Digitally Shaping the Future of the Prosthetic and Orthotic Field with Tony Gutierrez

Together , we will uncover the ways to make the lives of those relying on these incredible technologies even better . We hope these discussions are going to be the highlight of your day .

You know what's interesting about this podcast and is really the one of the last ones of the last season is we get a lot of comments on the one about how prosthetics and orthotics can be involved in multiple things , Kind of like when we dreamt a little bit like hey , you can , yes , you could be into shoes , but you could be into bike fitting .

You can fit the body , potentially exoskeleton . I can't tell you how many comments I've gotten about that specific episode and it was really neat .

So I thought that was really cool .

Thanks for telling me that .

I can't even imagine how he gets anything done or sleeps , Because now they have offices really all over the US , especially East Coast and Central , and so you've got multiple time zones and all that . But I wanted to have him on . He's not only a fan of the show , but he said hey .

I really love what you guys are doing and would love to share , also about some of the stuff they have coming down the pike , which is one source , and we'll dive into one source a little bit .

But the idea is and yours and I , yours , you and I have talked about this how , how can there be one place to get everything , so your electronic medical records , your fabrication , digitally scanning your notes and getting all the stuff ready so you can actually bill the insurance and get paid for the device ?

And that is essentially what one source is , at least what I've understood of it . So I'm really excited about diving into that and then also hearing Tony's journey as well .

So I ended up completing with my undergraduate from IUPUI in Indianapolis with a mathematics degree and the entire time I had the opportunity to do research in a biomechanics laboratory . So I really learned a lot about the human body and approaching it as a machine and how things work , how the muscles and joints work together to perform a motion .

And when I graduated IUPUI I went on to the University of Wisconsin and I was actually in a PhD biomechanics track . I really was interested in prosthetics but , coming from a mathematics background , none of my advising faculty had any clue what prosthetics were , so I thought that I'd kind of attack it from the research route .

So my master's , my graduate work at University of Wisconsin , was really focusing on balance during walking and how different joint mechanics and the central nervous system work together to keep us upright and stop us from falling . You know , really a simplified biomechanical model to say how do people stay upright and walk .

And during that journey I had the opportunity to present at a conference at the Rehabilitation Institute of Chicago and as I was walking around and meeting people , I walked in and received a tour of the Northwestern University Prosthetics and Orthotics Center and that's when the bell started going off . So I was like I can do this .

I can , I can play with all these cool things . I can help people , I can build things . I can help people walk again , use their hands again . Sign me up . This is this is what I'm interested in . So I actually ended my time at UW at a master's level and then enrolled in a New Pox Prosthetic Certificate Program back in 2010 .

And you know , my my interest at that time purely lied in looking at the human body as a mechanical problem that could that needed to be solved when there was some kind of injury or missing part or whatever it may be .

I soon learned throughout my career that that really is a small part of it when you're when you're working with patients and trying to provide a holistic treatment plan .

But but that's my journey , you know , and I think if I started again today , I don't know if I could get back to that same spot , but you know , I love the opportunity to use my hands every day , to build something every day and to have impact on people's lives every day .

That's always this helping thing , and everyone's way of getting here is always just like completely circuitous and kind of crazy . So so , so , uh , yeah , so that

sounds really interesting . And what did you ? But what did you do after that ? How did you ? How did you continue your career and then helping people and then , and then , yeah , getting the stuff met .

But just after school I was , uh , I was fortunate to , you know , land a residency with a place that I had been shadowing at during the online portion of my school at Northwestern , and I had practiced with a with a small practice named orthotic prosthetic specialists in Northwest Indiana , uh , under a dear friend of mine , joe Rooker , for about three and a half

years , and then he , uh , you know , he was ultimately kind of winding down in his career and I was just getting started , um , you know so that was the you know at that that at that point it made sense for me to kind of , you know , look to join another practice , and that's when the journey at Bionic started , um , but you know , one of the I think the

kookiest parts of this story is , um , and , and Brent Brent's probably of this age range too , in the field , you know , during my residency it was great , it was a residency . I learned everything . I was in a lab of building everything . You know , staying at the lamp till midnight modifying sockets , uh , you know , making making prostheses for people , um .

