Identifying research and development priorities for an in-hospital 3D design engineering facility in India

Abstract

Advanced three-dimensional (3D) design and engineering technologies have revolutionized patient-specific implants, prostheses and medical devices, particularly in the cranio-maxillofacial and oral medical fields. Lately, decreasing costs, coupled with the reported benefits of bringing design and production technology closer to the point of healthcare delivery, have encouraged hospitals to implement their own 3D design and engineering services. Most academic literature reports on the factors that influence the sustainable development of such services in high-income countries. But what of low- and middle-income countries where demand for custom craniofacial devices is high? What are the unique challenges to implement in-hospital services in resource-constrained environments? This article reports the findings of a collaborative project, Co-MeDDI (Collaborative Medical Device Design Initiative), that brought together a UK-based team with the experience of setting up and running a hospital-based 3D service in the United Kingdom with the Maxillofacial Department of a public hospital in the Uttar Pradesh region of India, which had recently received funding to establish a similar capability. We describe a structured design research approach consisting of a series of exchange activities taking place during the lifetime of the project that compared different aspects of the healthcare innovation ecosystem for 3D services in India and the United Kingdom. Based on the findings of the different activities, we identify key factors that influence the adoption of such services in India. The findings are of relevance to healthcare policy-makers and public hospital managers in resource-constrained environments, and to academics and practitioners engaging in collaborative export of healthcare initiatives.