Partnership for Patient Care

Customer service in central fabrication facilities is a joint venture between technician and practitioner.

  • O&P Business News, May 2010

In the O&P profession, end users are patients, not customers, and that has a definite impact on their treatment. But in the relationship between O&P practitioners and central fabrication facilities, practitioners are customers in every sense of the word.

  Mark Dentler
  Mark Dentler

The way that central fabrication technicians approach this partnership with practitioners sets the tone for patients throughout the process.

CFab customers

Just as with other aspects of the O&P profession, CFabs provide a necessary service for patients. Patients rely on their practitioners to provide them with quality care; practitioners who are unable or unwilling to fabricate in-house often rely on CFabs to provide their patients with quality products. Without a central fabrication resource, many practitioners would not be able to do their jobs.

“Our customers look at us as a friend to turn to in time of need,” Mark Dentler, owner of Spinal Solutions in Conyers, Ga., said. “We will spend half the time taking the order and the other half catching up.”

Many of Cascade’s customers are orthotists who use the company as their central fabrication facility, mostly for pediatric AFOs.
Many of Cascade’s customers are orthotists who use the company as their central fabrication facility, mostly for pediatric AFOs.
Image: Cascade DAFO

This type of relationship represents about 75% of Spinal Solutions’ customer base, with the rest consisting of customers who order infrequently.

Ohio Willow Wood in Mt. Sterling, Ohio, provides custom fabrication services for small, medium and large prosthetic care facilities, while also completing specific advanced fabrication jobs for another portion of their customers. Others use the company’s capailities to digitize casts for creating initial check sockets, and then fabricate the definitive socket in their own facilities.

At Cascade Dafo Inc. in Ferndale, Wash., 90% of customers are orthotists who use the company as their CFab facility, mostly for pediatric AFOs. The majority of its customers are located across the United States, but Cascade Dafo Inc. reaches internationally as well, to Europe, New Zealand and even Dubai.

Although Fillauer’s customer base includes practitioners as far as Israel and China, the company primarily conducts business with domestic patient care facilities that specialize in providing custom orthotics and prosthetics, instead of off-the-shelf designs, Michael Fillauer, CPO/L, president of Fillauer, said.

Consistent messaging

The ultimate goal of the CFab-practitioner interaction is to ensure that the product is right for the practitioner, so that it can be the right one for the patient.

  Michael Fillauer
  Michael Fillauer

“We feel like we play a huge role in their patient care practices because we keep our staff accessible to the practitioners,” Fillauer said. “When they call in it is just like having their own personal technician to help them.”

Fillauer, which is the parent company of Fillauer Central Fab in Chattanooga, Tenn., also employs 12 certified orthotists and prosthetists who visit customer facilities to consult on the company’s specialty products.

One way CFabs can establish a real-time experience with customers without actually being present is through sharing videos and digital photos of devices and other items.

  Bill Weymer
  Bill Weymer

“Utilizing technology, there are a lot of things that we can do that we couldn’t do 10 years ago, that will still allow us to be an integral part of patient care, even though we’re not physically there,” Fillauer said.

Fillauer has implemented this file-fsharing technology across the board. Cascade, too, recently began using Skype’s Internet video chat service. Practitioners are able to discuss a particular orthosis or mold with Cascade’s technicians the moment issues arise, just by holding it up to their computer’s camera when chatting with a technician.

Cascade also takes steps to ensure customer satisfaction by including a survey card with each order. These questionnaires, completed either by the practitioner or by the patient, provide information about the customer experience and fit of the device. Bill Weymer, president and chief executive officer of Cascade Dafo Inc., said that he is the first to review the returned cards, and he addresses all issues immediately. About 65% of those cards are filled out by parents of children who use the fabricated device, which offers the technicians an opportunity for feedback from the end user they otherwise might never get, he said.

  Matt Williams
  Matt Williams

“[The cards are] a simple thing to fill out but it’s important, consistent communication that we get from customers, even customers’ interactions with the practitioner that they work with,” Weymer said.

Spinal Solutions expects — and receives — the same positive feedback from its clients about the customer service experience, because its employees approach all contact with customers with the company’s philosophy: treat customers like family and go to great lengths to help them, Dentler told O&P Business News.

“You don’t have to be in the client’s office to understand their situation,” he said. “Your disposition and attitude have nothing to do with your demographics. Whether on the phone, fax, text, chat or in person, our employees treat our clients with dignity and respect.”

Customers and patients

Central fabrication facilities differ from O&P practices in that they are product-driven, not patient-driven, businesses. The practitioner’s only goal is to best fit the patient. The CFab technician’s ultimate goal is to create the best device for the patient, but the true customer in that relationship is the practitioner.

