2000 Conference Proceedings
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Corporate Assistive Technology – Returning People to
Work in a Corporate Environment
W. Skip Simonds
Kenneth Mitchell, Ph.D.
UnumProvident Corporation
Portland, ME
Starting with the broadest view of disability, one is led to
make finer and finer discriminations in order to develop a
coherent appraisal of the needs of an individual with a
disability and potential solutions to functional impairments.
Disability in the broadest view is any functional impairment
regardless of type, extent, or duration. Such a perspective
covers every deviation from "ableness" from poor but correctable
eyesight to high cervical events; from mild inability to
concentrate to traumatic brain injury, and, of course, much, much
more. While one can develop an all-encompassing view of
disability, it is impossible to conceive of one single solution
to all functional impairments. For every different impairment,
there is the potential for a corresponding functional impact.
Within a single impairment, there is a range of functional impact
depending on the severity of the impairment. Finally, regardless
of range, impairments can last from moments to months to
lifetimes, and solutions must take duration into account to be
usable.
To this obvious bore down list, type-extent-duration, a fourth
level must be added which has been largely ignored to date:
venue. The purpose of this paper is to outline the effects of
location and application on the facility of utilization of
existing AT products and the conceptualization and development of
newer and more effective products for a specific range of
applications: returning people to work with the corporate
environment.
Employers, especially corporate employers, recognize the cost of
lost workdays due to disability as well as the individual
affected by impairment. From the employer’s point of view,
the cost of lost workdays reduces the organization’s
productivity, profitability, and competitiveness as well as the
human costs of the loss of a valued colleague. While the average
American is between the ages of 35 and 65, he or she runs a 30%
risk of suffering an impairment of 90 days or longer in length.
What’s more, each year more than 750,000 Americans
experience injuries or illnesses that keep them out of work for 5
months or longer.
Catastrophic disability has been the focal point of much of the
development in new assistive technology products. The effects of
impairment on the individual’s ability to conduct the major
activities of life have served as a lightning rod for creative
efforts. Necessity is the mother of all invention, and nowhere
more than in the foundational efforts to see people create,
maintain, and extend independent living situations.
However, not all impairments are catastrophic, not all durations
are life long, and not all needs warrant unlimited resources in
their solution. Gaining quickly in the hierarchy of needs is the
need for flexible, inexpensive, readily available solutions for
non-catastrophic, non-permanent functional impairments. And
within that subset, there is a need for solutions that can be
applied primarily in the work place.
The Americans with Disabilities Act, Title I creates a mandate
for employers to provide their employees with a "reasonable
accommodation." This mandate placed a socially conscionable
responsibility on the employer to take the initiative in response
to a bone-fide request for an accommodation from an employee who
has a disability, is regarded as having a disability, or has a
record of having a disability. However, not all solutions
available lend themselves to the corporate environment. And,
contrary to expectation, this is more true with larger corporate
employers than with smaller.
Because of the predominant emphasis on individually conceived
solutions to catastrophic impairments, people don’t get the
concept of corporate assistive technology without help.
Product salespeople see it as individual solutions sold by the
10 pack. AT consultants see it as multiple single clients located
in a protected environment. End users see it as no different than
individual solutions. Even corporate sponsors of internal AT or
case management programs shrug their shoulders and don’t
get it. Barriers to the successful implementation of any
assistive technology in a corporate setting orbit around three
points: products, training, and technical support. The products
needed by corporate AT programs fill largely different needs than
those for the individual. The training required to attain
proficiency is different in both type and quantity than that
required by individual AT users. And the degree of sophistication
in technical support exceeds the need of the individual user and
is directly proportional to the size of the corporation.
