In January this year, the British Medical Association claimed that pressure on the NHS is “intolerable and unsustainable”, and called upon government to “step up and take immediate action.”
Now, as we approach the summer of 2023, little progress has been made and the healthcare service is in worse shape than ever.
The past few years have been unpredictably difficult for all healthcare providers – but especially publicly funded services such as the NHS.
The pandemic placed unprecedented amounts of pressure on hospitals which both needed to treat patients suffering the worst effects of Coronavirus and simultaneously manage a pre-existing caseload of the more mundane, day-to-day appointments, procedures and surgeries. And then there are the emergency cases to consider.
Existing in a turbulent economy whilst experiencing strikes, resignations and a reduction in government spending, hospitals are faced with several significant issues.
Staff are overworked and under-resourced and patients face increasingly lengthy waiting times for appointments.
Surgical procedures are delayed because of a lack of surgeon availability, who are still clearing backlogs and working on emergency cases.
On top of this, others are pushed back due to the non-availability of implants due to supply chain disruptions.
And, in the time it takes for a patient to be seen, their health conditions could be getting worse, meaning a more complicated treatment plan may be needed, and with it yet more time and cost… it’s a vicious circle which needs to be broken.
As with most things, the key to improving something is to invest in it.
Dedicating the funds and attention and expertise to devising new, better ways of tackling a problem or providing a service.
New and emerging technologies are currently redesigning the fabric of what we once thought was possible when it comes to day-to-day practice across virtually every industry.
Whether through virtual AI tools, or physically advanced machinery, technology can help to bear some of the burdens placed on human staff.
In the healthcare sector, it is no different.
The technology now exists to not only improve services but to speed them up.
For example, research I conducted alongside colleagues at ORT Braude College of Engineering in Israel, and the University of Southern Denmark found that technology such as 3D printing could prove to be a significant asset to hospitals when it comes to surgery.
By conducting interviews, running workshops and visiting hospitals to better understand how such technologies were being used by surgeons and professionals on the surgical teams, and the results of their implementation, we uncovered four key benefits the technology can provide;
- Improving outcomes of surgeries
Any operation comes with a degree of risk – whether from a surgical error or unexpected complications. Take, for example, a patient with a tumour in their leg.
If surgery to remove the tumour goes wrong or is not thorough enough, the patient is at risk of having the tumour come back, or even having their leg amputated.
To avoid such consequences, surgeons often remove extra healthy bone around the tumour.
Whilst this is the safer route, it often results in a longer and more difficult recovery for the patient, and the possibility that the patient may be limited in some ways afterwards.
The research shows that giving surgical teams the ability to 3D print anatomical models based on an individual patient’s surgical needs provides more detailed and exact information to both plan and practice the surgery, minimising the risk of error or unexpected complications.
Such technology is also useful when explaining the details of a planned surgery with the patient, helping to better inform and reassure them.
- Speeding up procedures
And with better planning comes better execution.
Pre-surgical planning using 3D printed anatomical models already removes a lot of uncertainties around conducting the surgery, thereby reducing the surgery time.
Using custom-designed and 3D printed surgical tools can help even further shorten surgery time.
Research shows that surgeries with typical durations of four to eight hours became as much as 2.5 hours quicker when patient-specific instruments were used.
The benefits here, aside from meaning less time on the table for the patient, and the need for less anaesthesia to keep them unconscious (removing an additional layer of associated risk – as complications can arise from being under anaesthetic), is that swifter, safer procedures allow hospitals to potentially schedule a greater number of surgeries each day, without the need to invest in more staff or find the space to build new operating theatres.
Finally, the healthcare sector has a realistic chance of cutting down waiting lists.
- Speeding up patient recovery time
Speed can be found in other areas too through the use of 3D printing – such as the time in which it takes a patient to recover and leave a hospital after surgery has taken place.
Hospitals which provide surgical teams with the ability to produce 3D printed anatomical models, surgical tools and implants saw a significant reduction in post-surgery complications, patient recovery times and the need for subsequent hospital appointments or treatments.
