3D Printing for Surgical Planning: The Clinical and Economic Promise using Quantitative Clinical Evidence
Reporter: Aviva Lev-Ari, PhD, RN
The Clinical and Economic Promise of 3D Printing for Surgical Planning
M A K I N G T H E C A S E T H R O U G H Q U A N T I TAT I V E CLINICAL EVIDENCE
Stratasys engaged Quorum Consulting, experts in health economics and outcomes research, to conduct a comprehensive analysis of the clinical and economic evidence on 3D printing for surgical planning. This white paper, authored by Quorum Consulting, summarizes the result of that analysis.
Wade Aubry1,2, Raj Stewart1 , Chance Scott1 , Jeffrey Chu1
The modern emphasis on evidence-based medicine centers on three core tenets: • Best available research findings • Clinical expertise • Patient value Incorporating cutting-edge technology alongside these principles – often delicately balancing material innovation against scientific rigor, state-of-the-art professional training and experience, and attempts to provide the best care while respecting patient perspectives – is a challenge. 3D printing, however, aligns with the first two tenets, and when appropriately employed, may inform and indirectly influence the third.1
1 Quorum Consulting, Inc., San Francisco, CA, USA
2 University of California, San Francisco; San Francisco, CA, USA
3D printing was used in surgical planning applications in a wide range of specialties including cardiothoracic, orthopedic, neurological, reconstructive and transplant surgeries, as well as gastroenterology and surgical oncology. When examining these use cases, five general benefits emerge in association with 3D printing for surgical planning:
- Patient communication
- Anatomic familiarity
- Procedure practice
- Procedure selection
- Patient selection / rule-out
INDICATION-SPECIFIC UTILIZATION AND EVIDENCEBASED EFFECTIVENESS DATA / RESULTS
- Cardiothoracic surgery
- Reconstructive surgeries
In a healthcare environment continuing to shift towards value- and outcome-contingent systems that penalize providers for inefficiencies and suboptimal outcomes in rendered care, 3D printed models for surgical planning – with their ability to facilitate procedural efficiency, improve treatment outcomes, and reduce downstream re-intervention costs – offer high potential value. Patients, clinicians and hospitals all have a vested interest in quality, affordable patient care and service, and surgical planning with 3D models appeals to each of these stakeholders.
Accordingly, results and trends from published literature and healthcare data support the effectiveness of 3D printing for surgical planning. As shown for several surgical procedures, clinicians with access to 3D printed models are able to provide better, more efficient care likely to improve patient outcomes and reduce the need for additional surgical interventions. Procedures that would most justify the financial and resource cost in creating 3D printed patient models are those with long operating times, high Relative Value Units (RVUs), greater risk and uncertainty, and risk of complications. Concurrently, this quality care is also potentially less costly and more profitable to providers. Amidst the growing commercial market for 3D printers and related technologies, there are some key differentiators when evaluating utility for surgical planning. As reflected in clinician surveys, the most effective 3D models should capably depict complex, fine anatomy with high fidelity to actual patient physiologies. This degree of fidelity crosses several characteristics:
- Accurate depiction of a variety of colors
- Simulation of multiple textures
including the ability to be dissected or probed with surgical instruments.22 Given these real-world requirements, next generation multi-material and multi-color 3D printers likely represent the best option for facilities and clinicians. Viewed objectively, additional data addressing the quantitative impact of 3D printed models is needed. Preferably, this data will be generated from well-designed, patient outcome-oriented studies. However, in the interim, the tide of evidence favors 3D printed models for surgical planning, particularly for leading-edge clinicians and healthcare administrators who are able to recognize its value.
A Brief RVU Primer:
Relative Value Units (RVUs) are used by Medicare to determine reimbursement rates for a given service:
• For each service, Medicare determines the cost value of three primary components – physician’s work, practice expenses and malpractice insurance.
• These three components are then adjusted based on differences in living and business costs nationwide, using a factor called the Geographic Practice Cost Index (GPCI).
• The adjusted values are multiplied by an annual conversion factor, established by the U.S. Congress, and totaled to calculate final reimbursement rates.
From: Medical Design & Outsourcing <firstname.lastname@example.org>
Date: Wednesday, February 15, 2017 at 2:00 PM
To: Aviva Lev-Ari <AvivaLev-Ari@alum.berkeley.edu>
Subject: The Clinical and Economic Promise of Surgical Planning Using 3D Printing
Other related articles published in this Open Access Online Scientific Journal including the following:
- 3D Medical BioPrinting Technology Reporting by Irina Robu, PhD – a forthcoming Article in “Medical 3D BioPrinting – The Revolution in Medicine, Technologies for Patient-centered Medicine: From R&D in Biologics to New Medical Devices”
Curator: Aviva Lev-Ari, PhD, RN
Technologies for Patient-centered Medicine: From R&D in Biologics to New Medical Devices