“If a surgeon is going to operate on a patient, they need to get the patient’s informed consent, which means the patient really needs to understand the procedure,” says Gary Turner, Managing Director, Additive Manufacturing, North America at Ricoh USA, Inc., an integrated services provider and partner that connects technology and processes. “Nothing explains it better than being able to hold in your hand a physical representation of the patient’s exact anatomy to show the patient what you’re going to do.”

Medical schools and researchers can also benefit from using models for cadaver-free physician training and to study rare conditions.

There are barriers, however, to making the technology broadly available to healthcare providers. The process of “segmenting” images such as CT scans and MRIs to identify the anatomic areas for 3D printing can be complicated, requiring much back and forth between surgeons, radiologists and 3D printing technicians. Complex segmentation can take hours of scarce biomedical engineering time.

Such barriers have caused 3D printing to be less available than it should be—perhaps only 5%–10% of physicians have access. “Currently, access to 3D-printed models is limited to very few healthcare organizations, meaning the vast majority of clinicians and their patients cannot benefit from this critical tool,” says Turner.

By partnering with Watson Health, a data, analytics and technology partner for the health industry, Ricoh USA gained the help it needed to create a broadly accessible 3D print service. Watson Health’s key contributions were domain and imaging expertise and a strong industry presence through its IBM iConnect® Access software. A web-based, FDA 510(k)-cleared, HIPAA-compliant medical image viewer, iConnect Access enables healthcare providers to aggregate, exchange and access medical imaging data across the enterprise and the extended care team.

With personnel at many hundreds of facilities already using iConnect Access for medical image sharing and management, it was the ideal platform for adding 3D printing functionality. “iConnect Access provides the interoperability across the radiology department, the surgical teams and the printing technicians who make 3D printing workflow happen,” says Ryan Hess, Director, Innovation and Strategy, Additive Manufacturing at Ricoh USA. “It offers the communications as well as the ability to pass along imaging data that sits in each of those areas.”

The Watson Health – Ricoh USA partnership began with a software development project to enhance iConnect Access with support for 3D printing workflow and interactive image segmentation. “iConnect Access is built on the foundation that automation can be applied to segmentation, and Watson Health is committed to furthering the automation that exists today,” says Hess.

The collaboration began with two IBM Design Thinking workshops, which provided insights into iConnect Access capabilities and what needed to be added for 3D printing workflow. The workshops also determined how the tool would interface with Ricoh USA’s case management portal that links the 3D printing and healthcare teams. All stakeholders had input into solution requirements, including a well-known segmentation expert and physicians who will use the solution.

“As we moved though the iterative Design Thinking process, we explored which data was relevant, how we could move it from one place to another and what we could do with it,” says Hess. “We worked well together because the Watson Health team understood interoperability and the Ricoh team understood how the interoperability could translate into physical output.” The sessions ended with a detailed requirements document passed on to developers.

The partnership continued strong during the give and take between the Ricoh USA and Watson Health development teams. “I think it’s important to recognize the collaborative approach that Watson Health software developers and product managers took with us to build exactly what we needed,” says Turner. “It was an extensive process that was extremely successful.”

The project resulted in RICOH 3D for Healthcare, an integrated end-to-end workflow solution that makes the development, design and production of 3D-printed anatomic models simple, accurate and easy. RICOH 3D for Healthcare makes it possible for healthcare providers nationwide to develop patient-specific representations of tissue and bone. The lifelike replicas serve as physical simulators to help clinicians see inside anatomy for greater visibility into patient needs. These 3D-printed replicas are for non-diagnostic/treatment use. Hospitals already using iConnect Access can simply upgrade to activate the tool’s FDA 510(k)-cleared 3D image segmentation and workflow features. A range of functions empower physicians to edit patient images to their specifications.

Once segmentation is complete, the tool communicates the 3D print file to the Ricoh USA case management and workflow portal, where biomedical engineers take over. Their work includes communicating with physicians to finalize model design and to document all decisions. This step is crucial because the models can vary considerably. For instance, a physician may request to color a tumor red so it stands out, to use materials of different flexibility to simulate actual organs, or to cut a model in half to expose the interior.

Next, the clinician reviews the working image in the iConnect Access viewer. “This is very important,” explains Turner, “because it’s the tool they’re already using.” The approved design then moves into 3D manufacturing for printing and quality control, and then shipping to the healthcare facility.