This is all due to customisation.
Built-for-purpose tools and pre-planning make surgery less invasive, by helping to avoid the need for excess healthy bone and tissue to be removed as procedures can be more exact.
Furthermore, 3D printed implants can be designed to be a perfect fit for each patient, helping their body to adopt them quicker and without complication.
Not only does the patient get a better post-surgery outlook, and a better quality of life afterwards, but the hospital benefits from freeing up beds on wards quicker, less need for post-surgery medications, rehabilitation, follow-up treatments or even future procedures.
- Real-life training opportunities
Like any discipline or skill – practice makes perfect.
3D printing provides a much-needed opportunity for trainee surgeons to learn and collaborate with those seemingly at the top of their game during surgical planning as well as during simulated surgeries using custom built models and simulators.
The technology not only enables surgeons to familiarise themselves with the steps to take in complex surgeries by practising on examples that more accurately replicate real patient problems, but it offers the opportunity to practice on a greater variety of cases too.
This allows junior surgeons to get much needed experience so that they can get to work on complex surgeries much earlier in their careers.
The benefits are certainly compelling.
However, a hospital with the spare budget to invest in state-of-the-art 3D printers, let alone set aside the time and the additional cost needed for training staff to use such advancements is hard to come by in a public healthcare system.
Our study sought to address two key concerns from the healthcare sector when considering whether to commit to the significant financial investment that 3D printing technology would require.
First, we wanted to discover how custom-designed, 3D printed anatomical models, implants and surgical instruments could impact upon hospital flow times, surgical outcome variability and any other clinical outcomes that may result from its use.
Second, we aimed to understand how hospitals make decisions regarding investment in 3D printing for surgical purposes, and how our research might help clarify that process.
One key finding, aside from budgetary and practicality restrictions, is that something of a fear of the unknown is holding the healthcare sector back – whether due to the worry of making a bad investment, or the reality of having to move with the times, adapt to the changing, increasingly technologically savvy world around us and lean into the opportunities such technologies provide.
To that end, alongside the evidence that such technology provides multiple wins for patients and clinicians, our research sought to support hospitals in their journey to implementing it.
Our framework, guides decision makers through the process of analysing the various factors which hospitals need to consider.
For example, whether to invest in building capabilities in-house or to outsource the specific tasks or models which the healthcare 3D printing service requires, or whether to set up 3D printers within or near the hospital and how to work closely with the clinical team to address key needs and deliver solutions.
Such factors include the volume, time criticality and complexity of surgeries, as well as meeting the hospital’s objectives and priorities, which so heavily influence how hospitals or healthcare systems such as NHS Trusts approach 3D printing.
In a follow-up study, we explored this further, by identifying all the resources and capabilities needed by surgical teams as well as the 3D printing service providers to work together to get the maximum benefits from the technology.
Above all, hospitals and their expert staff exist to save lives.
If a patient with a complicated condition cannot be scheduled for surgery due to lack of an implant or a surgeon being unavailable, or where it is risky to operate using a standard procedure, 3D printing can be that potential lifesaver.
Healthcare, by its very nature, is built on innovation – on pairing human intellect and curiosity with the will to take a leap, try something new and, ultimately, find a new way to help fellow man.
Whether through AI healthcare providers, or innovative technologies, the healthcare sector cannot afford to be hesitant.
It requires a will to embrace change wherever it is needed. After all, our very lives depend on it.
Surgeries will continue to be done using traditional approaches.
But, this should not stop us from using 3D printing where there is a compelling case to for both clinical and operational outcomes as well as for improving the existing process by using the anatomical model to pre-plan the surgery and thereby reducing the overall surgery time and hence freeing up scarce capacity.
Dr Atanu Chaudhuri is Associate Professor in Technology and Operations Management at Durham University Business School, a member of the Centre for Innovation and Technology Management at the Business School, and a Fellow of the Wolfson Institute of Health and Wellbeing at Durham
This research has been published in the International Journal of Operations and Production Management
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