With 3D printing in the VA healthcare system, everybody wins

April 26, 2017
Beth Ripley MD, PhD, Assistant Professor of Radiology, Veterans Affairs Hospital, Seattle Division

Initially dismissed by some as a fad, medical 3D printing is steadily gaining a foothold within the healthcare space. To date, the benefits have largely been anecdotal, but evidence-based studies are starting to emerge—reporting improved patient communication, enhanced quality of life through personalized technologies, shortened operating times, and better surgical outcomes. As we reach a critical mass of patients and caregivers who see 3D printing as fulfilling a need in medicine, industry leaders of the technology are looking toward implementation on a larger scale.

Preparing for implementation

Early adopters will likely face challenges when implementing 3D printing within a healthcare system. They must define and demonstrate the technology’s value to important stakeholders such as healthcare providers and hospital leadership. Additionally, they’ll need to identify and manage staff with the diverse skills necessary for 3D printing, including expertise in medical imaging, computer-assisted design, and engineering. Finally, consideration must be given to ensuring quality and safety throughout the process.

A partnership between Stratasys, a 3D printing manufacturer, and the Veterans Administration (VA) Center for Innovation will test and document implementation of 3D printing on a large scale—by simultaneously rolling out 3D printing programs at VA hospitals in Seattle, Boston, Orlando, San Antonio, and Albuquerque. These hospitals join a handful of hospitals within the VA system as early adopters of 3D printing in the assistive technology, bioengineering, and research spaces. This includes Richmond, Minneapolis, and Pittsburgh as well as the VA SimLEARN National Simulation Center, which is adopting the technology for education, training, and simulation. The VA 3D printing network project will stress collaboration through knowledge and resource sharing, with hopes of maximizing utilization of resources while minimizing costs and lowering the learning curve for adoption at the new sites. The project will also help define best practices and set the bar for the highest level of safety standards in the developing technology.

Defining 3D printing’s role in healthcare

3D printers create three-dimensional objects by laying down successive two-dimensional layers of material—hence the term “additive manufacturing.” To date, one of the largest uses of medical 3D printing has been creation of accurate models of patient-specific anatomies. Through a series of manipulations, imaging studies such as CT and MRI can be converted into digital blueprints of a patient’s internal anatomy. This can later be physically recreated as a model by a 3D printer.

3D models offer surgeons an unprecedented opportunity to see and interact with patient anatomy before stepping into the operating room—a strategic advantage in terms of planning the surgery and anticipating potential complications or challenges. They also improve communication between multidisciplinary teams that must coordinate before going into the OR. But this is only the beginning. With the right materials, models can be used to practice procedures and train the next generation of doctors. Working within FDA guidelines, 3D printing allows surgeons to imagine and create new tools to bring into the operating room and help nurses to improvise solutions at the bedside to improve care. Finally, and perhaps most importantly, 3D printing gives patients the knowledge and tools necessary to communicate with their healthcare team and advocate for their own well-being.

Defining value: Patient care and clinical outcomes

One hope of the VA project, and in working with Stratasys, is helping patients feel more in control of their healthcare. 3D printed surgical planning models can also potentially improve patient outcomes and streamline costs by decreasing the length of surgery and hospital recovery. Surgeon Dr. Michael Porter, Chief of Urology at the VA Puget Sound Hospital and an associate professor of Urology at the University of Washington, envisions two major areas where 3D printing could potentially improve patient care.

“The first is in surgical planning. In the case of complex kidney tumors, the life-sized replica of the diseased kidney can allow for a better understanding of the vascular anatomy and how this relates to the tumor, which could allow the surgeon to develop a better surgical plan. The other area where this has great potential is in patient counseling. So often we draw pictures and refer to imaging studies, but this can be really difficult for patients to grasp. But now for the first time, patients can see and understand what’s occurring in their body by being shown and holding a replica of their individual anatomy.”

Hospital value and financial outcomes

While there are potentially many significant financial benefits for hospitals in adopting 3D printing programs, innovation is another big outcome. Hospitals that encourage employees to innovate may see rewards in terms of licensing, patents, or tech transfer. For example, at the Minneapolis VA, 3D printing work has assisted creating prototypes for a number of new patented inventions. Further, by giving employees permission to think independently, employee engagement and satisfaction will likely rise. Retaining good employees translates to cost savings, but even more importantly, engaged employees are more likely committed to solving difficult problems within the hospital system. This could lead to more streamlined workflows with more associated time and cost savings.

Next steps forward

Stratasys, VA staff, and the VA Center for Innovation have the opportunity to nurture major innovation through its own growing pains. Challenges include streamlining the process and developing methodologies and best-practices to ensure quality and safety. Among the rewards will be defining new practice standards, improving patient care, and proving out many anecdotal successes of 3D printing. If the VA network project is a success, we envision more widespread adoption, bringing the power of 3D printing to many more hospitals and patients.

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