Dr. Philipp Brantner is a radiologist at the University Hospital of Basel, Switzerland. In April, he presented his case study, "Hospitals and 3D labs. Why, how and what now?" at the 2017 Materialise World Summit in Brussels. His inspiring talk centered on his experience in deploying and running an in-hospital 3D printing lab at the Basel University Hospital together with his team. He shared fresh and useful perspectives on implementing a new workflow, its successful outcome, and how to keep the lab sustainable.
The Basel University Hospital is the largest medical center in the northwest of the country. It has 780 beds which were occupied by 35,000 patients in 2015, and 50 clinics with medical specialties. The radiology department began with 3D Printing about three years ago and opened its 3D printing lab last year in June. Nearly a year later, the verdict is that the addition of 3D Printing has contributed positively.
Why start with 3D Printing?
The creation of custom devices tailored for specific patient needs is made possible by revolutionary technology. 3D Printing allows hospitals to stay innovative by adding an additional layer of patient-specific care to their offering, and gives them a competitive edge.
Dr. Brantner highlighted the hospital's motivation behind implementing 3D Printing. Keeping a 3D printing lab in-house has its internal advantages, he says. There's no dependency on external service providers, and no need to wait for the delivery of a newly printed product.
He also made it very clear that having an in-hospital 3D printing lab greatly improved patient care and outcomes at the Basel University Hospital. There's increased understanding of complex anatomical relationships which can bring positive effect on saving surgical time. Patient education, as well as the education and procedure training of medical students and residents are also major benefits.
Furthermore, cooperation has notably improved within the surgical teams that use the 3D-printed models. Communication between surgeons and radiologists begins earlier, before the model is printed, says Dr. Brantner. A referring physician can view the 3D-printed model and discuss the preferred course of action with the radiologist in more detail. This more efficient collaboration expands opportunities towards all disciplines within the hospital.
Radiologists embrace new technologies
The role of radiologists is being challenged by new technologies such as artificial intelligence. Many day-to-day tasks could increasingly become automated. The vast experience that radiology centers have with medical imaging however, opens up new, valuable avenues. For example, one such avenue could be high-end consulting in therapy for complex conditions. Another opportunity could also present itself by expanding radiologists’ service portfolios to include radiologic reports with 3D representation. Technologies such as 3D Printing could be great allies for radiologists in redesigning their roles.
Making room for a 3D printing lab
Your hospital wants a 3D lab. Where to begin? Dr. Brantner suggests finding a partner first. In his case, as both radiology and cranio-maxillofacial (CMF) departments already had 3D printers, Dr. Brantner found CMF surgeon Dr. Thieringer to join him in this interdisciplinary adventure – which turned out to be a very strategic move.
The joint experience of radiologists and CMF surgeons means there is more shared knowledge about the acquisition of imaging datasets, and more experience in visualization and image post-processing. CMF surgeons have in a sense become 3D experts in a surgical context, as 3D Printing has been part of their discipline for decades already.
3D printing lab hacks
Dr. Brantner's valuable advice is to start small, and expand the lab as demand for 3D imaging rises. The use of the lab should be simple, and the access open, so that surgeons can easily file report requests for models. Its location is also very important. Their lab is centrally located, close to the radiology department, and easy to reach for busy surgeons who try to pop in between two operations.
The Basel University Hospital implemented a direct workflow from their electronic medical record (EMR) system. A referring physician can simply order a 3D print and the request arrives in one shared inbox. Dr. Brantner, or his colleague Dr. Thieringer, can check what prints are coming in, and which still need to be made. Routine cases are directly processed and the more complex cases are discussed further with their referrers.
The next step is to define and monitor the 3D printing process; from DICOM exportation to the photo documentation of finalized prints. The setup of the lab also includes a cloud platform that monitors the printers, to keep track of which machine is currently free.
The results after one year include 4000 hours of printing time, 9 printers on-site, 11 in remote hospitals, and one SLA printer. The hospital printed approximately 34 kilos of material, and 4 liters of resin.
“These results have really been appreciated,”
says Dr. Brantner.
"Not only by patients, and in-house, but also by press mentions."
What happens now?
What's the medical equivalent of advertising? According to Dr. Brantner: communication, and lots of it. Many physicians are not familiar with 3D Printing and its potentials and benefits, he says. He encourages talking to colleagues, educating the public, and starting projects involving 3D Printing. He also says to engage the hospital's press department and share what's going on in the 3D lab.
"Make it sustainable," is another recommendation from Dr. Brantner. Also, creating a regional network and working closely with other hospitals and universities can help in more complex cases where different materials are needed, for example.
Finally, the lab should be profitable. Dr. Brantner underlines the importance of establishing a reasonable pricing structure, and the Basel 3D lab also plans to negotiate with insurance providers for reimbursement models, as well as expand the lab's service portfolio.
Setting up a 3D lab is a step away
The work of Dr. Brantner and his colleagues has shown that setting up a successful 3D lab is entirely possible. Their work has proven that a hospital can benefit from the technology enormously. The right partners, a great location and dedicated tools can provide all the needed support.
Dr. Brantner's setup includes using Materialise Mimics technology for the segmentation and creation of 3D anatomical models. There's no need for initial large investments. It is possible to start just by creating digital anatomical 3D models, while outsourcing the actual 3D Printing. Then your 3D Printing lab can take its next steps accordingly.
Do you want to find out which solution works best for your hospital, and how you can get started? Get in touch with us!