But at the end of my residency , we had this wonderful thing crash into the industry called Medicare Rack Audits , which really almost crippled the industry , because orthotics and prosthetics , um , back then and and really for its entire existence was , was a network of mom and pop shops , um , that are just in an area serving their community taking care of the patients

, and the rack audits really , really affected the industry , uh , in a in a terrible way . It it created such a financial pressure on all these small practices that are , you know , just doing what they can to , you know , to to make a small living , uh , make a little bit of money , take care of their patients , um .

But there was a time I remember during my , just after my , residency , that we got rack audits on 22 prosthetic cases in a row , uh , which had anywhere from a six to 12 month resolution period . By the time uh , all all of this was all of the uh paperwork was acquired , all of the appeals were , were , were completed and it was a .

It was a challenge in the small practice especially . You know , joe's practice is . His notes before I walked in were uh , patients , uh , bk amputee . They're going to be a K three level uh expect good results . They need , you know , low profile carbon fiber foot and a pin socket system . That was an evaluation , you know .

And then we had to radically change the way we thought about evaluating patients .

The level of complex medical documentation we had to collect from not only ourselves but supporting physical therapists , occupational therapists , physicians , and and nobody knew the language of prosthetics orthotics , uh , nor the rules to be able to get these things reimbursed in a timely manner . So that really is .

You know that that's what I was born into into the field of prosthetics orthotics , um , so that's , you know . A lot of what I do today was was born out of my , my pure hatred of writing long notes .

I'm doing this .

I don't know if there is any logic behind it , but , um , I guess that the you know there was probably some times where there was over prescription of devices going on in the prosthetic and orthotic industry , uh , and they probably dug into some cases and found some fraud going on , um , you know , throughout practices , uh , or or over prescription of devices or or

technology for patients .

So they they wanted to I think they wanted to make it clear that , as prosthetists and orthotists were , we were a supplier of medical goods , uh , to patients , um , and we we need to practice under the the order and direction of a physician to ensure that what we're planning to supply for this patient is truly meeting their unmet medical needs and gonna support

them to regain their mobility or activity in any way possible .

And so when you start looking at those dollar claims and then potentially some other big dollar claims that are kind of associated or allied to that , then prosthetics was like a very easy target at that point in time as well . And so that's to me that's another catalyst .

Is the orthotic and prosthetic industry never separated itself out of this kind of durable medical equipment and established themselves as like a professional field that is on par with , say , physical therapists , because physical therapists did it , occupational therapists and then obviously physicians , and so this kind of guilt by association was also happening during this time .

He said literally Brent , I had a guy show up in a Bentley covered in gold chains wanting me to build wheelchairs for him . It's like the Nigerian Prince scheme and he wasn't alone in that .

And so you have these people that are probably in jail now because of fraud , but literally going after true businesses , and these true businesses that were kind of struggling anyway and looking for a quick book kind of got sucked into this thing and it just became a mess . So it's crazy , some of this stuff .

to physicians to help them be a part of your plan and support what your medical decision making was for the patient . So I wanted to be able to say hey , joe , you're a great clinician but you type with your pinkies at three words per minute .

How can I help you see all the patients that you want to see and help your practice , you know , become remain financially viable while battling these , these changes in the way that Medicare is looking at reimbursement for prosthetics or thought X .

So that's where I started really playing with with automation of documentation , creating good templates , creating note templates , l code templates , physician communication templates , and trying to create that in a easy to use system .

For Joe , who really only saw the value of a computer , of checking his fantasy football scores , but you know , had had invested in this practice to utilize multiple different medical systems to make it easier . So that was that that . That first goal is how can I help Joe ?

You know , if I leave this practice , I don't want Joe's practice to close because he's a good friend of mine , he still takes me golfing every once in a while . So that was kind of the project in the beginning is , let's , let's make sure Joe has , you know , the best leg he can stand on to fight these things in his small practice .

