Bringing computer technology to the VR system.

Bringing Computer Technology to the VR System

During the past decade or so, personal computers have become an integral part of everyday American life. Because computers may offer special advantages to people with disabilities, vocational rehabilitation (VR) clients are beginning to ask for computers as part of their rehabilitation plans at a time when VR agencies are beginning to adopt computer technology for case management and casefile documentation.

Although many questions remain to be answered about the most appropriate uses of computer technology in vocational rehabilitation, many human factors are at the forefront. The VR service delivery system, when viewed as a whole, must contend with a variety of human issues that will ultimately help decide the quality of VR services in the new era of computer utilization. This article presents an overview of some of these human factors from the perspective of how they might influence the VR system's ability to perform its basic mission of providing services to people with disabilities.

Basic Uses

A VR agency can use personal computers in three basic areas: management, client rehabilitation and agency worker accommodation. Although these areas share some common characteristics, they are different in the sense that technology must be used in specialized ways in each area if the VR system is to achieve its goals. In VR management, for example, the goal is to use computers to instill a high degree of uniformity in case management, casefile documentation and casefile review for quality control. In comparison, using computers to help clients achieve desired rehabilitation outcomes requires planning for individualization, not uniformity. Finally, when the VR system seeks to use computers for job accommodation for employees with disabilities, the task is to provide individual adaptation without sacrificing uniformity within the system's management system.

These differences in applicability may put a strain on the VR system as it attempts to meet the needs of people in all three areas. How well the VR system achieves its goals in these areas depends upon its ability to analyze and plan for the differences in human needs, intentions and goals in light of its fiscal limitations. Its policies must reflect a recognition that coping with these distinct areas remains an agency responsibility and that successful adaptation of computer technology will involve all three.

VR Management

Once VR management identifies the role it wishes computers to play in service delivery, many different combinations of hardware and software may be appropriate. However, management has the important task of planning a good system within the framework of existing or projected budgets. For this reason, human factors must be considered in terms of hidden costs.

For example, training VR counselors to use the new system can be an expensive proposition. Because counselors within a VR service delivery system typically are spread throughout a state, geographical location becomes a major expense in that it requires time and funds to bring them together for training. This problem, in turn, may have a direct impact on the selection of hardware and software, as some systems are more easily learned and require less training time.

The purchasing habits or policies of the agency may also involve human problems. Some agencies are restricted in how they may purchase equipment. If an agency has to conform to purchasing policies by buying only that type of equipment that is currently used throughout a state's different agencies, the VR agency may find itself with equipment better suited for administration or accounting than for rehabilitation management. Similarly, if that equipment is routinely delivered to state agencies with bundled software, the VR agency may find itself with inadequate or superfluous software. The software and hardware may be inadequate to the VR mission, or they may have capabilities that are not needed for VR agency use.

These situations are human problems in the sense that the VR agency may be forced along a certain path without regard for its primary mission. Trying to get a state purchasing system to alter its policies for the sake of tailoring a computer management system for a single agency may involve more human factors than policy ones. In such instances, the VR agency may be precluded by the state's own bureaucracy from getting the best equipment at the best price. For example, if a VR agency needs a simple word processing program to allow counselors to prepare case narratives and the state's policies encourage the purchase of a full-featured package bordering on desktop publishing capabilities, the VR agency may have to go along with policy even if its managers know that the required package is "overkill" and higher in cost.

Such problems create additional concerns for the VR agency because mandated purchasing may increase training costs, contribute to needless system complexities, and force the agency into long-term hidden costs for system updates and equipment service.

These problems may be compounded by the need for the VR agency to provide reasonable accommodation for its personnel with disabilities. On one hand, the agency needs to preserve the uniformity of any system it adopts, while on the other hand, it must make that system accessible in some way to those with special needs. The degree to which it is able to perform these tasks simultaneously may be reduced by the same purchasing policies mentioned above. Some special accommodation devices work best with particular computer systems, systems that may not be available because of a state's purchasing polices. The VR agency may then have the additional expense of purchasing other software that can translate files from one computer system into a form recognizable by another system. Another hidden cost exists here because some personnel must also be trained to use the additional software.

