Q&A: Microsoft, Rusk Institute Hold Forum on Benefits of Accessible Technology

NEW YORK, July 13, 2005 – The Rusk Institute of Rehabilitation Medicine and Microsoft today presented a forum, “Innovations for a Healthy Workforce,” at NYU Medical Center to show healthcare providers how accessible technology can enable people with disabilities or age-related impairments to re-enter or remain in the workforce.

A research study conducted by Forrester Data and commissioned by Microsoft found that 78 percent of working-age adults in the United States now use computers – 68 percent at home and 45 percent at work. Yet, according to the same study, 60 percent of working-age adults could benefit from accessible technology because they currently experience some type of disability, impairment or restriction that interferes with their ability to use a computer or perform other routine tasks. Now that computer technology is such an integral part of so many occupations, inability to operate a computer effectively can put workers of any age at a competitive disadvantage that may lead to unemployment or lack of career advancement.

Today’s forum included presentations by medical and technology experts about workplace and health issues faced by people with disabilities, and demonstrations of accessible technology that can help to mitigate those issues. Earlier, PressPass spoke with three of the participating physicians – all thought leaders in the field of accessible technology and disability – about the role of accessible technology in medical rehabilitation:

  • Mathew H. M. Lee, M.D., Howard A. Rusk Professor of Rehabilitation Medicine, NYU Medical Center School of Medicine; medical director, Rusk Institute of Rehabilitation Medicine

  • Mark A. Young, M.D., MBA, FACP, chairman of Physical Medicine and Rehabilitation, Maryland Rehabilitation Center and the Workforce and Technology Center in Baltimore, Md.

  • Bill Crounse, M.D., Global Healthcare Industry Manager, Microsoft

PressPass: One purpose of today’s forum is to help raise awareness among healthcare professionals about the value of accessible technology as a tool for rehabilitation. Why is that necessary? Don’t most doctors already know about accessible technology?

Mark A. Young. M.D., MBA, FACP, Chairman, Physical Medicine and Rehabilitation, Maryland Rehabilitation Center and the Workforce and Technology Center

Dr. Young: For a long time, traditional medicine and rehabilitation didn’t really focus on technological solutions for meeting the needs of people with disabilities. With the availability of bold, new, cutting-edge technology, that has changed dramatically. In the year 2005, medical professionals can choose from a whole array of innovative state-of-the-art technology, marvelous devices like screen readers or screen magnifiers, voice recognition software, and programs that make it possible for people to control a computer using only their breath or eye movements. We’re now able to harness technology very effectively.

There is more to medicine than surgery and drugs. There’s also the whole issue of helping people modulate their environment. One of our challenges has been getting the word out to physicians about the value of accessible technology for patients as part of treatment. I am deeply inspired by the example of my colleague, Dr. Steve Stiens, a physician and a person with paraplegic spinal cord injury, who works at the University of Washington in Seattle. He’s famous for saying, “Rehabilitation medicine is like doing surgery from the skin outward.” You’re modifying a person’s environment to help improve their quality of life. Really, that’s what rehabilitation medicine is, and I can tell you that accessible technology has facilitated that objective in the grandest fashion.

Dr. Crounse: One of the things we’ve discovered through some of the studies Microsoft has done is that even among specialists there often is not enough information about accessible technology and how it can help their patients. Nor is there always an appreciation for the degree to which a physical disability or impairment due to injury, illness or the effects of aging can impact workers and their ability to do their jobs. An important part of what we’re trying to do at today’s event is to call attention to the need for medical professionals to become more aware of what is available, not only the accessible technology Microsoft has to offer but also the software and devices Microsoft’s technology-industry partners have developed to assist people with disabilities and to help them remain productive.

Dr. Lee: I think it’s an educational process. Sadly, many medical professionals, like most people, become interested in rehabilitation only after a friend or family member experiences a disability. Educational conferences like these raise public awareness of how technology is being used to address these health issues, which will lead to more innovation in the future. It’s a matter of exposure. Education will lead to greater use of accessible technology, and that will inspire new ideas.

PressPass: How is the use of accessible technology changing or improving medical rehabilitation?

Dr. Young: It helps the medical professional and caregiver do his or her job better. Accessible technology helps physicians take the important leap from simply treating our patients’ injuries or diseases to enhancing their functionality and improving their quality of life. It gives us more tools to help them get them back to work, so that they can really start enjoying their lives again.

