Welcome back to OrthoAmerica's online cranial training program. This module will focus on the SmartSoc scanning technology. Only a brief overview of the SmartSoc system will be presented, and specific topics to be covered are patient preparations, scanning tips, report functions, and directing clinical care. Please note that the SmartSoc training program provides much more information and is a requirement for purchase and use of the technology. Prior to 2000, the most common method used for obtaining a mold to create a cranial remolding orthosis was the plaster casting technique.
This was a very labor-intensive, messy, an unsettling procedure for everyone involved. Today, cranial orthotists have transitioned to scanning procedures for the improved clinical efficiency, accuracy, and effectiveness. The SmartSox system eliminates the need to take messy, expensive, and time-consuming plaster casts.
The speed and efficiency of the process allows the capture of a scan in about three minutes or less. The system is extremely portable as the phone fits into a pocket with a smart sock garment and stickers. The cloud-based system allows easy access to the data by the clinician and OrthoAmerica. This system improves patient management procedures by documenting cranial shape and volume changes throughout the course of treatment.
It helps to direct cranial care efforts, supports the efficacy of the treatment program, and reflects clinical outcomes at the end of treatment. The SmartCam is used for fast, safe, and accurate video scans. Other features of the SmartSoc system include the SmartSoc is user-friendly and requires very little special training. The scanning technology was specifically developed for cranials with great accuracy. The white generic head model in the upper left corner of the screen display shows real-time smart scan progress.
The scanning halo turns green, indicating the optimal standoff distance for scanning. The entire system was developed to allow for patient movement during a smart scan. and the portability of the SmartSox system allows easy transport to other clinics and satellite offices.
The CurveCapture app works behind the scenes to convert the 2D video images into a 3D model. This revolutionary technology analyzes the 2D images for optimal 3D conversion in the cloud. This data processing and transfer occurs on a secure and HIPAA-compliant platform. The eBRACE platform can be accessed at eBRACE.orthamerica.com.
This web-based application was developed for quick and seamless ordering. As mentioned, the eBRACE web portal enhances patient management, is HIPAA-compliant, and allows the clinician and OrthoMerica to access the 2D and 3D models stored in the cloud. Attention to detail during the scanning process will allow the clinician to obtain and provide the best data to OrthoMerica. Areas of focus include the SOC, the hexagon reference marker, anatomical landmarks, and the camera position during scanning.
After obtaining the infant's cranial circumference, select the best Smart Sock to match. All Smart Sock garments have sizing labels on the inside seam. If an infant is in between sizes, it's best to try the size smaller to prevent wrinkles.
Pull the sock on over the head and smooth all areas and contours. The colored circles should not be stretched to the point that the colors begin to fade, nor should the fit of the sock allow wrinkles in any part that will be needed to fabricate the star band. Smooth and fold under at the neck area if needed.
Make sure the entire forehead and cheek areas are covered by the sock. Secure the two ties in front below and over the chin. Take a moment to reassess the entire fit of the sock.
This is the foundation for the best and most accurate scan. After applying the Smart Sock and verifying the size and fit, the hexagon reference marker and anatomical landmark stickers are placed prior to scanning. Step number two shows the application of the large hexagon reference marker on the top of the head. Center this in the sagittal and coronal planes.
Next, place the landmark stickers. Locate the cellion, number three, the tip of the nose, number four, and just anterior to the distal edge of the earlobes, number five. The earlobe markers are placed at the junction of the distal lobe of the ear and the cheek.
For MCU alignment, add right and left cheek markers. For CCU alignment, add right and left trageon markers. The ear covers are a critical part of the scanning process.
It is not necessary to ever trim the size of the ear covers even for very young infants. The effect of the ear covers is to block the pattern of the SmartSock fabric and create flattened areas on the 3D model. This will allow the technical team to know exactly where the ear cutout should be on the finished starband.
After applying the SmartSock garment, make sure the ears are flat against the head and have not become folded underneath the fabric. Apply the ear markers as follows. Line up the top of the ear cover with the top edge of the ear and line up the back of the ear cover with the back edge of the ear.