Computers for Rehabilitation

As complex as it is for a VR agency to plan and adopt a computer system for its own management needs, this complexity is minor compared to that which arises when an agency attempts to establish policies and guidelines for the purchase of computer equipment for vocational rehabilitation clients. Most rehabilitation counselors and managers have not been trained in computer technology and simply may not know what is or is not appropriate for a particular client. Likewise, the agency may not know either; it may have only general policies to guide the direct service providers, usually in terms of maximum amounts that may be spent. It may be argued that such general policies allow the rehabilitation counselor to retain decision making at the local level. However, the ability to make such decisions is not an adequate substitute for knowledge of computer applicability.

To manage the human factors that enter into the use of computers in rehabilitation, the individual counselor needs concrete criteria that are backed by agency policy and philosophy. Without such criteria, the counselor may end up purchasing a computer simply because the client wants one, without knowing how it will fit into the intended outcome of rehabilitation. A counselor may, in fact, use VR funds to buy a computer when a typewriter would have worked as well for the client's needs.

This example reflects the important point that the criteria used by the counselor in deciding on computer purchases must include some basic provisions that are in accord with existing rehabilitation concepts. The following list describes some of these concepts as questions the counselor must ask before buying computer equipment for a VR client:

* Will the equipment help the client achieve his or her vocational objective?

* Would lack of the equipment prevent or hamper the client's attempt to achieve this objective?

* Is the equipment the most appropriate, cost effective and suitable for the task?

* As a tool of accessibility, to what will the client gain access with the equipment?

* Does the client need such access to be successful?

* In what ways will the equipment make the client more independent in terms of employability?

* What additional training will VR need to fund so that the client can use the equipment?

* Will the equipment produce hidden costs for the client or the agency?

* How will the client obtain needed peripheral devices?

* How will the equipment influence the client's psychosocial situation?

* How will the equipment influence the client's Individual Written Rehabilitation Plan (IWRP)?

* How will the counselor justify funding computer equipment to help a client get needed training even if the equipment will not be needed later for the actual job?

* If the agency's purchasing practices, such as receiving bids, will take months to accomplish, how will the client's plan or training be affected?

* To whom can the counselor turn to get help in answering such questions; does the agency have resident experts?

Human factors will help determine the answer to each of these questions. The nature of the client's disability in relation to his or her vocational objective is the most important such factor. For example, a client who is blind and wants to work in the retail industry may need a speaking calculator more than a computer. A client with a back injury who wants to work in an office may need a computer to increase productivity and lessen back strain; a detached keyboard may allow such a client the ability to change seating positions often. A client whose mobility is severely impaired may gain access to the outside world with a computer that includes a telephone modem.

A client must, of course, have the physical and mental ability to operate the computer if it is to have a positive impact on rehabilitation outcome. The client should also have a clear perception or understanding of how a computer will help. This may present new problems for the VR counselor because the client may not know enough about computers to answer such questions. Clients and even counselors may think of the computer as a panacea, without giving much thought as to how it will help. An important point here is that the type of disability does not automatically justify the expense of a computer in the sense of making life easier for the client. Specific uses and intent related to vocational objectives must be documented and considered.

VR clients are like other people; they may want computers because others have them, because they think they are needed to offset limitations caused by disability, because someone they know has one, or because they simply desire to have one. On a practical level, however, a VR agency cannot afford to buy computers that will not be used or which will be used only for recreational purposes.

As suggested in the above list, a computer can have a direct impact on the client's psychosocial well-being. A client who feels isolated and withdrawn may become even more so with a home computer. The client's family relationships may suffer if the client spends too much time on the computer. If the client uses the computer with a modem to gain information through a telephone linkup, he or she may incur telephone charges that erode family financial resources.

How the Agency Can Help

Faced with so many factors, most VR counselors would turn to their agency for help. Even when a client has a legitimate need for a computer and the counselor believes it will help lead to successful rehabilitation, neither the client nor the counselor may know what to do next. The agency can help initially by adopting sound criteria for determining need and fiscal limits. Additionally, it can help by providing current information on combinations of hardware and software that work best in particular situations.

Few VR agencies have the resources to conduct extensive research in computer application. Most agencies can, however, have personnel whose function is to gather, maintain and disseminate timely information about computer applications for people with disabilities. Rehabilitation professionals working to provide such information can use existing rehabilitation sources of information, such as the Job Accomodation Network (1-800-526-7234), and can establish relationships with manufacturers who may provide information from direct research and with VR agencies in other states willing to share information. Once gathered, this information can be quickly disseminated to field service providers who have immediate use for it with specific clients.