There has been a huge increase in the number of patients who have been able to re-enter the workforce as a result of technological innovations that allow people to do their jobs more efficiently in the face of disability, more skillfully, and with a greater sense of confidence and self-esteem.

Really, accessible technology can be viewed as a “magical bridge” that helps to connect a person who has a disability to his or her workplace. Working with people who have disabilities gives renewed meaning to Freud’s famous proclamation that “the two essential things in life are to love and to work.” In many cases, accessible technology is the critical link that makes it possible for our patients to return to the workplace.

We have to remember that along with technology innovations we have also seen marvelous developments in medical techniques – from diagnosis to treatment – that are enabling people to live a lot longer and a lot better. Pharmaceuticals fight disease and help to prolong life, but accessible technology goes one step further. It helps to prolong quality of life, so with accessible technology we’re adding life to years, not only years to life. I think assistive technology is an extremely powerful medium that doctors need to use in their practices.

PressPass: So is accessible technology allowing you to offer your patients work-related alternatives today that weren’t possible before?

Mathew H. M. Lee, M.D., Medical Director, Rusk Institute of Rehabilitation Medicine

Dr. Lee: Absolutely. At Rusk, we have looked at this issue very closely. Technology creates many new work options for people. Let’s say, for example, that an insurance company employee suffers a spinal cord injury and has to use a wheelchair. One of the biggest employment challenges for people in that situation is transportation, just getting to and from the workplace. They have a heavy piece of equipment that travels with them, and often that requires assistants and special vehicles. Technology enables people to work from home, to receive and process information just as efficiently as they could at the office, so in many cases the workplace can shift to the home environment. That is a great advantage for people with certain disabilities.

Dr. Young: Yes, that’s an excellent point, but it’s also true that accessible technology makes it possible for many people to return to work in the same location, despite severe disabilities. Computers are so widespread and so readily available in the workplace, and so essential for so many different jobs, that it is easy to leverage technology for the benefit of a person with a disability.

I think very fondly of a patient of mine who became blind rather late in life. He worked in a call center as an airline reservations agent. After his disability became worse and he could no longer see, he was in quite a pickle. But today we have solutions for that kind of problem. With the right technology and training, he was able to go back to work and continue his career. This kind of thing was unheard of 10 or 15 years ago.

We’re seeing remarkable results in some cases. In working with young patients with Parkinson’s disease or spinal-cord injuries, for example, they have motor impairments such as paralysis or significant weakness that prevent them from using a computer initially. But once they’re provided with the tools to succeed, whether it’s an adaptive keyboard, a specialized mouse, or voice-recognition software, their lives truly open up and start to bloom. It’s really impressive.

Dr. Lee: Another point I want to make is that some of these new options are only possible because of the Internet, which has made a tremendous difference in the lives of people with disabilities. At Rusk, we teach children with disabilities how to use computers. I tell them, “You press a button, and you are connected to the world. All you need is intelligence.” Computers and the Internet give these children access to information and experiences far beyond the four walls of their rooms.

Last week, I had a meeting with three recent war veterans. One was badly burned on his face and hands because of a tank fire, another had lost his arm, and the third was hit by a grenade which put him in a wheelchair. I told them the same thing I tell the children: “You’re only limited by your brain.” I can say that truthfully today because accessible technology eliminates old barriers and creates new opportunities for people with disabilities.

PressPass: You mentioned age-related impairments. How does age factor into medical rehabilitation and accessible technology?

Dr. Young: As our population ages, we’re seeing more and more people with disabilities in the workplace. In my work I deal with many people who have severe disabilities, but there are even more people who aren’t likely to end up seeing a specialist in rehabilitation medicine yet could benefit tremendously from accessible technology. These people are members of the baby boom generation, folks who are aging in place. Generally, they’re healthy, but they’re gradually losing some vision or hearing or dexterity. They can’t hear as well, or grip as tightly, or see words and images on their computer screens as well as they once did. We all experience that sort of thing as we age.