Issue:
Corporate AT is based on three groups: stay at work, return to
work, and bring to work. Individual AT is based on the
individual, usually in a bring to work situation. Corporate AT is
work focused. Individual AT is impairment focused. Corporate AT
is partially therapeutic and partially preventative. Individual
AT is almost wholly therapeutic. Corporate AT demands the
solution fit the situation Individual AT assumes the situation
can be changed to fit the solution
Thoughts:
This suggests that the aims of corporate AT are different from
those of individual AT. Many of the solutions in the AT field
have been developed with the severely disabled in mind. While the
corporate world is interested in putting the severely disabled to
work, they are more concerned with helping the current employee
return to work, or helping to prevent that employee from leaving
work in the first place. I say "more concerned" because,
understandably the corporate commitment is to the employee that
is already working for the company rather than one that is not.
This "on the job" focus for AT translates to a need for solutions
for the mildly disabled and injured more than to the severe,
although there is that need, too, but to a lesser extent. The
very best corporate AT is preventative, catching the injury while
it is still acute, before it becomes chronic. Most individual AT
is not considered until after the chronic stage is reached.
When the AT in question is software, the corporate situation is
further complicated. The marketplace assumes the individual user
is free to upgrade operating systems, enhance hardware, or buy a
new system altogether, and generally do whatever is necessary to
change the situation to leverage the value of the software.
Because corporate systems are frequently networked, tied to
legacy systems, and use older versions of operating systems and
software; it is the AT solution that has to give. It frequently
has to be modified, tweaked, and/or pruned to work in an older
environment because the environment is relatively concrete.
Training:
Issue:
Corporate AT is implemented in partnership between the
corporation and the individual. Individual AT is implemented
almost entirely by the individual.
Thoughts:
The motivation to learn and apply what is learned is very
different. On a basic level, AT is an expense born by the
corporation. However, the individual AT user either has to pay
their own way, or has had to jump through hoops to get funding.
Corporate training is frequently, "cook until done" at no cost to
the employee while the individual user is paying by the hour for
training. The corporate user already has a job while the
individual user is trying to learn skills to get one. The
motivations to learn and use the technology are, therefore, quite
different. Training systems, and even original system design,
must reflect these differences.
Technical Support:
Issue:
Corporate AT looks for common solutions to multiple problems.
Individual AT looks for unique solutions. Because of security
concerns corporate AT requires a support infrastructure.
Individual AT depends on the savvy of the individual user.
Corporate AT requires a multiple location solution and support.
Individual AT does not.
Thoughts:
With a corporate emphasis, common solutions, integrated support
of systems, and portability are critical issues. Too often the
delivery mechanisms that drive the individual AT market do not
meet the needs of the corporate market. Individual focus, stand
alone solutions, unique applications pepper the individual
market. None of these appeal to the corporate sponsor who needs
more universal solutions. While no one is advocating a corporate
"one size fits all" program, there is a need for consistency in
the application of AT solutions. This is especially true when 1)
corporate security makes individual "tweaking" of systems
difficult or impossible, 2) corporate operating systems are
server based or server oriented, a dynamic not found in the
individual field, and 3) corporate applications (like a mainframe
emulator) are often not anticipated by product developers and
consultants with an individual focus.
General Discussion:
All of this cries for the development of a corporate approach to
AT. Such a paradigm shift will not come without effort because
what the market is providing, in this case, has been determined
by historical, not future, needs. Why is the status of the market
place important? Because…
"The status of the marketplace determines our potential to
deliver timely solutions that truly meet the needs of the
individual and the corporation without sacrificing one for the
other."
At present, the solutions being generated by the marketplace are
dominated almost entirely by the individual paradigm. Even in the
corporate setting AT is delivered to the user not the
corporation. Currently, the marketplace does not recognize the
differentiation between individual and corporate needs and,
therefore, has not responded with any corporate solutions. Why
this is so can be explained on many different levels. At the
forefront is that corporate America itself has not recognized its
own need for a corporate solution. All too often, it is too easy
to accept the injury or disability as a final state and to use
short and long term disability insurance, both public and
private, as the "solution". Once the individual is out on claim,
it becomes their responsibility to rehabilitate themselves, and
the more aggressive among them seek out their own solutions and
develop their own technology. For example, a recent survey of
over two hundred blind or visually impaired people using screen
readers determined that more than one in five were AT consultants
or providers.