The agency which can provide counselors with this sort of information can also plan more precisely for cost control. Once the agency has criteria to determine need, appropriateness and cost effectiveness, it can develop projections of client needs in coming years. In this way, costs can be budgeted, held to a minimum and accounted for by the agency.

The agency which supports field counselors with such information also makes an additional contribution to the agency's overall mission achievement. Because computers can play a major part in rehabilitation and can help people with disabilities enter or re-enter competitive employment, the agency can establish a service environment and philosophy which can help move rehabilitation services and clients toward full participation in an informational society.

Preparing for the Future

Computers and other forms of high technology are here to stay. Demand will increase as human imagination and creativity produce new uses. This technology will offer people with disabilities new opportunities to work and live in better ways. Vocational rehabilitation agencies will play a vital role in putting this technology in place. The human factors that influence the nature of that task will be numerous and will place additional demands upon agencies.

The Technology-Related Assistance for Individuals With Disabilities Act of 1988 (Public Law 100-407-AUG. 19, 1988) will eventually require all states to provide detailed information about technology that can be of use to people with dissabilities. As this law now stands, the governor of each pilot state will designate a particular state agency to plan and carry out this complicated task. In many states, the VR agency will probably assume this role of designated agency and will have to move immediately to implement the law.

State rehabilitation agencies do, of course, possess more knowledge and skills about such matters than other agencies. Still, the task will not be an easy one. Technological information is available from many different sources, some of which deal with computer technology and some of which are more oriented toward rehabilitation engineering and assistive devices.

However, to provide such a service to consumers, agencies will have to have concurrent information on the same human factors that are discussed above. People will want such information because the technology can help improve the quality of their lives. For consumers to use that information and for the designated agency to know which information is most appropriate, the agency must have some knowledge about how and why specific equipment will or will not work in a given situation and must be able to discuss the technology in terms of consumer objectives and human need.

One important objective that consumers will have is to discover funding sources for high tech equipment. The agency must be able to identify such sources when asked. From the perspective of VR funding, the agency will be called upon to explain its criteria for purchasing computers or other devices. These criteria may be the same that VR agencies now use or need to use as a matter of policy to guide rehabilitation counselors in the field.

The Technology Act may help improve VR services in two distinct ways. First, it may encourage agencies to formulate or review current policies regarding the criteria for buying computer equipment. This, in turn, may give counselors a better understanding of the uses of computers in the rehabilitation process and may help them avoid wasting agency funds through inappropriate purchasing.

But more important, the new law will give each state a base of information that can be used to provide direct service to clients and counselors on demand. For example, once an agency or state has established a program under the new law, VR clients an VR counselors can ask for information and assistance from that program to help identify appropriate technology for specific and immediate client needs.

Because the new law will carry new federal funding, it will allow many VR agencies to provide new services and depth of services leading to better rehabilitation opportunities. The new law may enable an agency to get professional "opinion" or recommendations before it authorizes funding for expensive technological equipment.

Conclusions

This brief article mentions but a few of the human factors that are and will continue to be important to rehabilitation counselors and to VR agencies that provide funds for computers. The central message here has been that agencies need to understand computer technology and its impact on disability well enough to establish clear criteria and policies about how such equipment will be selected and purchased. In this way, agencies can save money that can be used to help other clients with their needs. Because computers are "high dollar" items, agencies need to make certain that their counselors know when it is appropriate to purchase a computer for a client and when it is not.

If consumer demand for computer equipment and training continues to increase, agencies and counselors who are unprepared to apply reasonable rules may find that they are spending more and more on computers without achieving much in terms of successfully rehabilitated clients. Such a scenario would mean wasted resources, less money for other clients and a degree of failure for the VR system. If an agency has no other criteria, it at least can have common sense, a criterion which will help define client needs in terms of employability and empowerment to succeed.

As VR agencies move into the age of technology, they will become better at helping clients identify and use available information that can help them in rehabilitation and in life. Agencies will also become better at selecting equipment for their own management uses and will find new ways within bureaucracies to build computerized information systems that will be specifically tailored for vocational rehabilitation. The cost will be great but so, too, will the rewards. People with disabilities will have more chances to develop skills that will allow them to find meaningful work at competitive wages. They will have more opportunities to use technology for its intended purpose of improving the quality of life.