Some CFabs have begun using videos and Internet chat programs to discuss issues with practitioners as they arise.
Some CFabs have begun using videos and Internet chat programs to discuss issues with practitioners as they arise.
Image: Cascade DAFO

“In a sense, it is easier to deal with one personality than several. We understand the needs of the patient through the practitioner,” Dentler said.

Regardless of turnaround times, Spinal Solutions will fabricate a custom device to a practitioner’s specifications.

“In our world, pressure is a constant,” he said. “Working with certified practitioners … we have complete confidence that the information we need to make the best fitting orthotic possible is in our hands. That takes a good bit of pressure off us and makes our job a whole lot easier.”

Fillauer addresses this issue by accessing its own team of practitioners, who understand the process of fitting patients. As a practitioner, Fillauer can relate to the situations that practitioners encounter with patients on a regular basis.

On the other hand, the fact that practitioners are experts in matching patients with the correct devices also benefits the group. While dealing with expert customers brings its own challenges, most CFabs see working with practitioners as an advantage.

“We sometimes can learn from them as much as they learn from us,” Fillauer said.

Since the customers are just as knowledgeable as the companies, the conversation runs more smoothly. Each party knows the right questions to ask and information to provide, and, in the end, whether the products will be correct for the patients.

“We see that as an asset,” Fillauer said.

Long history

Ohio Willow Wood also employs a team of in-house prosthetists, who consult with technicians on a daily basis. Combined with the technicians’ own formal training and on-the-job learning, the company offers a solid understanding for what its customers need, Matt Williams, RTP, supervisor of Ohio Willow Wood’s custom fabrication and design liner departments, said.

Information from the practitioner’s experience aids the process. Practitioner suggestions for matters involved in fabrication orders provide technicians with a starting point for creating componentry.

But practitioners also benefit from having a strong relationship with their CFab facilities, Williams said, because central fabrication facilities bring their expertise to each job they fabricate.

Spinal Solutions technicians work with practitioners’ schedules to fabricate custom devices, regardless of short turnaround times.
Spinal Solutions technicians work with practitioners’ schedules to fabricate custom devices, regardless of short turnaround times.
Image: Spinal Solutions

“Customers will ask for our advice on fabrication suggestions and tap into the expertise our team has cultivated from being in business for so long,” he said. “The ultimate outcome is positive for everyone … especially the patients.”

Many of Cascade’s technicians have been with the company for decades. Tom Escovar, who leads its tech support group, has worked with the company for 20 years. He and each of the other technicians accompany Cascade’s clinicians to fittings to experience face-to-face interaction with patients. Weymer said they travel together on a regular basis because it is a valuable educational opportunity for the technicians.

Cascade also offers educational workshops for practitioners new to fabrication with the company, and encourages the practitioners to extend this opportunity to the physical therapists on their teams. Both of these options together help form a common vocabulary among all of the members of the patient team.

Governmental concerns

It remains unclear as to how the new health care overhaul will affect the O&P profession. One thing is for sure: all O&P practices are preparing for the next steps.

For now, people seem to remain tentative about getting new devices, preferring to “wait and see.”

Despite patients’ apprehension about the future, however, Weymer said he feels that the O&P profession has been fortunate among the other health care sectors thus far.

Cascade provides opportunities for its technicians to see the end result of their work by meeting with practitioners and patients.
Cascade provides opportunities for its technicians to see the end result of their work by meeting with practitioners and patients.
Image: Cascade DAFO

Most custom fabrication facilities do feel the impact of today’s economy, Williams said. Ohio Willow Wood’s customers are working to keep their costs stable, and the company aims to help them achieve this goal.

Dentler said he hopes to avoid a market where CFabs bypass O&P practitioners and sell prefabricated products directly to the surgeon or the hospital.

“Ultimately, the patient is the one most negatively impacted by this,” he said.

As a result, he said Spinal Solutions will only sell its spinal products to trained, certified orthotists who are best qualified to fit and maintain them.

Cascade Dafo Inc. has felt the dip in the economy, with a slowed growth rate in 2009 and in 2010 so far. Weymer, too, said he does not know what to expect from health care reform.

“The fact that more people will have health care may increase our business,” he said. “On the other hand, kids usually have a pretty good source to health care through state Medicaid and [other programs], so we don’t expect a large increase.”

He said he does foresee an increase in costs, however, based on early information about a tax on manufacturers and devices.

“We have to wait and see.” — by Stephanie Z. Pavlou

For more information:
Editor's Note:
  • This article includes a small representative sample of central fabrication facilities. O&P Business News does not intend to promote any particular facilities or products, nor to achieve an industry wide consensus on the issue.

Comments

Healio is intended for health care provider use and all comments will be posted at the discretion of the editors. We reserve the right not to post any comments with unsolicited information about medical devices or other products. At no time will Healio be used for medical advice to patients.