And you know , like I said , purely out of out of a dislike or displeasure of writing notes , I tried to create these automatic pathways .

So what we , what we did is we really focused on on growing our practice in our area and being able to integrate more strongly into this surrounding medical community . And in Brent , I'm sure your practice can speak the same language as this . When you do good work and you take care of patients , more and more patients start coming in your door .

The community recognizes your efforts , they recognize that you're a value to whatever population that you're working with , and then they're going to support you .

And you know , at Bionic we were , we were doing great work , we were growing , we were being asked to office , open offices and new locations and shortly after I joined , you know we were at 13 clinics in that same area and not much change in the amount of clinicians we had , because I think we're all well aware there's a clinician shortage .

You know , and you know we're we have a challenge in our practice because we bought up to the city of Chicago , so a lot of people that want to come to this area , want want to work in Chicago , don't necessarily want to work in our lovely state of Indiana , which is great , by the way . I highly recommend anyone come visit Indiana . It's a wonderful place .

So we we were forced to figure out how can we be more efficient , considering we have limited resources . And , and you know , the next real , you know , propelling point for me was I was , I had my practice and I had my own fabrication lab .

In my practice I had two small children they were four and two at the time and I was , you know , averaging , with myself and my resident , probably 25 prosthetic patients a month and my resident was managing another 50 or 60 orthotic patients a month . So we were busy and I was building everything from my practice and a couple other practices .

So there was a couple of months in a row where I'm getting in at 5 am To make sure I can pour all the casts up and modify them and get check sockets pulled throughout the day , getting all my notes done throughout the day so I can see these patients . And you know , we're we're we're prosthetists and we love our patients .

So we tell everyone hey , we can see you in two days for this check socket fitting . Let's go , we're excited to get you up and going . So you know I drive home 45 minutes , have dinner with my family , put the kids to bed and come back to the lab till 11 or 12 o'clock at night .

And that was just a very regular occurrence for me and I started to know what started to notice burnout occurring and that that's not a good sign . And you know so early in your career . You know you're so dedicated to your craft and helping people that it starts to affect every part of your life . So that's when you know I we bought our first 3d printer .

I think Brent was actually one of the first people I called said hey , I bought this . Can you tell me how it works ? I don't know if you remember that , brent , you were helping me in my resident at the time .

But it but it was that step in the right direction that , hey , we can . We can offload our workflow just a little bit . You know , with implementation of this technology , and you know , then that's when the automation of Documentation really started to take place .

You know , if you , I don't know what health record system you guys use , brent , but we use opi and bionic .

Yep if you sit down and have a Young , active patient that needs a microprocessor knee and you know , maybe a vertical shock foot coming to your clinic and and and truly document why they need to get out of a mechanical knee and get into a microprocessor knee and build that chart .

No , check all your L codes , make sure your justifications are correct and you don't have any wrong names or wrong words in there . Order all your parts and then go back in the lab and take that cat , that wonderful cast you just took , and modify it and pull a check socket .

That that's easily three and a half hours worth of physical manpower to be able to get that complete . And when you , when you have that volume of patience per month , then you have , you know that , two to two and a half to three and a half hours of just data entry into a computer per patient .

That's not what we're built for and I know Brent can agree with that a hundred percent . You know we're not orthodist and prosthetist because we love writing notes and love checking all the right boxes .

You know we're worth it is in prosthetist because we're Excellent at seeing a biomechanical problem and applying a solution to it and helping someone become mobile again . So that's really when I , you know , I started to Turn my focus . You know what ? Can I control the printing technology ?

It wasn't quite there yet to help us fully automate that side of the practice , but I could Really focus on how can I make this time I spend in an EHR more efficient , you know , and that's that's really where the idea of one source Started to take off . You know , we were able to .

I Was able to create a custom software solution Utilizing some free tools that I found , and I have a little bit of coding experience , but nothing , nothing extensive , just a lot of hard work and man hours . I think I spent five thousand hours Making it , so I don't have to write a one-hour note at this point in time .

