Interview with Dr. Evin Chen, China Medical University Hospital (Video/Podcast)

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Dr. YiWen Chen received her M.S. and Ph.D. degrees in Industrial and Manufacturing Engineering (Nanomaterial Group) Florida State University, USA. She joined China Medical University Hospital and funded the 3D Printing Medical Research Center in 2014. She is responsible for leading the team and developing and implementing the 3D printed medical research and clinical application integration. She is also the Associate Professor of Graduate Institute of Biomedical Science at China Medical University since then. Dr. Chen’s research interests focus on developing and delivering advanced and affordable 3D printed medical care including biomedical devices, implants, and therapeutics for medical applications. Several of her patents and technologies have to tech-transfer to industries. She was awarded the 2017 and 2018 Innovation in Taiwan. She is also a member of the Board of Supervisors of the Additive Manufacturing Association in Taiwan(AMAT) and a board of directors of China Medical Derivatives Corporation – Everyoung Biomedical International. She is responsible for providing relevant technical advice and is often invited to serve as lecturers at many international academic conferences. Many achievements of her research team are also recognized by high-impact journals, media, conference scientific publications, and published works. She has published 35 peer-reviewed articles and holds 15 issued/pending patents. Dr. Chen will be a speaker for the upcoming 3DHEALS2020 conference.

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Jenny: What inspired you to start your career in medical 3D printing?

Evin: I was a faculty and researcher in Engineering Fields. Comparing to the medical area, I am relatively familiar to 3D printing technology.  The high level of China Medical University would like to engage 3D Printing Technology into their healthcare system, therefore, I was invited to in charge of the 3D Printing Medical Research Center in CMU in Taiwan. It is interesting and challenging. I remember that the first strategic plan draft of 3DP MRC for CMU was made in a small convenience store, 7-11, at an alley nearby CMU. CMU’s consultant, Prof. Ben Wang who is also the Director of Georgia Tech Manufacturing Institute, and I had a long meeting to scheme a broad and impactful vision for CMU’s 3D Printing Medicine Application with his help. Afterward, those works have done in CMU 3DP MRC have been penetrated to many hospitals and clinical organizations, moreover, drive the applications in Taiwan. 

Smart Spine Surgery-from planning to 3D printed templates
Figure 1: The function scheme of 3D modeling and manipulation system for precision spinal fusion surgery

Jenny: What makes Taiwan unique compared to other countries when it comes to innovations in healthcare 3D printing? 

Evin: Taiwan has known for its ICT (Information and Communications Technology) ecosystem, Machine Tooling Industry, and the healthcare system. With these three key pillars, Taiwan should be able to develop and deliver advanced and affordable 3D printed medical care including biomedical assisted devices, bioprinters, implants, and therapeutics to improve the quality of life of the general public. Frankly, the Taiwan market is not the highest preference for many global medical device companies due to our national healthcare insurance. But Taiwan’s ICT and Machine companies are able to manufacture the product at a low cost but the high quality which will meet Taiwan’s healthcare characterizes. I believe that global medical devices in 3D Printing companies should approach Taiwan and seeking high-quality supply chain or clinical trial help.  

Jenny: Can you share with us some of your early successes and failures with your work? How did these shape your work today? 

Evin: As a team leader of CMUH 3D Team, the most critical and challenging thing in my duty is to decide project priority. Whether they are in the team or not, people always like to see many magnificent works done, or high tech save lives just in a snap of the fingers. But the reality is always disappointing. In the early stage, our team’s capacity was relatively low and I would need to select the project wisely. The clinical outcomes were positive in the first few cases and won surgeons’ trust. After then, our team rapidly armed ourselves and aimed to higher and challenging targets. However, not all project selections were a success. Take an example of spinal surgery, we developed a spinal surgical template to assist the surgical operation. It was a success until surgeons started to import the information into the spinal navigation robot. The patient-specific surgical templates that are applied to high-risk surgeries and the related long-design process did not fit the hospitals that owned spinal navigation robots. However, based on our expertise in spinal surgery and the unmet needs, our team created another software that can process the digital model creation, spinal segmentation, pedicular screw placement planning. Additionally, this innovation can also provide precise bone density when the screw location has been made. “Focus on what health workers actually need, rather than what you think you can invent” was the conclusion of that experience.

