Factors Affecting the Implementation of Additive Manufacturing Technology in Healthcare.

Abstract: Additive manufacturing (AM) has made it possible for patients to have personalized healthcare treatment such as implants, surgical guides etc., which was not possible previously. Despite the massive opportunity of custom-made implants, some factors made their use in clinical practice more difficult. Keeping this in focus the purpose of our thesis is i) To identify stakeholders relevant to AM in healthcare ii) Identify barriers for AM in healthcare iii) Propose a business framework based on barriers and stakeholder identification.  A literature review delineated current barriers for AM in general as well as specific to healthcare. Additionally, different dimensions that AM impacts in healthcare and the current business frameworks used were explored. A case study design was applied using deductive reasoning. The Data was collected from semi-structured interviews with the help of snowball purposive sampling. Also, a part of the studies relied on archival data. CFIR framework was employed for data collection, and an interview guide was prepared using the same. The stakeholder analysis model and new business concepts were also utilized under the theoretical framework. Data from the interview was analysed by thematic analysis. The main themes were the Inner setting, Intervention characteristics, Network, Individual professional characteristics, and Outer setting.   The study results are categorized based on the technology used for printing, i.e., Metal printing and Polymer printing. Metal printing superseded polymer printing in terms of the number of barriers. Moreover, in terms of the ‘Inner setting,’ common barriers for both printing technologies were lack of training for medical professionals w.r.t AM machines and lack of skilled personal for handling the design software. In terms of ‘Intervention characteristics’, lack of infrastructure (not good enough scanner for scanning patients) and lack of user-friendly software were few common barriers for both printing technologies. The theme ‘Individual professional characteristics’ contained barriers like lack of entrepreneurial mindset (lacking in individuals who take initiatives and invest time), laggard’s attitude (individuals not willing to change the way they work), technological barrier due to generation gap, and lack of practical experience. Lack of demand and lack of legal framework were barriers for metal printing in the context of the ‘Outer setting’.  Lastly, with evidence of AM facing numerous barriers, it becomes paramount to examine those barriers at different levels critically during its implementation. Addressing and tackling them with a solution regarding business frameworks and knowledge of relevant stakeholders can alleviate some of the hurdles.