But that that's where we really saw the implementation of us , of a system like we call one source , you know , being really utilized in a practice . How can we get great , consistent results that are Error-free and only take a few minutes of a clinician's time ?

And then you can have a support team behind them , really support them , so they can focus on what matters most .

And you know , during this time you know , I think in the beginning of my residency I spent 90% of my time with a patient , 10% of my time within a computer , and I feel that has changed over this past 13 , 14 years , where you spend Maybe 20% of your time with the patient and the rest of your time you're trying to make sure .

Hey , how do we make sure we get this device paid for so we can keep seeing more patients ?

So just for our listeners and some people that listen are not in the OMP field , so they don't necessarily , or they may be a patient they don't understand the pain that we feel on the backside , the stuff that they don't see , and Then can you take us through how that would work in one source ?

You know your history , how , how you got to to this point of your amputation , whether it's a new amputation or whether you've been an amputee for a while , but we need to understand , you know what your activity level was prior , prior to your injury , what your goals are and what we think your activity level can be with the implementation of a new prosthesis .

We've been fortunate in prosthetics over the last decade to have a lot of wonderful technology introduced that really , you know , helps our patients do Amazing things on a daily basis . Now , with this new technology that's been introduced , there's always a challenge on the on the payment side .

So we , like anyone , we , you know we want to help you out , but we also need to get reimbursed for our services and George brought it up that you know , prostatious and orthodist . We're not , we're not paid for time work , we're paid for a device and helping manage that device over a specific period of time .

So you know , after I saw you for that hour in clinic where we really , you know , put together this holistic treatment plan , you know me and the patient together .

You know I would I would take my cast of the patient and then go straight to my computer and try and document all of this stuff in a clear manner that I have to take time and review what your specific insurance policy is and what level of technology we can Fit you with , as well as what the requirements for implementing that level of technology are and Not

all all insurance policies are different . So there's there's the time for the research on that . Then we have to properly say I think you know you've you've been using a mechanical need for the past couple years . You have , you have a history of falls , you feel like it's holding you back and everything you want to do .

There's a microprocessor need that I can really enhance your stability , that can really help you regain that independence that you've been struggling to find . That's since your amputation . This is why I think it's medically necessary for you .

And then when you rely on support from the manufacturers , they give you all of the the technical bells and whistles lingo that tell you how it works , but they don't really provide a lot of support as to as to why it works .

So that's , that's really a large part of our documentation Timeline is trying to match this level of technology to your specific needs as a patient . So what ?

What we've done in one source is we you know being being a large practice that sees a large volume of patients and deals with a large scope of insurance policies and criteria for coverage for all sorts of medical devices we were able to create a more efficient system that can allow our practitioner to document all of this information , with all of the complexities

of the ever-changing reimbursement landscape , in about seven to ten minutes , once they become efficient with it . So once you know that and a lot of them are practitioners will do this point of care Documentation in the room .

So as soon as they walk out of the room , in that our time frame , they've They've seen you , they've evaluated your needs , they've documented what those needs are and and their charting is complete . They don't have to go sit down for another hour and a half , two hours to To focus on the rest of it , to make sure that .

Hey , I told you I'm going to get you your prosthesis in about three weeks , but I messed up my coding three times and I messed up what I had needed your physician to say .

So now it's a six week , eight week timeline , or hey , we got denied by your insurance company because our documentation didn't say that you know why this specific feature of a microprocessor knee is beneficial for you . So now we have to fight and appeal that for the next two months to be able to , to get you what , what you deserve and what you need .

So we , we've created this nice holistic platform that Our clinic , our clinicians , can quickly navigate and really Pinpoint the medical need of any device that they want to give to a patient , all before they leave the room and then and their their L codes that describe the prosthesis are correct , the justifications to support those L codes Specific to your medical

needs are correct , the documentation that we need the physician to To corroborate and then make a part of their medical record is correct . And we can , you know , get that information off the same day to a referral sources to really expedite that authorization process .