Make sure that the ear cover lines up accurately with the baby's ear as this will define the ear opening on the finished star band. It does not matter how much of the ear cover extends below the lobe of the ear, as this is outside the material coverage of the star band. It does not matter how much of the ear cover extends anterior to the ear, as an anatomical reference sticker will be added to define the anterior edge of the ear opening and the posterior edge of the temporal extension.
Remember that the camera on most phones is at the top, not in the middle. This will require you to tilt the camera slightly to accurately capture the suboccipital and neck region. During the scanning process, you are guided by the white generic head model in the upper left corner of the screen. Various sections turn green as the camera captures data over that region of the head.
The thick green line encompassing the head keeps your camera at the correct distance. If this scanning halo is not green, then you are either too close or too far from the infant's head, and the scanning process will be paused. Simply adjust the distance that you are holding the camera from the head. and scanning will resume when the halo turns green. A little practice is all it takes to master this distance.
consistently. Finally, when all areas of data have been captured and the white generic head model is now green, you will be notified that the scan is complete. Let's first look at CCU alignment for deformational plagiocephaly and the CHOA plagiocephaly severity scale. Critical anatomical landmarks for the SmartSocScan are the cellion, nasal tip, and right and left earlobe markers. For CCU alignment, you will need to also identify the right and left travian.
Now let's discuss MCU alignment. The six markers needed for MCU alignment are shown here and include the cellion, tip of the nose, right and left ear lobes, and apex of the right and left cheeks. It is important to know how to use both CCU and MCU alignments. Clinical indications for CCU alignment include deformational plagiocephaly and use of the CHOA plagiocephaly severity scale.
Clinical indications for MCU alignment include deformational brachycephaly and heads with a significant vertical ear shift or windswept presentation. Choose the data that you wish to be presented on your printed report. This may be any or all of the data shown by clicking on the standard, quadrant, or calculated tabs.
If you are planning to present a more simplified version, simply click on the measurements not wanted. These line items will turn gray and not be printed on the report. Prior to printing, the scan must be aligned properly and accurately before sharing the subjective data.
The best parts of the scanning and reporting processes are the increased accuracy and efficiency of these cranial measurements. This quantitative report also takes the clinical opinion out of the equation, as well as the challenges of trying to accurately and consistently measure a moving target. Here is a sample SmartSoc comparison report presenting standard measurements.
Remember that the images on these reports will be labeled in either the nose-up or nose-down. alignment. The inner purple line represents the head deformity at the beginning of treatment.
The outer blue line represents the head shape at the end of treatment. As you can see, significant improvements obtained with the Starband can be quantified and documented, but they do require consistent and accurate placement of the reference stickers and alignment procedures. Here is another page of the SmartSoc report comparing quadrant measurements for scans at the beginning and end of treatment.
SmartSoc benefits for physicians include quantitative information for decision making, immediate education for family, and the opportunity to communicate patient care decisions with the orthotist and physical therapist. SmartSoc benefits for the orthotist include eliminate messy and unsettling casting procedures, provide quantitative information on treatment progress, educate the family and other team members, and clinical documentation for claims submissions. The SmartSoc reports can also be used to document the progress made in therapy for infants with torticollis and or neck muscle involvement. Therapists are also helpful in educating the family on the infant's condition.
Payers now have quantitative documentation of the patient's condition and changes over time. Quantitative data can now be verified to determine if the child meets the individual payer's coverage policy. The first SmartSoc module was focused on the management of patients with skull deformities. This was followed by the trans-tibial prosthetic module.
Other modules planned for development include AFOs, knee orthoses, spinal, and other areas. Stay tuned for announcements on these developments. You have now reached the end of the SmartSoc scanning technology module. The topics covered include patient preparations, scanning tips, CCU and MCU alignments, and report functions.
Remember that the purpose of this module was just to provide a general overview of the SmartSoc scanning technology. Now it's time to continue to the quiz and brief survey.