Bill Crounse, M.D., Global Healthcare Industry Manager, Microsoft

Dr. Crounse: This is an issue throughout the industrialized world. In Europe, Japan, all of the developed countries, the workforce is aging rapidly and people are increasingly dependent on computer technology to do their work. Statistics show that seniors are one of the fastest growing demographic groups on the Internet. Partly that’s because the Internet is becoming so much a part of the social fabric of our daily lives. We use it to keep in touch with friends, family members and colleagues, and increasingly we are expected to turn to computers and the Internet to conduct a lot of our business – from filing our tax returns to paying our bills or arranging our vacations. Not only our work, but also our life outside of work, is placing greater demands on our ability to use technology, and on the ability of technology to adapt to our individual needs. Using computer technology and the Internet is clearly becoming a life skill, and its importance will only increase over time.

If you look at some of the more subtle effects of aging such as mild-to-moderate loss of vision, hearing, dexterity, or cognitive ability, there’s no question that if we’re going to keep these aging workers in the workforce, which our economies will demand that we do, then we must be prepared to offer assistive devices and technologies that will allow these people to remain productive. In some cases, that may be as simple as making sure that aging workers and their employers know how to use the accessibility features that are already available on their computers, the capabilities that are inherent in the software as it comes out of the box.

PressPass: Can you explain what you mean by accessibility features and capabilities that people have available on their computers already?

Dr. Crounse: Sure. I consider myself a pretty savvy technology user, and certainly someone who knows a lot about Microsoft software, but, until I started working with the Accessible Technology Group at Microsoft, I didn’t know anything about the accessibility features that are built into the Microsoft Windows XP operating system. I didn’t know that the software included a screen magnifier and a text-to-speech narrator to help people with low vision, or an on-screen keyboard for people with dexterity issues. And I didn’t know that there was an Accessibility Wizard that would ask for information about your particular disability and then guide you through the process of fine-tuning such things as screen color and contrast, font size, or sound and visual alerts that can be extremely helpful to people with various impairments. All of these things are easy to find and easy to use, but most people don’t know about them.

Dr. Young: I agree. Operating system optimization has been a key factor in helping to improve the lives and destinies of people with disabilities by providing them with accessibility tools that are as close as their mouse or their keyboard. The magic of the Windows operating system is that it allows people to make small adjustments to their computers to keep pace with the gradual onset of age-related impairments. For example, as it becomes increasingly difficult for an aging worker to see letters on their computer screen, they can adjust the font size and eventually switch to the screen magnification feature. Windows is almost like a survival toolkit for the aging workforce.

PressPass: In addition to forums like the one Rusk and Microsoft are co-hosting today, what else is being done to educate healthcare providers about the benefits of accessible technology for people with disabilities?

Dr. Young: I have been on the forefront of educating colleagues and young residents. At our facility, we pioneered a residency rotation that focuses on teaching young physicians about the power of accessible technology, and when and how to prescribe it to improve the quality of life for the people they serve.

We’ve also taken our educational endeavors internationally under the auspices of the International Society of Physical and Rehabilitation Medicine. My research group and I have presented technology workshops in Brazil, Israel, Lithuania, Italy, Greece and many other international locations. This has a lot of meaning, because the use of technology is really just beginning to blossom in many of these places, and the lives of people with disabilities in the workplace are being transformed.

PressPass: Looking ahead, what else needs to be done?

Dr. Lee: The cost of healthcare is equal to about 20 percent of the GNP; in 1960, that figure was 8.6 percent. As people live longer, the cost of medical care will go up. Prevention is going to be more and more important, keeping people healthy and independent for as long as possible is going to be important economically as well as personally. Making accessible technology an integral part of medical treatment for people as they age will be one of the keys to helping people live full and productive lives.

Dr. Young: Tomorrow’s generation of employable individuals is going to be older people with disabilities. People who have talents, who have been strong all their lives, and then because of age start to experience chronic pain or visual difficulties or other issues that need to be overcome.

Technology providers must have a staunch and unwavering commitment to keep innovating, to be on the forefront of discovery, to provide adaptive solutions to meet the needs of people with disabilities and, more importantly, to meet the needs of the masses. And in this case, the masses are the people who are growing old and gray, but have wonderful skills and need to continue working into their later years.

Dr. Crounse: Speaking on behalf of Microsoft, we couldn’t agree more. As a responsible company and a technology industry leader, Microsoft would be negligent if we faltered in our commitment to innovation and accessibility. We have been working on accessibility issues for a very long time, well over 15 years. We have whole teams of researchers, scientists and developers working on building accessibility tools into each new version of the Windows operating system and many of our most popular applications. And we continue to work closely with our assistive technology partners to make sure there will always be a full range of Windows-compatible assistive devices available to the people who need them.

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