Crossing the 3D Printing Chasm: Bringing Optimization to the Masses

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Additive manufacturing, popularly known as 3D printing, is not new nor is its hype. It has promised gains in product optimization, cost and waste reduction, and a plethora of other noteworthy benefits. Some industries, most notably dentistry, have taken advantage of the technology and adopted it widely but others who stand to benefit tremendously have yet to. 

As a firm believer in the value-add, it has to offer, I must ask, why has it not spread further? In particular, why has it not spread into the world of medical devices, an application that stands to benefit greatly from the tech’s ability to make custom products? 

There are without a doubt a few good reasons. In fact, a recent edition of a leading orthotics and prosthetics magazine, O&P Edge, presents the perspective of various members of the said industry that have pioneered the adoption of 3D printing on this matter.

They refer to a need for education and increased awareness of technical details relating to 3D printing materials, capabilities, and so on, which is tied to another topic – the importance of developing design skills. They then mention the role of professional associations and the standards they could develop for guidance. 

Interestingly, they point out that many are satisfied with the methods established in the industry, and as one expert mentioned, this may be “because they don’t have to [change], they’re craftsmen and they’re good at their craft”. Unfortunately, poor patient adherence to their prescribed medical device makes me wonder: can the craft be improved? Are the needs of the patients truly being met? Can additive manufacturing technologies help reach this objective?

It bears pointing out that I consider the barriers to adoption mentioned above to be valid yet to also be the opinion of early adopters of 3D printing, i.e. the innovative and risk-taking folk – the pioneers. Their perspective is the product of who they are – innovators eager to test new tools, to tinker and assemble whole solutions themselves from scattered solutions made available by early players in the market. 

Furthermore, we may benefit from taking an innovation marketing perspective to add to that of medical professionals to investigate if it digs up insights on how to facilitate adoption by a broader user base – as inspired by the flagship book – “Crossing the Chasm” by Geoffrey Moore, for example. 

As such, the points discussed below take a step back from the medical perspective and investigate how we may convince the remaining majority to adopt 3D technologies. The points relate to the need for 3D printing enterprises to focus their efforts and to band together to create a whole set of products that will enable the technology to reach the masses. 

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Don’t fall in the chasm, jump to the other side! https://unsplash.com/photos/Mlc-qTvpHSU

Be the big fish, in a small pond. 

Innovators and marketers must select a very specific market for their big aspirations. It does not suffice to market 3D printing as a technology anyone can use, for anything they may dream of. 

Defining a market goes beyond selecting an industry. There is a need to define the specific problem addressed and who this is affecting; what are their values, what do they care about/what do they not care about? For example, individuals needing to prototype may benefit from a different solution than those wanting an end-product manufacturing process. It is imperative that innovations be developed and optimized, as well as marketed in a way that serves the purpose for which it was acquired. 

Even within a given market, depending on the preferences of those adopting the technology, various approaches can be taken. As described in a previous article on approaches to custom-fitting orthotics, there are varying degrees of tech integration, with options of techniques that rely minimally on, yet nonetheless benefit from 3D printing and others that rely entirely on the tech. Hence, it must be acknowledged that there are varying degrees to which the tech can be adopted and thus, how much we can benefit from it in a given context.  

Making a blanket statement that the technology can serve any application is most often a gross exaggeration that leads to heightened expectations by a wide range of individuals. This not only leads to expectations that surpass the tech’s capabilities but will also inhibit the tech from specializing itself for a given application as the feedback of users pulls product development teams in different directions. 

HP entered the 3D printing market in 2016 and has quickly become a major stakeholder. Their Multi-Jet-Printing technology offers several benefits and has been employed by various industries. However, HP seems to have strategically focussed their developments on specific verticals where their printers offer the greatest value – ie the field of orthotics and prosthetics, and more specifically that of pedorthics. 