And then , you know , really , with the implementation of the digital workflow and utilizing printers in our practice , you know we're not staying till 10 o'clock at night pouring cast up and modifying them anymore .

You know we have the ability to capture a limb shape with a scan in a matter of minutes and get to our computer , you know , modify your scan based on your clinical needs and send that scan right to the printer and get it started . And you know , at the height of my time seeing patients on a full duty , I was utilizing this one source system .

I would have a patient come in . My first patient would be at 8 o'clock . We do the evaluation process . I would scan them . I would say , hey , go get a cup of coffee or breakfast . By the time you come back , maybe around 10 o'clock , I'm gonna have your check socket ready for you and we're gonna get you walk in today .

We're gonna see how things are working . If we need to make any changes , go out and grab lunch , come back , you know , at 1 o'clock we'll have a second check socket ready and that's . You know , that's a model that really , you know , disrupted our practice , because I'm sure Brent can speak to it too .

You know , usually you see a patient come back in a week . We have a check socket . Oh , it's 10 plight too big . Oh , I'm sorry , come back in another week . Okay , this one's pretty close , but you know we need to .

You know we didn't schedule enough time for us to be able to walk you today , so come back in a week , we'll get you up and walk in .

We're already three weeks into that timeline and three weeks of immobility or discomfort for that patient , depending on what the level is , before we're even ready to say , okay , this prosthesis is ready , but is our authorization in time ? Is our compliance good ?

Are we able to say , hey , we have this prosthesis fully authorized for you and we can meet that three week goal ? And chances are in most practices , no , that that's not occurring .

You know we're seeing more and more pushback from different payer sources saying this isn't enough , this isn't enough , you haven't justified this , so it's taking more and more time to get you back .

It's taking more and more time of our clinicians really focused on the medical necessity , documentation , charting time , and all that's doing is delaying our care and the ultimate , you know , payer for that is the patient . You know it's .

You know we're delaying your ability to get what you need in a timely fashion because there's so many things that we can't control in this process .

But I think for a lot of people listening to me , I'd be like , yeah , okay , that's like yeah , never 10 years or something , but I'm liking very much this , this time saved . You have any kind of indication , like it seems like you were talking about three hours versus seven minutes , is it ?

You know , by adopting as yourself , do you know how much time you guys are saving , like in hours or expressed in a kind of way , or you know it's .

But once we were able to implement some , some high flow printers and really create that speed in the process where we can get a diagnostic socket and just just about an hour or so , all of our clinicians went from I'm never going to use printing . It doesn't work , it's never going to be vital or it's never going to be a crucial part of my practice .

To six months later is like I don't know how I ever did it . Without this digital workflow I have so much more time .

We're seeing our practitioners efficiency go through the roof because they're able to see more patients in a day , they're able to build their practice , they're able to see more of their practice at the rate that they want to build it and and they're all going home at at five o'clock .

They're not carrying the burden of I have to get my notes done or I have to get in the lab and modify a socket done with them . So you know , one source has kind of had the same effect on all of our clinicians . You know when , when we tried to implement it with everybody , it was a bunch of naysayers in the beginning .

I've already got all my templates built and they work for me and they work well and I , you know I I don't think this is going to work to . You know , within our practice alone Since full scale implementation in November of last year , we've had about 800 prosthetic cases go through one source and well over 1000 orthotic cases go through one source .

And you know the the time saving that we've seen is Reimbursement . Challenges are real across across the board and let's say we want to implement something like a microprocessor ankle for a for a below the knee patient .

On the authorization side , it would typically take us at least two rounds of appeals with a payer source to be able to get that approved and implemented on the patient and we're starting to see the documentation packet that we're able to submit , you know , go through on first pass on these authorizations and it took our clinicians not several hours to fully understand

and document this and and match the needs to the patient specific insurance policy . It just took them a few minutes and they were able to , you know , march along , provide that next patient with care . So I guess that's a long answer to your question , joris .

