Jul 14, 2021 
Daniel Crawford is the Founder & Chief Strategy Officer of axial3D, a company creating automated 3D printing solutions to make patient-specific surgery routine practice in hospitals globally. Daniel graduated with a BSc Hons in Biomedical Engineering and an MSc in Medical Visualisation and Human Anatomy. He has over 10 years of experience in medical device development and deployment into clinical settings, 7 of which are specifically related to medical 3D printing and automated applications. Daniel is responsible for the strategy within Axial3D, including its machine learning algorithms for use in creating 3D printed models from 2D medical scans. Dan will speak at the upcoming Point of Care 3D Printing webinar this coming Thursday.
Jenny: When was the first encounter you had with 3D printing? What was that experience like? What were you thinking at that moment?
Daniel: The first hands-on experience I had with 3D printing was back in 2009 when I was prototyping innovative hospital monitors with a local biomedical engineering firm. Having worked within traditional injection molding workflows for so long, seeing the quick turn around and capabilities of 3D printing had me hooked!
When I was completing my postgraduate research at the Medical School in Glasgow University, I knew I wanted to explore the use of the technology in medicine. During this research, I found innovative ways to create 3D printed physical replicas of patients’ traditional medical scans. Having learnt about medical physics in depth and training my brain in CT and MRI analysis, just seeing the scans in real life, at scale was incredible. I knew from then on that I wanted to make this routine for hospitals all around the world.
Jenny: What inspired you to start your journey?
Daniel: During my research I worked with a number of orthopedic physicians at the Glasgow Western Infirmary in analyzing the use of 3D prints for teaching junior surgeons about complex anatomy and pathologies. The ‘light bulb moment’ for starting Axial3D came when I got my hands on a CT scan of a female patient who had been in a road traffic collision. The surgeons had planned to treat the patient’s multiple fractures later in the week once she had stabilized, which gave me time to segment and 3D print the anatomy. What happened next was incredible, I walked into the surgeon’s office with the patient’s 3D print and the surgeon’s first words were oh gosh !(substituted swear word out!). There was a portion of the patient’s fracture on her iliac crest that the surgeon had completely missed. He took out additional plates and screws from his desk and made a completely new plan for her based on this new information. Just seeing the 3D print increase insight and allow the surgeon to dry run the procedure on his desk with his team made me realize that this technology would have a huge impact on patient treatment.
Jenny: Who inspired you the most along this journey in 3D printing?
Daniel: That’s simple. The patients. During the first year of Axial3D, we made countless models for pediatric and adult patients that had a transformative impact on their care. Just seeing how 3D printing changed the way surgeons thought about how they treat patients was incredible. One patient in particular has stuck with me;a little boy with osteogenesis imperfecta, a congenital brittle bone disease. The surgeon was having trouble getting a complete understanding of his anatomy and how he was going to stabilize it. With 3D printing, the surgeon was able to ‘treat’ his bony anatomy in multiple different ways before he even stepped foot into theater. This meant that he was able to get the perfect plan, right the first time, allowing the little boy and his family to leave the hospital earlier and with reduced complications.
Cases like this are the reason why Axial3D are laser focused on reducing any barriers to hospitals adopting this technology.
Jenny: What motivates you the most for your work?
Daniel: Hearing the stats about hospitals using our models. This is what motivates us and makes it easy to get up everyday knowing that you are having a direct impact on patient outcomes.
During the last 5 years we have received feedback from hundreds of medical models and in almost 50% (yes half!) of surgeries, the diagnosis or surgical plan is changed with use of a 3D printed model. It is stats like these that motivate us to create innovative, automated ways for hospitals to adopt this technology at scale.
Jenny: What is/are the biggest obstacle(s) in your line of work? If you have conquered them, what were your solutions?
Daniel: Segmentation. There are a number of processes in creating an anatomical model, but segmentation is the biggest bottleneck for 3D printing being used in every hospital around the world. It requires a specialist skill set. To address the market need for 3D printed planning models, it requires 1000’s of years of manual processing by skilled engineers with segmentation taking up most of the time needed.
For the last 4 years, Axial3D has developed a cloud-based automated SeAAS (Segmentation As A Service). An AI segmentation solution hosted on the Amazon Web Services cloud which allows any hospital, anywhere in the world to upload DICOM data and get a 3D print file the same day or a 3D printed model delivered in 72 hours. With this technology we have seen a dramatic increase in a hospitals ability to adopt the technology. By removing the complex barriers to adoption and allowing surgeons to just get access to the solution has had huge implications on patient outcomes globally.
Jenny: What do you think is (are) the biggest challenge(s) in 3D Printing/bio-printing? What do you think the potential solution(s) is (are)?
Daniel: Besides segmentation, one of the limiting factors is reimbursement. Getting hospitals to adopt this technology requires evidence, and lots of it! There are plenty of case studies and evaluations of 3D printing that show huge benefits to patient care. But getting peer reviewed studies of the quantifiable benefits will massively help with the adoption of the technology into clinical care pathways.
One of the most significant developments to this is the CPTIII insurance code in the US that was released by the American Medical Association. Trial codes that are used pior to full reimbursment. Having a structure to capture this evidence and use it to influence routine reimbursement in US healthcare will give the rest of the world a platform from which to benchmark their adoption.
Jenny: If you are granted three wishes by a higher being, what would they be?
Daniel:
- Instant 3D printing – Axial3D automate the software part of the workflow to make it instant, an instant 3D print would be the holy grail!
- An open access global hospital dataset – there are so many ways in which AI can help with diagnosis and treatment of disease but availability of data is still the biggest hurdle.
- To be master brewer of New England IPAs – I’ve spent years trying……. so resorting to wishing!
Jenny: What advice would you give to a smart driven college student in the “real world”? What bad advices you heard should they ignore?
Daniel: Focus. Don’t try and boil the ocean. Fix one thing well and be the best at it and then more opportunities will open up.
Related Articles:
Segmentation: The Real Struggles Behind Converting DICOM to Patient-specific 3D Printable Models
Why Copper? A Conversation with Daniel Martinez Copper3D (Recording and Notes)
Newborns, Warriors, Unicorns, Winners: Commercialization of Healthcare 3D Printing In 2020
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