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They have created a centralized workflow they call Arize that combines various processes involved in the practice of pedorthists; from equipment and software, to creating a digital file of the patients’ foot, to writing a prescription, ordering, manufacturing, and delivering the insole. 
As discussed in this article, they worked closely with their end-users to understand their pain points and developed a solution accordingly. The process of ordering a 3D printing insole would have traditionally involved several more steps, but the Arize platform simplifies it to ensure streamlined operations. While innovators may have wanted the individual solutions, the majority don’t and the focussing of HP’s efforts on a specific application has enabled them to develop a unique platform. 

Beyond product optimization, selecting a specific market enables the word of a successful product to spread through the network of individuals more easily. Although international conferences and the internet may lower the barriers to communication between professionals on different sides of the planet, word-of-mouth remains highly influential and marketing strategies must take this into account. 

It is important to establish trust between innovators and users. As many have stated before, “it doesn’t matter how much you know, what matters is how much you care”. Users want to see a commitment from innovators, they want to ensure that if they invest in technology, the potential issues that may arise will be taken care of and that the innovators will not simply pass to another market segment.

The takeaway here is that the ultimate goal is to establish your organization and its products as the market authority – to develop a highly tailored product that meets the needs of a user base that can spread by word-of-mouth among users. 

This process requires strategy and discipline. Picking a segment, in which efforts can be focussed on a specific, less guarded front, can have a greater potential for success. Yet this is not easy to abide by and strong discipline is necessary. 

Whole solutions.

Successful innovations, including their adoption and spread through the market to become the status quo, requires it be shaped around a specific problem – a pain point. By satisfying such a need – at a reasonable cost – value is created. 

This is enabled through what is called the value chain, a series of services or products that when combined appropriately solve a problem. Moore refers to the “whole product” as the set of solutions a specific individual needs access to. 

As such, we are poised to ask: what set of solutions are needed by orthotists and prosthetics to achieve their goal? As mentioned above though, there are different approaches that can be taken to custom-fit products using 3D printing, each with its own value chain. As such what sets of solutions are required? 

The whole product can either be accomplished in house by creating a one-stop-shop (which can be done for a very specific segment and problem, with a tremendous amount of resources, as demonstrated by the Arize platform offered by HP), or through partnerships between organizations that each offer different parts of the solution and are banded together through joined processes, which have historically also lead to mergers and acquisitions as the value of the partnerships solidify.  

Another company that has banded whole solutions together is another Silicon Valley-based company – Carbon. Known for their 3D printing technique called Digital Lights Synthesis and their numerous commercial products, such as the custom 3D printed CCM hockey helmet liner and the Adidas 4DFWD 3D printed shoe, Carbon is an industry leader. 

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Their products range from 3D printers to post-processing equipment and from software to training programs. To ensure all can access their technology, they also offer a printing service or can partner with an outsourcing production center equipped with their printers. An interesting aspect of the Carbon offer is the payment plan they utilize. Rather than requesting a substantial upfront cost requiring substantial commitment from the client, they chose to function through a subscription model. 

They claim this leads to several advantages, including better maintenance and continuous improvements to the technology through remote updates. Overall, they have studied their market and understood the pain points of those trying to operate 3D printers. Through their line of products and services, it is becoming evident with the line of commercial products they are affiliated to that they are indeed crossing the chasm, if they have not already. 

Reflecting on the answers given in O&P Edge, I wonder if the whole product required by the individuals surveyed is the same as that for someone more hesitant and less likely to assemble the different pieces of the solution together. 

As described by Moore, early adopters of tech have different personas than the majority of users of a product. The latter relies on practical gains offered by the tech and needs the entire solution to be delivered – they search for established solutions (the big fish), and will wait for the competition to be established to identify the best, most well-supported course of action.  

As such, I believe there is a great need to further support the different steps and transition between them. But exactly what is needed? For a start, we must support the design process further! 

