Niall Haslam is the CTO for Axial 3D. He will be a speaker at our upcoming London event. 

Jenny: When was the first encounter you had with 3D printing? What was the experience like? What were you thinking at that moment?
Niall: I first came across 3D printing in Dublin at UCD in 2010. The School of Architecture had an early mCor paper based printer in the building next to Complex and Adaptive Systems Laboratory where I was working at the time. One of the engineers from the Genetic Algorithms team had been using it to print the outputs of one of their designs for electricity pylons. The machine had its own room and took up most of the space. It was very noisy and slow, but it made really cool objects. I was intrigued and started experimenting with creating protein structures to help explain how protein-protein interactions worked. Quite quickly moved on to using FDM printers as they were able to handle some of the more complex shapes. It was clear to me that these machines were going to be very important in education and visualization. It was great to meet the guys from mCor again recently and see the enormous progress they have made since those early prototypes. Their machines are now able to produce the most wonderful colors and detail in their prints. You’d never know that it was made from paper!
Jenny: What inspired you to start your company in 3D printing?
Niall:  I joined axial3D to be a part of making medical 3D printing routine. 3D printing is having an enormous impact on healthcare already, and we are only at the beginning. The range of healthcare applications for medical 3D printing is growing rapidly, and there is still some work to do in making it accessible to the surgeons and healthcare provider. A key area to be addressed is the software. Combining clinical and technical understanding with machine learning to develop automation of the process will drive the adoption of 3D printing in healthcare. Tools are needed for augmenting segmentations as well as ensuring good manufacturing processes in fabrication is adhered to. I’ve always enjoyed working in new technologies and exploring their limits. This has given me an insight into how to get products off the ground but also to make sure that they are going to be used and be useful to the user. My colleagues have that same drive, to make 3D printing routine, and with the medical, software and machine learning skills we have, we are uniquely placed to make 3D printing easier and more affordable for healthcare practitioners.
Jenny: Who else inspired you the most along this journey in 3D printing?
Niall:  I am inspired mostly by the surgeons who use the technology. They are the true innovators. They are not content that a 2D or 3D visualization is giving them all the information they need, and they want to improve their insight to increase the chance of a better outcome for their patient. These people are not happy with the status quo, they want tools to make them better. Even if they are leaders in their field already, they still see the potential of 3D printing to deliver improvements. Early adopters are needed in every industry, and in healthcare where there is a conservative approach to adopting new innovations, they are more important than ever.
Recently, Transplant Surgeon, Tim Brown visited the axial3D offices to meet the team. He gave a talk at our offices on the surgery and how he has been using 3D printing in transplant surgery. He talked about the life-changing impact of transplant surgery and I found his dedication to improving outcomes inspiring. He was part of the Belfast team who carried out five kidney transplants in a single day to equal a UK record, falling just short of the world record of 6, held by a US hospital.
Jenny: What motivates you the most for your work?
Niall: I’m motivated by a desire to improve processes and make things easier for people. I’m a big believer in making the best option the easiest to follow. The tools we create make it easier to do the right thing by default. With service delivery, we have spent the last year refining our web platform to make it even easier to order an anatomical print for surgical planning. We’ve been lucky to get funding from the UK government to collaborate with Ulster University in applying design thinking methodologies to our service. This has resulted in a more streamlined service and better user experience. This is also obvious in our 3D printing workflow platform which is used by 3D printing laboratories to manage the production of medical 3D prints within the hospital setting. Here we have applied the same techniques to improve the flow of data and ensure that the engineering staff captures the right information, at the right time-points, to provide the underlying foundation for task management, tracking, reporting and quality assurance.

(photo source: axial 3D pelvic trauma model)

Jenny: What is/are the biggest obstacle(s) to your work? If you have conquered them, what were your solutions?
Niall: The biggest obstacle for not just our company, but all medical 3D printing solution vendors, is who ‘owns’ medical 3D printing, and therefore who pays. Inside the National Health Service (NHS) in the UK we’ve been fortunate to navigate this and be listed in the procurement framework to provide 3D printed models, much like a vendor would provide plates or screws for surgery. In the United States, there is a need for insurance to start recognizing medial 3D printing, in all forms, to ensure reimbursement for their use. I don’t think this is too far away, as the impact data is growing each day. Budget is always a problem when a new technology is introduced, but it is becoming easier as more departments want to be involved. In our experience, once a surgeon, no matter how skilled, holds a 3D printed model of their case in their hands, they really understand the impact of added insight.
Jenny: What advice would you give to a driven college student in the “real world”? What bad advice you
heard should they ignore?
Niall: I would tell them to work on something that they are happy working on. There is no substitute for passion when it comes to research. Working hard on something you don’t particularly care about is always going to be a struggle. If you find something that you like working on then you don’t mind putting in the hours required to succeed. Part of this is also about learning to be comfortable with failure. If you aren’t enjoying something it’s ok to walk away, you’ve learned something about yourself and have freed up a time to work on something more productive.
Jenny: If you could have a giant billboard to promote a message to millions and even billions of people in our community (i.e. healthcare 3D printing and bio-fabrication), what message would that be?
Niall: I’m a big believer in design thinking and so I’d have to say ‘Start small – experiment’. This allows you to create a more sustainable solution and one that will get used more. Don’t just rush out buying a printer – think about the whole service offering and the long-term view of your printing needs. This prototyping approach allows you to build your understanding of what you need before you invest. We hear a lot of stories about machines being bought without anyone to operate them, or without a defined application. We work with hospitals to gather the data before they build the business cases or make investments which work well.

