On the 9th of July, the webinar about “Building the Business case for 3D Printing in Hospitals’‘ organized by ASME, was conducted. The main topics included Medical Additive Manufacturing and 3D Innovations. There were 4 panelists in the webinar and they discussed the most important cases of medical 3D printing at the point of care. The event was hosted by Andy Christensen, who has spent his whole career on developing 3D printed medical applications. The guests were Jonathan Morris, Neuroradiologist and Director of 3D Printing & Anatomic Modeling Lab at Mayo Clinic, Beth Ripley a radiologist at the VA Puget Sound Healthcare System and a Radiology Assitant Professor at University of Washington School of Medicine, Justin Ryan, Research Scientist at Rady Children’s Hospital in San Diego and Gaurav Manchanda director of medical applications from Formlabs.
In the beginning, the host, Andy Christensen, an expert in the industry for many years, shortly introduced the topics that are going to be covered. He mentioned that there 3D printing at the hospitals has been used for use cases such as models or guides based on the patients’ imaging data. He also outlined that the radiology plays an important role in all of the following processes. A clear statement about the current and previous state of the 3D printing industry was presented as well. The point of the introduction was to cover the historical model of 3D printing including what and why it has changed as well as what is the business case of 3D printing at the hospitals today. It was also outlined that the historical model of 3D printing was previously focused on the service, which included the anatomic models, surgical planning, or guides and patient-matched implants that currently are usually being manufactured using additive manufacturing technologies and sold to the hospitals by medical devices companies.
By using 3D printing at the point of care, a new value proposition is being created. Hospitals and other medical centers begin to be more independent and thanks to that, a significant opportunity for cost-saving and competitive advantage is developed. The hospital can actually become a medical 3D printing manufacturer and have much easier access to the market. Hospitals and healthcare centers are now beginning to provide services themselves and they also should be able to work more on their own terms, get more localized and be responsible for the processes that are happening over there. However, speaking about the regulatory, the FDA has not yet regulated the practice in medicine and there is still room to work on that. Such independence may still be away for a couple more years
What was also mentioned, was the COVID19 impact on the 3D printing industry. It was outlined that the hospitals started to use their labs for other cases and that the personalization started to matter even more now. Personal protective equipment was created in their labs and using the already installed 3D printers in this specific case and not necessarily anatomical modes. This also proves that hospitals can try to get more independent and self-sufficient.
The next part of the webinar included the Q&A section and questions prepared for the panel.
While the main topic regards the business case for 3D printing in the hospital the first question regarded the core institutions started the service of 3D printing and the financial aspects in terms of that. Reimbursement may be challenging in that case. It was generally stated that for non-profit hospitals, there is still a challenge of revenue to support 3D printing processes. However, there is still a point in bringing medical devices production in the hospital. Like the panelists of the webinar confirmed, hospitals and the administrative side is supportive of that.
There are many more advantages. The cost of the machines is getting lower, the entrance is enabled and that’s why more and more health centers and hospitals begin to invest in that. “When people start to use 3D printing, they don’t want to go back. We’re doing about 300 hundred guides per year now and it’s getting busier” claims Dr. Morris from Mayo Clinic.
The time is also reduced. Mayo Clinic confirms that additive manufacturing has enabled them to save a significant amount of both money and time (80$-100$ per minute and 2h in time for surgeries). Especially in case of elbow surgeries, which they are performing the most often. “We provide the same service, however with a decrease in OR time” says Jonathan Morris. What is also important is to constantly reduce the barriers and also not making one department responsible for all the costs.
However, “The biggest hidden cost is people, You need positions, engineers, designers, people to run the printers. The single biggest investment is getting the right people and investing in these people” says Beth Ripley from VA. For example, the engineering team is playing a key role in the process. The Mayo Clinic has now around 70 engineers, states Dr. Morris. “To run the complex, 3D printer 24 hours per day, we really need dedicated people for that. So that’s why there is always going to be the need for engineers” What Justin Ryan from Rady Children’s Hospital says is that “the engineers can help in very advanced processes. While ”Machine learning or AI isn’t there yet and it may be a challenge in which they can help out. The case of COVID19 also proves that they play a very significant role”. He also outlines that radiologists may not be the right ones to deal with the 3D printing technology yet. However, he believes that now that is rapidly changing and that the radiology technologists are gaining engineering skills.
The challenge lays also in choosing the right and reasonable in price, technology. “Printers can value from 300$ to half a million dollars”. That’s why it’s important to know what purposes they are needed for, what specific features should they have, or what other processes need to be involved in the decision of choosing the right one. Taking into account all of that, the situation in the time of Covid19 has changed a bit. “In the last couple of months, we have seen more hospitals within VR and other health systems purchasing multiple printers with the intention to use in the Covid19. Many hospitals start right now with the 2,3 or 5 printers, where it used to be 1 or 2 a year or 2 ago “ confirms Gaurav Manchanda from Formlabs. This means that such hospitals are able to support the immediate demand, what was actually needed the most at that time.
Speaking about the case of the COVID19 and 3D printing, it resulted in decentralization and the change of the supply chain. What Beth Ripley, a radiologist at the VA says, is:
“We were making the things that you can’t buy while making sure that they have high quality and standards. This is really an essence of what we’re doing during Covid19 and beyond. These are the things that you can’t get off the shelf. A true business case. Something you can deliver in the time of need”
However, it doesn’t mean that there were no challenges. As Dr. Jonathan Morris from the Mayo Clinic claims that even if they were able to “make 10 000 face shields under a week on their own, but it was just a small part of the puzzle”. As Justin Ryan from Rady Children’s Hospital outlines that even if they did a lot of ventilators, splitters, swabs, the learning experience was face shields. “We printed out the prototypes of face shields, just developed the design that we can laser cut, it’s [laser cutting] a lot faster. Leveraging the best technology for the best application was the learning experience”.
While the business case and different aspects of the 3D printing were discussed in the webinar, everything was shortly summed up by the Gaurav Manchanda from Formlabs, the company which sponsored webinar. He outlined that as The VA and Mayo Clinic are the fully resourceful institutions, the benefit of the point-of-care 3D printing is great for them. Taking into consideration the current situation of pandemic COVID19, hospitals that were already having the 3D printing machines at the point-of-care for years were in the best position to repurpose them at that moment. He also outlined that it was possible to come from concept to design to clinical trial within only 3 weeks. “Taking into consideration all of the point-of-care manufacturers around the world, they will print out around 10 millions of swabs this year in addition to ventilators system components.” This way, we can clearly see that 3D printing is becoming very attractive for the hospital’s supply chain because this is the moment where we see it changing and evolving. And here is the chance for Point-Of-Care 3D printing.
We hope that you enjoyed our article about the webinar about “Building the Business Case for 3D Printing in Hospitals”. Let us know what you think in the comment below!