3D Printing in Medicine and the Impact on HealthCare Management.

The different applications of 3D printing in medicine have the potential for many benefits, including personalization of medical devices, and drugs, these can increase the cost-effectiveness of healthcare delivery. However, significant challenges in the application of this technology, with scientific and regulatory challenges still remain to be addressed.

3D printing has been used in medicine since the last decade when this was first used to create custom prosthesis since then the application in medicine has evolved significantly. Recently, it has expanded to organ printing and also the development of drug delivery systems. However, unrealistic expectation of these technologies and the hype associated with the current state of development as the panacea for all the issues with healthcare delivery are a major concern.

The obstacles preventing delivery of healthcare in emerging countries include poor infrastructure, inadequate medical supply chain, lack of physical resources and trained personnel. 3D printing technology may help in addressing these critical concerns in an easy and inexpensive fashion. The optimum application of 3D printing technology to create medical devices, which have significant practical benefits in emerging countries, is one of the ways to addresses.

These could include potential issues relating to the production of medical devices, which are functional, for early and rapid detection of serious health issues and also for customized prosthetics limbs. In a review of 227 surgical papers, it was noted that the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. However, in emerging countries, the development of low-cost prosthetic limbs, medical diagnostic devices that are simple and affordable for anyone in resource-poor countries who needs one, will be the major benefit of 3D printing technology in medicine.

The World Health Organization (WHO) estimates there are about 30 million people require prosthetic limbs, braces or other mobility devices. However, less than 1% have access to them. The many hurdles in getting these healthcare devices are lack of resources, poor infrastructure, and cost. In addition, getting the right limb at the right time is also difficult, as the custom designed prosthetic in established countries may not be optimum fit for emerging countries.

One of the key issues involved in developing countries is that the person who requires prosthetic limbs is more dependent on the lower body as the ability to work and mobilization is improved. Shifting of focus to lower limbs will be more practical than the upper limb. In addition, a survey by Harvard School of Public Health also predicted that the situation is likely to get worse as the health demands of emerging nations evolve, with a shift from communicable to chronic diseases –which typically require surgery.  Surgical interventions require myriad surgical instruments, and 3D printing could help in design and development of simple surgical instruments.

3D printing in healthcare has evolved considerably in the last few years with the increasing affordability of printers, and also increased the processing speed of computers and better software to process the Computer Aided Designs. However, for 3D printing technology to create maximum effectiveness in the low resource setting, it is important to consider using them for the most practical Issues at first, then to focus on hyped up vision.

References

  1. Medical Applications for 3D Printing: Current and Projected Use: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189697/
  2. Three-dimensional Printing in Developing Countries doi:  10.1097/GOX.0000000000000298

 

Point of Care Testing and 3D printing Applications in Healthcare

In evidence-based medicine, the PICO model (Population, Intervention, Comparison, Outcome) is generally used to frame and answer clinical research questions. This tool can be used to assess the clinical and economic value of 3D printing in healthcare.

Healthcare workers use various diagnostic tools to detect and to determine the severity of a disease, as well as plan for future treatment and track patient’s response to disease management. Point of care testing (POCT) devices enable optimum delivery of clinical therapeutics to countries which are economically challenged. To achieve a significant impact while delivering clinical services, the technologies that use point of care testing should use cost-effective strategies.

One possible solution using POCT strategies suitable for resource-limited settings is 3D printing with low cost, sensitivity, robustness, rapidity, and ease of use.3D printing offers a viable option for rapid prototyping and cost-effective deployment of various tools like using microfluidic chips and integrating with the smartphone via smartphone applications.

The advantages of 3D printing for microfluidic device fabrication are already well-known and that their method, digital light processing stereolithography (DLP-SLA), is an especially promising lower-cost approach. DLP-SLA uses a micromirror array chip, like those in most consumer projectors, to dynamically create the optical pattern for each layer during layer-by-layer printing of a device.

Although, these technologies are at an earlier stage, in future, the 3D printing with smartphone applications can be used for POCT in resource-poor countries.

 

Journal Reference:

Huang, X., Lin, J. & Demner-Fushman, D. Evaluation of PICO as a knowledge representation for clinical questions. AMIA Annu. Symp. Proc. AMIA Symp. 359–363 (2006).

Hua Gong, Bryce P. Bickham, Adam T. Woolley, Gregory P. Nordin. Custom 3D printer and resin for 18 μm × 20 μm microfluidic flow channels. Lab Chip, 2017; DOI: 10.1039/C7LC00644F