loss and related sensory challenges to solely rely on an annual event or the incomplete recommendations from a third party. Sight and Sound Technology supported by VisionBridge can introduce patients to some highly innovative hardware, software and literacy support solutions that will help those in education, employment, on the move or simply to enjoy an improved quality of life. At the very least, we can give them the information and experience of handling equipment so that they can then make an informed choice. We would like to apply the same educational principle to professionals across the UK and Ireland too. We not only recognise just how confused they might be by the ever widening and evolving range of AT but also appreciate the only too brief and pressurised time that professionals can spend with their patients. We invite them to simply offer more informed advice and guidance to their patients about experienced and trusted AT providers who can support them along their patient journey. They have an important role to play in helping to create and maintain a much clearer “line of sight” between themselves acting as “touch points” for their patients and specialist distributors. In this regard, Sight and Sound Technology has launched the “Referral portal” which offers eye health professionals a quick, simple and seamless method of referring patients directly to a pool of AT experts who can offer guidance and advice and a wide range of appropriate AT for referred patients. There is an additional option for those patients who wish to self-refer. We all need to remember that “information” about AT is not the same as “recommendation” and will simply give patients much needed choice which they can take, or return to the eye clinics offering a more limited range of basic equipment. Personally speaking, AT continues to help me work, communicate and retain a measurable degree of mobility and independence. I am amazed by the ability of technologies and devices to evolve and make life just that little bit easier. Assistive technology is certainly not a panacea for sight loss. It does not pretend to prevent, treat or even cure. However, I strongly believe that it should be considered as a useful friend in times of crisis or specific need and I would urge all professionals to explore the wonders of assistive technology and participate in an online interactive session now with an ethical, trusted and experienced national distributor such as Sight and Sound Technology for the ultimate benefit of those with visual impairment and other sensory challenges.