This one statistic goes a long way in describing the state of
the marketplace at this time: cottage industry. Disabled
individuals, their relatives, or associates develop unique
solutions for the one, and the marketplace snaps up any solution
tossed into the void. Even larger corporate developers tend to
focus on disability specific, single user products. Unique
solutions abound. Corporations, especially larger corporations,
spend their resources trying to make these individual solutions
work in the multi-user environment, too often with limited or no
success.
Currently in the marketplace, there are many individual AT
consultants and a corporation could, if they chose to, cobble
together a network of the individual consultants in each of the
various locations that need accommodations. This is not a good
solution. While we might be able to find a consistent level of
expertise in each of our markets, it is questionable whether the
application of AT would be uniform. Ongoing support is also
problematic given the difficulty of maintaining unique hardware
and software in a corporate IT setting. It is highly unlikely
most individual consultants would have the technical expertise to
troubleshoot problems. Corporately it is as important that the
consultant knows the corporate system as they know their own
products. And there is some question as to the independence of
each of these consultants to offer truly appropriate solutions.
Many offer only one or two products or specialize in only one or
two types of disability. To someone who has a hammer every
problem is seen as a nail.
Conclusion:
What is needed is not the reinvention of the wheel, but the
re-framing of a paradigm. Corporate users of assistive technology
are not different from their individual counterparts. In fact,
most are individual users when not at work. However, the
constraints that corporate users work under are far more
stringent and demanding than those who work at home.
Corporations, especially large corporations, are viewed as
having deep pockets. What is unreasonable for the small employer
is well within reach of the large corporate employer if all one
looks at is dollars. However, more often than not, cost is not
the issue. Applicability, flexibility, supportability are. The
corporation becomes the partner of the impaired employee. But
that facility of that partnership is often limited by elements of
the environment within which that partnership occurs. As noted,
this is especially true in the computing environment.
With a change in paradigm, developers can begin to design
operating system flexibility into their products from the ground
up. Often, with a desire to provide a comprehensive product,
developers paint themselves into a technological corner by
producing software that is unnecessarily complex, prone to
failure, and rigid in configuration in order to provide the most
in-depth solution possible. In the corporate environment, because
it is significantly comprised of the marginally impaired, a less
complex, and therefore more stable and fluid configuration would
meet the need. If developers realized the need, they would
develop the product. It’s a reverse of the Field of Dreams:
if the corporations come, they will build it.
Here is an incomplete, but provocative grocery list of
considerations for the disability services community:
First, from a delivery and support perspective, as corporations
become more diverse in location but more centralized in their IT
systems, there is a huge need for a multi-state, multi-discipline
presence for sales, support, and training. Individual consultants
can enter this market by developing business relationships with
other consultants in other metropolitan areas. Second,
consultants who specialize in products responding to a single or
tight constellation of disabilities can become more familiar with
and begin to offer more diverse products and services for a wider
range of impairments. Think AT not impairment. Finally, all
consultants can become more knowledgeable about corporate
computing platforms, server based environments, and various
corporate security systems. Press developers to modify existing
products to work with servers, legacy systems, mainframes, etc.
With this as a starting point, the way is opened for a wider,
more creative consideration of the corporate assistive technology
user.
William W. Simonds, MA has over 25 years of management
experience in medium to large corporations. Prior to joining
UnumProvident in 1998, he was Director of Assistive Technology
Programs for L. L. Bean, Inc. For the past year, he has been the
primary program developer for all assistive technology programs
across UnumProvident.
Mr. Simonds is a member of RESNA (The Rehabilitation Engineering
and Assistive Technology Society of North America) and AAES (The
Association of Access Engineering Specialists). In addition, he
has provided consultative input to companies such as Microsoft
and IBM on a wide variety of assistive technology development
issues.