(Team Axial 3D, front row, right: Niall Haslam, left: Daniel Crawford)

Jenny: What were/was the best investment you made in 3D printing/bio-printing/bio-fabrication?
Niall: Our investment in machine learning has already reaped enormous rewards. We’ve created a number of important collaborations with public and private health trusts as well as research-intensive universities both in Europe and the US. We’ve also recruited a number of key staff and are rapidly building our capabilities, including through the NVIDIA Inception program. This investment will continue as we gain further operational efficiency from augmentation of our processes. Already we are able to significantly reduce the amount of time spent segmenting and spend more time on quality assurance. The machine learning platform is giving us more time to ensure that we are doing production correctly. We’ve also been looking at blockchain and related technologies. There is a lot of hype around this right now. I think it has the potential to have a major impact on supply chain management and manufacturing. The baked in the provision of provenance and security is going to be vital as we move to bioprinting. I think we’re going to have to learn a lot of lessons about manufacturing bespoke products at scale in the 3D printing world before we can start to offer that as a service commercially. People need to have absolute confidence in the supply chain and manufacturing process in order for bioprinting to be adopted by the world. I think blockchain may just be one of the underpinning technologies that give people the confidence in the manufacturing process.
Jenny: What was/is the biggest risk you took in your career?
Niall: Joining axial3d from a large corporation was a big risk for me. I had a great role in my previous company and was very happy. The lure of a startup in medical technology was too great though, and the opportunity to work at the ground level was very exciting. It’s been a real roller coaster as we’ve now launched our new software products and started deploying to customer infrastructure. In the last ten years, we’ve seen a massive jump in the number of startups globally. I believe this is in part due to a realization by corporations that it is tough to innovate. Bigger companies tend to be invested in their existing cash cows and slower to embrace new technology and potential efficiencies. Here at Axial3D, we believe in continuous improvement and we are able to push improvements into production monthly.
Jenny: What do you enjoy in your spare time? What are you passionate about outside of your work/3d printing?
Niall: I’m a big believer in open data – information about our society that is freely available and made available by large and small organizations. Some examples are the likes of OpenStreetMap – an initiative similar to Wikipedia but for maps. This kind of resource has been invaluable when providing aid to disaster zones as NGOs can plan more effectively. To me, this is an extension of open-source software. Open source software has been transformative in unlocking innovation in the last twenty years. Linux, Firefox and Apache software have all changed the way we deploy and think about technology nowadays. Similarly, I believe that many innovations in the next twenty years will be driven by open data sets. We can see this already in the smart cities where information about bike rental schemes, for example, is freely available so people can practice their machine learning skills by predicting if bikes will be at a particular stand at a particular time. Open data challenges have already delivered real impacts in healthcare. In the UK several challenges have opened public health data to examination by scientists, statisticians, and programmers resulting in real improvements in the provision of healthcare by identifying previously overlooked problems and identifying new solutions. It would be great to see some progress in this direction in radiology – the availability of common shared open datasets would allow benchmarking of machine learning algorithms and promote progress in this application domain. Initiatives like the 3D print Exchange at the NIH show the potential of open data in 3D printing.
 Meet Niall in person during our London Event. 

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The 3D printing market and more specifically, the medical 3D printing market, is still very much in a development stage as opposed to a mature state. Given this, a valuable exercise for existing and potential industry players is to examine the market along Porter’s Five Forces. This classic b-school framework shows where competitive power lies within an industry and thus how the industry is shaped going forward.

Figure 1: Porter’s Five Forces

Threat of New Entrants

This force is high. While there are barriers such as high R&D costs and IP protection, other key criteria for successfully entering into a new market look to be advantageous for new entrants in this area. This includes lack of a traditional manufacturing distribution channel needed as solutions can be printed and offered through e-commerce channels, lack of significant initial capital needed including labor costs, and the significant market growth forecast.

Buyer Power

This force is high. The buyers here are medical and surgical centers, pharmaceutical and biotech companies, and academic institutions. Because 3D printing in the medical space is still considered a novel concept rather than a mature solution, there is little information on what price or quality buyers require before moving forward with a purchase. This gives them significant bargaining power over the minds of 3D printing companies. Moreover, much of the buyer base in concentrated in a small number of powerful institutions.

Supplier Power

This force is low. The materials used for 3D printed solutions use commodity substances, though the printers require highly specialized components supplied by a small set of vendors. On a broader perspective, the 3D printing supply chain brings many of the components in traditional manufacturing in-house or near-house. This includes local printing and distributing solutions versus pushed-out-through distributed warehouse networks; low versus high transport costs; and customized production via “pull” demand from customers versus mass factory productions.

Threat of Substitutes

This force is low. The 3D printing technology in the medical industry is very much a brand new technology and it would take several years for another technology to prove it would be a viable alternative. Continuous advances in 3D printing itself are occurring, making any likely threat of substitutes from outside the industry unlikely. More likely, substitutes would occur from within the industry (e.g. quality of solutions in terms of material, durability, lifespan, etc.).

Competitor Rivalry

This force is medium. While companies such as Stratasys, 3D Systems, and Materialise have developed brand names for themselves within this industry, brand notoriety outside of this industry is less strong. Moreover, there are currently few major differentiators between solutions provided by each of the existing companies. One major differentiator is the time required to print a solution, however other key factors such as material selection, resolution, color variety, ease of use have not yet been established as unique selling points from any player.

Predicting the future of any developing industry is a challenging task. However, understanding the driving forces within the industry is valuable for determining areas of opportunity as well as areas of caution for firms who are in the industry and firms considering entering the industry.

About the Author

Jessica Lan – MBA Technology Management and Strategy; BS Computer Science, Summa Cum Laude.

Established management consultant focused on advancing healthcare through technology. Proven success in transforming large and small healthcare organizations through strategy development and operational change. Award winning recognition for business plan development and enterprise software solutions.

 

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