The U.S. Department of Veterans Affairs (VA) grew its national integrated virtual 3D printing network from three hospitals in early 2017 to 20 at the close of 2018.
The expanding network, which started at VA’s Puget Sound Health Care System, allows VA health care staff to share ideas, solve problems and pool resources on best practice uses of 3D printing to improve the health care of the nation’s over 20 million veterans.
According to the VA, Veterans Health Administration (VHA) “innovators across the 20 sites are using 3D printing to solve a wide range of issues, from presurgical planning to manufacturing hand and foot orthotics.”
“The VA remains at the forefront of innovative work in 3D printing by expanding our expertise across VA,” said VA Secretary Robert Wilkie said in a statement. “Through this growing virtual network, VA continues to help define how 3D printing technology will be used broadly in medicine for the benefit of patients.”
Prints of model kidneys for patients with renal cancer now aid surgeons at the Puget Sound Health Care System. The prints allow physicians to plan their surgical approaches to save normal kidney tissue and avoid disturbing unaffected vessels that surround a tumor. The technology also saves hours of surgeons’ time which also reduces the time patients are under anesthesia and increases operating room availability.
Occupational therapists at the VA are also using 3D printers to manufacture specialized hand orthotics, to provide same-day fitting and delivery. This offers veterans the luxury of immediate care and reduces the need for multiple visits. And a saved digital blueprint of the device makes replacement a speedy option if the orthotic breaks or is damaged.
According to the VA, its researchers are currently “working with collaborators to create a bioprinting program that uses 3D printing to fabricate replacement tissues that are customized to an individual patient. This would decrease wait times for tissues and organs, reduce the need for grafting surgeries and enable hospital and health care providers to improve the quality and safety of medical procedures. The group is targeting a competitive three-year timeline to have a bioprinted vascular bone implanted into a patient.”
The 3D printing virtual Center of Excellence is part of the VHA Innovation Ecosystem. The Ecosystem includes the Diffusion of Excellence Initiative and VHA Innovators Network, two programs that aim to identify and scale innovations and best practices across the VA by empowering and enabling employees.
In keeping with those goals, the VA Puget Sound Health Care System and GE Healthcare entered a research partnership in November that they hope will accelerate the use of 3D imaging in healthcare. Per the agreement, GE Healthcare will provide software and work stations, and the VA will provide input on its use of the technology. In the past, the VA has used 3D software that wasn’t designed for medical use. Now, however, GE will provide software specifically designed for the medical field. With the new agreement, GE and the VA hope to reduce the time it takes to create 3D models from hours to minutes.
The new partnership is also making it possible for the VA Puget Sound and the VHA Innovators Network to integrate GE Healthcare’s advanced visualization AW VolumeShare workstations with 3D printing software across its facilities in Seattle, San Francisco, Minneapolis, Cleveland and Salt Lake City. “VA radiologists specializing in cardiology, oncology, orthopaedics and other areas will use this technology and software to develop new 3D imaging approaches and techniques to deliver improved precision healthcare for our nation’s veterans,” the VA said.
“For most radiologists, 3D images are limited to reconstructions on a computer screen,” said Beth Ripley, MD, PhD, VA Puget Sound radiologist, VA Innovation Specialist and VHA 3D Printing Advisory Committee chair, who added that the VHA has been on the forefront of bringing 3D printing to the bedside. “By harnessing the power of 3D printing with a rich data set, we are able to pull images out of the screen and into our hands, allowing us to interact with the data in a deeper way to fuel innovative, personalized care based on the unique needs of each of our patients.”
According to the VA, software designed to allow manual preparation of image data into 3D printable files can be extremely labor intensive. Using GE Healthcare’s advanced visualization tool, specifically designed for the medical community, VA radiologists say they “will be able to produce models of normal and pathological anatomy using automation techniques that will speed up the pre-3D printing preparation work and the diagnostic process. This is expected to reduce the time it takes to create 3D models from hours to minutes.”
Terri Bresenham, chief innovation officer for GE Healthcare said, “This partnership will result in significant innovation for the growing application of additive manufacturing in medicine…”
A $19 billion healthcare business of GE (NYSE: GE), GE Healthcare provides medical imaging, monitoring, biomanufacturing and cell and gene therapy technologies. With over 100 years of experience in the healthcare industry and more than 50,000 employees globally, the company also enables precision health in diagnostics, therapeutics and monitoring through intelligent devices, data analytics, applications and services.
While 3D printing is primarily used to manufacture orthopedic implants and guide surgical cutting, peer-reviewed research on its potential impact in patient care has expanded exponentially.
“You can fashion almost anything on a 3D printer these days, from the most intricate airplane parts to near-perfect replicas of the human skull,” says GE Reports writer, P.D. Olson. “But back in 2007, few had printed an object that could be implanted into someone else’s body.”
It was then that a surgeon named Dr. Guido Grappiolo, of Fondazione Livio Sciutto ONLUS in Savona, Italy, joined forces with orthopedic implant maker LimaCorporate and Arcam, a manufacturer of 3D printers now part of GE Additive. The Italian surgeon and the companies made the world’s first 3D-printed hip cup, the Delta-TT Cup, in 2007 for a woman with advanced arthritis who had already received a titanium hip cup.
“How long will a 3D-printed hip last? As yet there’s no frame of reference. But signs are good, considering Grappiolo’s patient is still going strong, as are many others,” Olson wrote. “The surgeon has since implanted close to 600 hip cups — his group has implanted over 1,500 — that were created by 3D printers made by the likes of Arcam. He believes the devices could last ‘a lifetime.’”
Recent industry and regulatory advancements such as the establishment of clinical guidelines, 3D printing reimbursement tracking codes, and the integration of technology and software are all expected to support the widespread adoption of point-of-care 3D printing in hospitals, according to the VA Puget Sound.
According to its website, the VA Puget Sound provides comprehensive care to more than 110,000 Veterans across its nine facilities in the Pacific Northwest. It has the 5th largest research program within the national VA system and seven Centers of Excellence, in areas from limb-loss prevention and prosthetic engineering to primary care education and substance abuse treatment.
The Veterans Health Administration (VHA) program is one of the six major government health care programs which provide health care services to approximately one-third of Americans. The others include Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), the Department of Defense TRICARE and TRICARE for Life programs (DOD TRICARE) and the Indian Health Service (IHS) program. According to the National Academies Press (NAP), which publishes the reports of the National Academies of Sciences, Engineering, and Medicine, “The federal government has a responsibility to ensure that the more than $500 billion invested annually in these programs is used wisely to reduce the burden of illness, injury, and disability and to improve the health and functioning of the population.”