I don't , I don't have a physical , you know , time in front of me , but I know that if I sat down in front of my computer and documented what I had to document , like the like , the output of one source , it would probably take about an hour and a half , and I'm probably one of the most skilled in the practice .

So , you know , we have practitioners from residents all the way up to to 65 years old in our practice , you know . And so for even seeing some of the , the old people , some of the older , older guys and gals that have a fully adopted one source into their practice and , you know , really are utilizing . It is awesome .

And another bright point of it is , you know , because of our practices , grown fortunately , over these past couple of years , we see a lot more cases coming through than the average small practice . So we're able to catch reimbursement trends and make changes to the one source platform on the fly .

So , you know , maybe , like like six months ago , we noticed that every , every claim coming from from a Medicare payment plan was getting denied for ultralight and acrylic codes because they weren't properly documented in the chart note and the work order .

So we were able to implement a change into one source overnight , essentially , after we realized this trend , and we were able to stop that . You know , those denials , you know and those denials and authorizations coming through that delayed patient care . So I mean the time , the time saved , you know , can't just be measured on the clinical side .

I think it's , it can also be measured on the administrative side and it's been significant for our practice .

Like the idea is I get my customer in quicker , I get my money quicker , I can invest quicker , pay people quicker , everything . My cash flow is much better . And I love that idea of being able to optimize for that kind of thing and then , and also , like you know , just be able to spot where the problematic areas are .

You know , maybe for some people it doesn't make sense to do certain things because you're actually a few . If you look at it , you know the it's not profitable for you .

So I think , and I love this just for the profit velocity perspective , and you know , especially if you sometimes , with a mistake , have to wait a number of weeks for getting approval and then the number of weeks as subsequent to that for cash flow , I think that could be super viable for either business that are small or those that are cash constraint or those

that are expanding very quickly .

And that average small business owner they're not just seeing patients , they're also the accountant , they're also accounts receivable , they're also accounts payable and and that's a challenge , right , you know you have all these other side side jobs . You're trying to negotiate the best possible prices that you can with your vendors to to get yourself a break .

But you know you can't compete with some larger companies because you just don't have the volume to do it . So you know your your cost of goods can can be quite high and then if you factor in your time cost as well , you know it really is a struggle to remain profitable and grow your business as a small practice .

Do you see a model for stuff like that , for for kind of this hybrid chains , where , where , where is more about working together ? Or you know we're , we're talking about a kind of a I don't know what you call it a purchasing combination where you know you don't do anything together but we buy stuff altogether , so we have a better negotiating power .

You know , our clinics to grow into and everyone's clinics to grow into is , you know you , you feel like you know prosthetics can operate like , almost like , in a retail space .

You know your , it's not your traditional old building that has , you know , a lab in the back and it stinks like resin and it's dusty everywhere because we're a bunch of kids playing in plaster in the background , getting dirty and and grinding on carbon fiber .

You really want to try , and you know , make this experience as positive as you can for the patient and you know , with you know , in our one source platform , we're not nowhere .

Part of the platform that we're launching is we have agreements with all the major manufacturers in the lower limb and upper limb prosthetic space so that we can utilize our size and our buying power and pass those savings on to those smaller practices , and that's really where we see the value of this , in addition to the automation of compliance and automation of

digital workflow and providing diagnostic sockets . That's really cool .

You know how profitable is that , you know you know , is it profitable ?

You know you would see the cost of some of these prostheses and assume that all prosthesis and practices are flying around in helicopters and driving Porsches . I don't think that's the case . I've got a Subaru Outback with 250,000 miles on it .

But the one thing that you know Tony kind of alluded to at the very beginning I mean , you heard his journey five o'clock in the morning and he's pouring casts at 10 o'clock at night , getting ready for the next day . Well , I can tell you definitively that this next generation of prosthetics have no tolerance for that kind of work .

It's not that they don't work hard , they're not going to work those types of hours . They want to work smarter , not harder . And so one thing that's interesting and as I'm here and Tony explained this , like Bionic can now go out and say listen , we want you heading home as quickly as possible .