Figure 3 (a) 3D schwann cell bocks;(b) Live/Death of 3D schwann cell after 3 days culture; (c) schematic of schwann cell blocks into 3D printed PU-based conduits and the animal implantation.
Figure 2 (a) 3D schwann cell bocks;(b) Live/Death of 3D schwann cell after 3 days culture; (c) schematic of schwann cell blocks into 3D printed PU-based conduits and the animal implantation.

Jenny: What are your thoughts on 3D Printing providing “Point of Care”? How does the particular setup at China Medical University Hospital make that work?

Evin: China Medical University Hospital (CMUH) is the first hospital in Taiwan to establish a total solution of 3D Printing medical device processes for clinical applications. However, despite the progress of 3D Printing technology, the most critical concern will be the regulation and reimbursement for 3D printing medical devices for Point of Care 3D Printing. In recent years, several global companies and top-ranking hospitals are promoting 3D Printing tech that should be considered “just in time” point of care. Most clinical users and healthcare providers agreed that 3D printing technology really helps to enhance the quality of the healthcare system and quality of life. In order to incorporate 3D Printing technology into a hospital, many efforts and preparations are needed. CMUH recruited several Engineers and designers who are able to use CAD/CAM software or surgical planning software to build the patient-specific digital 3D models. Moreover, they are capable of designing surgical assisted devices that can fulfill surgical unmet needs. In fact, the talents who are capable to rapidly understand the surgical operation procedure and design perfect tools are rare. Additionally, the CMUH 3D team was composed of physicians and engineers, who would discuss the clinical cases almost weekly. All surgeons and healthcare providers in CMUH are welcome to join this team and provide their ideas and obtain assistance. This is a strong circle of trust for all stakeholders with various backgrounds. The team provides a natural environment for brainstorming, in the end, several innovative devices or solutions would be developed and launched to market.

Jenny: Software, materials, or 3D printers. It has been a debate in the industry forever as to which is the most important player. What do you think is the most important player in healthcare 3D printing? 

Evin: That will be a tricking question regarding what the most important stakeholder is. Without any one of three key players, we are not able to print anything. However, among the three players in healthcare 3D printing, some do play more important roles than others. In my opinion, I’ll say material should take the most important role in 3D printing healthcare applications since we do want all implants, healthcare solutions, assisted devices are biocompatibility. Currently, most 3D Printing materials are not biocompatibility and it could not go through the regulation and should not be used in the healthcare system. On the other hand, 3D Printing medical software is an edge-cutting technology. We can observe that several large global companies in medical image devices are putting their resources in 3D printing. They embedded three-dimension digital construction technologies into their imaging devices. Another novel area is surgical planning and simulation, I noted more and more innovative startups have involved digital surgical planning and analysis, furthermore, simulation. Whether or not these virtual planning will 3D printed or not, it does help the surgeons and physicians, and even more importantly, help the patients.

Jenny: What do you think are the biggest challenges in 3D Printing/bio-printing? What do you think the potential solutions are?

Evin: For 3D printing any medical devices, tools, or implants, I believe that the obstacles are less difficult to overcome. However, there remains a huge gap between the current status of bioprinting technologies and the goal of bioprinting functional organs or tissue. Those hurdles included the limitations of biomaterials, cell type selections, and nutrient supply. Fortunately, numerous researchers are making progress with the bioprinter, materials, and related technological advancements. When a bioprinter can handle multi-materials in high resolution, and when new biomaterials could meet various medical needs, and when fine vasculature can be created to provide a delicate supply of nutrients, bioprinting a complex organ will be an achievable dream.

Once technological milestones are achieved, I believe the remaining challenges will be regulations and business models. Tasks like persuading and helping the health authorities to establish the examination and review standards, and establishing innovative business strategies that will effectively enhance the penetration of bioprinting solutions into healthcare systems, would be paramount. I expect new solutions via bioprinting for unmet needs will appear soon.

Jenny: What advice would you give to a smart driven college student in the “real world”?

Evin: Brilliant technologies are wonderful, but the key issue is what unmet needs it can solve.

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