Kenneth Mitchell, Ph.D. received his Ph.D. from the Pennsylvania
State University and served for seven years (1975 -1982) as an
assistant and tenured associate professor in the School of
Medicine, University of North Carolina, Chapel Hill. Dr. Mitchell
served for four years as a Clinical Assistant Professor at the
Case Western University Medical School’s Department of
Rheumatology. He also held a Clinical Assistant Professorship at
the Ohio State University, School of Medicine, Department of
Physical Medicine and Rehabilitation for 10 years. Dr. Mitchell
currently serves as a visiting faculty to the University of North
Carolina, Duke University Occupational Health Education and
Resource Center.
As a researcher, Dr. Mitchell has been the Principle
Investigator or Co-Principle Investigator on multi-year studies
and demonstration projects dealing with Arthritis in the Work
Place (PI); Disability Management and the Older Worker (PI);
Vocational Adjustment of Individuals on Renal Dialysis or
Transplant (Co-PI with the Cleveland Clinic Foundation); and the
Development of Disability Management Model for Small Businesses
(Co-PI).
Kenneth Mitchell was the Director of Vocational Rehabilitation
for Highland View Hospital in Cleveland, Ohio during the early
1970’s. Dr. Mitchell served a two-year term (1982, 1983) as
the Director of Rehabilitation for the Ohio Industrial
Commission. From 1984 to 1993 Dr. Mitchell served as the
President of the National Industrial Rehabilitation Corporation
and as the Executive Director of the International Center for
Industry, Labor and Rehabilitation, a private non-profit research
and education group.
Dr. Mitchell has been an International Visiting Fellow for the
World Rehabilitation Fund, completing a critical analysis of the
Accident Compensation Commission of New Zealand. Other
international activities include serving as an industrial
rehabilitation education consultant to the Canadian Disability
Institute, Toronto, Canada; the U.S. State Department’s
Joint American-Yugoslavian Disability Project; the European
Society of Cardiology, World Health Organization; and the
Worker’s Compensation and Rehabilitation Commission of
Western Australia.
Dr. Mitchell currently serves as Vice President, Return to Work
Programs for Provident Companies, Chattanooga, TN. In this role,
he provides program development services to large multidivisional
employers as a stand-alone service or incorporated within a fully
integrated disability insurance program.
Mitchell, K. "Principals of Vocational Rehabilitation: A
Contemporary View:, Treatment and Rehabilitation of Ischemic
Heart Disease. New York: Williams and Wilkins, 1980. Charles
Long, M.D., Editor.
Mitchell, K. "The Aging Workforce and the Politics of Incapacity
in the proceedings of the Eleventh Mary W. Switzer Seminar; The
Aging Work Force: Implications for Rehabilitation. May,
1987.
Mitchell, K. "An Employer Based Disability Management Model:, In
the Proceedings of the Statewide Conference - New Directions in
Worker’s Compensation in Western Australia, July 14, 1988,
Worker’s Compensation and Rehabilitation Commission, Perth,
Western Australia.
Leclair, S.; Mitchell, K. "Work Disability - Corporate
Assessment, Policy Development and Cost Reduction: A Resource
Manual for Employers" International Center for Industry, Labor
and Rehabilitation, Worthington, Ohio May 1988.
Mitchell, K.; Negotiated Disability, How to Prevent Light Duty
as a Career Path. Provident Companies Training Monograph. Fall
1997.
Mitchell, K; Leclair, S. Building a Working Alliance with
Employers; The Politics of Work Disability; Physical Medicine and
Rehabilitation Clinics of North America Volume 3, Number 3,
August 1992 pp.647 –663.
Mitchell, K.; Long, P., Lost Prevention and Disability
Management - An Employer Resource Manual. Acordia McElroy
Minister, Publishers, June 1996, 2nd Edition.
Mitchell, K.; Leclair,S. The Human Resource Managers’
Light Duty Survival Kit, Acordia, 1995, Columbus, Ohio.
Mitchell, K. Editor, The Medical Management of the Injured
Worker. A Single Day CME program for Family Practice Physicians.
A Cooperative Program with the Ohio State University, School of
Medicine, Department of Family and Occupational Medicine, April
1997.
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