title: Laser imaging and computer-aided design and computer-aided manufacture in prosthetics and orthotics.
abstract: Although Hanger Orthopedic Group, Inc., has been developing clinical protocols for its INSIGNIA scanner for more than 2 years, there are many applications that are currently in development and will be released over the next 2-year period after this publication. It is the goal of Hanger Orthopedic Group, Inc., to replace all plaster casting procedures with the laser scan and move toward a paperless environment where all images and documents are passed through its virtual network. INSIGNIA currently has five major production centers throughout the United States, which support more than 600 INSIGNIA certified clinicians. These clinicians staff more than 600 clinics in North America, all under the Hanger company name. The central fabrication service and the central design center processes hundreds of shapes per day (Fig. 27). So that any clinician in the field can use the expertise of the central designers and central fabricators to help with overflow or problems they might be having, the network that exists within Hanger is tied together and enhanced by INSIGNIA. Through virtual modification and centralization of these services, each patient receives the virtual collaboration of several clinicians with a total of years of experience. INSIGNIA has enhanced the patient experience. The enhancement is not only in removing the plaster from the process, but also in exposing each patient to the team of prosthetic experts working collaboratively behind the scenes. The rehabilitation industry continues to be bombarded with compliance paperwork and justifications. The INSIGNIA scan and resulting measurement reports give inherent strength to justifications based on volume change, surgical revisions, or tissue change. The files are kept in a data warehouse where they are vaulted and preserved presumably forever. Also, any of the shape graphics or measurement instruments can be printed into a discrete report that can become part of the patient's permanent record. Many physicians receive update letters from their orthotic and prosthetic clinician with a status update before and after treatment of their patient. This update includes a descriptive narrative, a printout of the pertinent metrics, a printout of the scan graphic, and often a digital image of the patient wearing the device (Fig. 28). The network is HIPAA compliant, and all private health information is held in tight security. If a practitioner does not have a HIPAA agreement in place with Hanger Orthopedic Group, Inc., and would like one, or ifa practitioner would like to have an INSIGNIA representative call or visit with more information, the practitioner is encouraged to call 1-800-4-HANGER and request an INSIGNIA in-service or visit INSIGNIA on the web at www.hanger.com.
authors.affiliation: Hanger Orthopedic Group, Inc., Two Bethesda Metro Center, Bethesda, MD 20814, USA. JSpaeth@Hanger.com
authors.forename: John P
authors.initials: JP
authors.lastname: Spaeth
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000534:rehabilitation; D002056:Burns / Q000534:rehabilitation; D002648:Child; D017076:Computer-Aided Design; D003952:Diagnostic Imaging / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007223:Infant; D007834:Lasers; D008397:Masks; D009140:Musculoskeletal Diseases / Q000534:rehabilitation; D009989:Orthotic Devices; D011474:Prosthesis Design / Q000379:methods*; D013122:Spinal Diseases / Q000534:rehabilitation