We want you to be going home knowing that all your notes are complete , your justification , all that stuff . We call it the hot potato . Right , the hot potato is in somebody else's hands . It's either on the 3D printer , it's in the administration hands , but it's not in your hands .

And I think a lot of younger clinicians coming out of school are going to be looking for situations to get themselves into where there's this and I know it's cliche and I hate even to bring it up like this idea of work-life balance , because for me , tony , and probably it's very much the same my work and the play , they go together and it's in harmony .

But for this newer generation of clinicians it's , you know , once the clock strikes , whatever they're off unless they're on call and they're out with friends , family , what have you ? And that's really the expectation . So if you're able to help them achieve what they feel is the work-life balance quote unquote you have something to .

You have an advantage to getting some of these new clinicians you know from school and that's the only way right now that you're going to be building a practice and growing , because there's , like Tony said , there's not clinicians just hanging out there looking for jobs Like you've got to do this organically and I guess I would say I'm a little bit jealous on that

side because that's something that you know . We have some of the different 3D printing side of things , but this front end is a big deal .

You know , having these printers working all day and you know , right now our practice as a whole is at a 95% digital prosthetic workflow on the diagnostic , preparatory and flexible inner and we're still combining the hybrid approach , using a lot of laminations , having fully dived in , like your group has , with utilizing a more definitive approach to printing sockets .

But yeah , the inspiration , you know you can't go , you know , unnoticed in this because you know seeing what your team is doing and the effort you've put into industry to really try and change a thought process , you know it was inspiring and that's really where a lot of this took off , you know , and really said , okay , can we ?

We were able to tackle the problem of digital workflow . Now let's tackle the problem of patient chart workflow and we're starting to see the fruits of it .

And what we're doing is because of the size of our group and the buying power of our group . Our goal is to pass those discounts on to you , so to get in the taste of OneSource , then let's walk through an average workflow and walk through some scenarios .

Brent , if you went back to your workshop right now , are you going to see all of the same boxes from the same manufacturer on your shelf ? Or do you operate in a greatest hits landscape for prosthetics like the rest of us do ?

That saves us time , unprocessing , and it saves us some money there too . But I think that's what's interesting is this idea of it's one check for this and you get essentially a leg in a box right .

Then you can choose your lineable components from Bulldog that make the most sense for you . You can change your suspension mechanism from Bulldog as well . Then you can choose your foot option , that hydraulic ankle space .

Right now , at the K3 level , our current options are a you know , proteor Kintera and a College Park Odyssey two of the most popular feet on the market . Our goal isn't to offer everyone's entire catalog for purchase .

I'm sure that you've gotten lost in an SPS catalog or a vendor catalog brand trying to decide between the 95 different low-profile carbon feet that are out there . We're giving you a peek into our practice of what our most successful solutions have been over time and what our most advantageous solutions for the patient have been over time .

In our one-source platform we've got K1 , k2 , k3 options with the most common coding sets . For the K2 , we look at that flexible keel multi-axial ankle or flexible keel hydraulic ankle . We can add vacuum into those systems . At the K3 , we look at the low-profile carbon fiber feet , the hydraulic ankles , the vertical shock feet , the microprocessor ankles .

We have mechanical knees , we have microprocessor knees in the platform . We're really selective in who we're letting into this one-source group . We only want to use the best of the best that are out there .

We want to be able to get our clients within one source , a price that is either better than they're currently paying whether it be direct through a manufacturer or through a distributor or at least on par with what they're paying . There's the added benefit of your notes are done , your compliance is in check .

You have two diagnostic sockets coming with this one-source package as well . We want to be able to offer someone a turnkey solution , to be able to say , hey , this has been the biggest struggle in my practice is trying to manage all these different balls that I have juggling in the air .

We want you to say , hey , I need to focus on patient care and one source is here to help me with that .

Ultimately , all you want to do is take care of your patients , but you also got to take care of yourself and your family too .

The digital stuff is really the openness and letting other people learn from experience , which a lot of times involves costly mistakes . Thank you for coming on for sure .