The medical professionals that contributed to the O&P Edge article point to design skill development as a strain on the adoption of 3D printing, but what if we were to remove this step from the process? Yet craftsmanship is a value held dear to these medical professionals and they may want to control the design process, whether it be through manual or digital processes.

As discussed in a previous article, there is a need to respect the value system established in an industry and we must not swim against its current. As such, the repetitive and tedious tasks of design could be automated, while the process of optimizing the product to meet the personal needs of a patient can be made the responsibility of the practitioner, through either semi-autonomous design, improved user interface, and/or through collaboration with a design firm.  

Alternatively, the manufacturing and post-processing of the product could be assigned to the orthotist’s office to leave some of the craft to them. Although points were made in the article that justifies outsourcing the production steps, the value-system of orthotists reminds us that there is a need to leave some of the craft in their hands. If the equipment was owned by every O&P office, then the issue of maintenance and upkeep would require greater support by the printer manufacturers – thus creating or fortifying a wing of services offered by these companies – one of maintenance and training. 

Alas, it will be critical that we remove the tedious steps of adjusting a design to fit the patient to maximize the practicality of solutions, and we should avoid having medical practitioners design the products from scratch. Where then is the middle ground?

The inadequate adherence to a prescribed device and plan serves as a signal that there are improvements to be made to the system and the products it puts out. Since there are massive functionality gains to be achieved through 3D printing and associated technologies, there is a need to facilitate its adoption. Innovators developing such solutions must take the “whole product” approach and ensure the process is complete while leaving enough craft on the table. 

Call it for what it is – disruptive.

3D printing and associated technologies are not “just a tool”. Sure, it is a tool in the sense that it helps to achieve your goal. Yet, it is revolutionizing the way in which this is accomplished by unlocking greater freedom of design and creativity, but also enabling new ways of operating. For example, as discussed in the O&P article, the use of scanning technologies can allow work on the go, changing how we operate with clients and cutting travel time and costs. As such, 3D printing in O&P is a disruptive innovation as it changes the way we behave, and even the way we think of what is possible.

The CCM Super Tacks hockey helmet is the first in the world to feature a custom-fit 3D printed liner. Composed of a lattice structure, it balances optimal mechanics, breathability and comfort, to address the literal and figurative pain points of previous helmet designs. Not only is it highly advanced and pushes the boundaries of performance equipment, but it also introduces new behaviors in the market. From the scan of the athletes head, to bespoke and just-in-time manufacturing, new needs are created with players joining to link together to form a new value chain.

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For the 3D printed hockey helmet though, CCM was faced with limited scalability due to the time required to manually customize each helmet and thus restricted production to a few NHL players. With the challenge of scaling their highly complex product, they teamed up with software developer Shapeshift 3D to automate the custom-fitting process, and as such, is yet another example of the value of partnering to connect the value chain and facilitate the democratization of innovation. 

Unfortunately, many fear disruptive innovations. Associated with change, from a past that started with a long learning curve that over years of grit built up to success, to a fleeting sense of security. These difficulties are not inherent nor the fault of the innovation or to those adopting them, but they are the result of poor innovation marketing.

In closing, I am passionate about innovation and committed to addressing adoption in the medical sector. I am a fervent believer in designing for the user and acknowledge the importance of involving a variety of stakeholders.

About the Author:

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Jacob Lavigne is a Ph.D. graduate from the program of Experimental Surgery at McGill University. His research interests include orthopedics and associated technologies (algorithm development, 3D printing/additive manufacturing, simulation, and targeted drug delivery) as well as innovation management and marketing practices. Lavigne previously held the position of community engagement manager at Shapeshift 3D, a software development firm empowering orthotists and prosthetists to create optimized products through the use of AI and 3D technologies. He also works as an independent innovation consultant working to facilitate the adoption of various technologies and the paradigm shift to personalized medicine. He achieves this through knowledge development and dissemination, partnership development, advocacy/lobbying, and product development.

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