Review of Prosthetics & Orthotics Needs for 21st Century - Vision for 2025

What would we do, if only we had the power to go back?! The best way to consider this is to align and join all the known dots. To think of Prosthetics and Orthotics (P&O) as a system holistically centred around care of the user, identifying all their needs continuously, in their environment and in their lifestyle. This could produce a new value proposition for all multi-disciplinary team members by generating patient-centred therapeutic benefits and clinical outcomes that align all stakeholders in P&O towards using a common narrative, which makes decisions based on data. In this case, data is the outcome, using Standards and Instruments which are validated (e.g. www.amprom.uk) to quantify questions such as: "Have we reduce risk of falls?", "Have we reduced risk of tissue injury?", "Have we reduced risk of low back pain?", "Have we reduced long term risk of osteoarthritis?", etc. If we have, we are assured this will benefit the comfort and confidence for the user. We can have confidence in rehabilitation measured by improved stability and increased activity, and other measures which enable the accurate classification of products and services to match users. A prescription index, based on Outcomes, could, for example, be calculated by a formula which accounts for the percentage reduction in falls probability, a patient satisfaction score, a mobility score and a quality-of-life score, allowing practitioners to base their choices of treatment pathways and component selection. This paper provides both the context for and contributing factors that make the proposing of such an objective Prescription Index an interesting thing to consider when discussing Health Economics in P&O.