3D printing can help physicians and surgeons in creating different models that may be used in space, as well on Earth to help train physicians, speakers revealed on the last day of Arab Health 2022.

“One of the things that always strikes me when we try to challenge ourselves is that we have to be creative and invent new technologies,” said Dr Scott E. Parazynski, Ambassador for 3D Life, who spent 17 years at NASA as an astronaut, during a panel talk named "Medical 3D Technologies: From Earth to Space" at the Healthcare Transformation Talks. 

“Those technologies have enormous value. It's the reason we make investments in space - so we can improve life for all of us,” added Dr Parazynski.

He gave the example of telemedicine, which has helped the space programme through taking care of astronauts remotely. Remote patient monitoring (on Earth) helps improve patient’s lives and also reduces costs of healthcare significantly, he continued.

“My vision for telemedicine is that you can give feedback to a surgeon in Singapore while he operates on someone in Nigeria. All you will need is human precision,” he stated. “When there is a daunting challenge you have to do things that have never been done before,” he told the audience.

3D printing in healthcare: exciting, but with limitations

Henry Pinchbeck, CEO, 3D LifePrints in London said during the discussion that 3D printing is “a factory in a box, with the ability to produce individual items," while cautioning that the technology comes with limitations such as cost. “it's really expensive,” he said.

3D LifePrints is a technology company that uses 3D printing to create patient solutions. Pinchbeck elaborated that while people expect a lot from 3D printing, the technology remains limited.

According to Dr Parazynski, when humans start to think of going to Mars one day, they will want to take raw materials to the red planet, rather than a complete ICU. “It's a very exciting capability used in space,” he commented.

One of the Earth examples provided was of a patient with a tumour in the pelvis and they needed margin that was designed digitally from a CT scan. It was manufactured and the surgeon was able to cut through and insert it around the tumour. 

“The patient is individual, the tumour is individual, so you want something that captures this and allows the surgeon to conduct their surgery,” said Pinchbeck, adding that the future of healthcare was to look at patients' specific solutions. “Intuitively and scientifically patient specific devices are better than non patient specific,” he explained.

He added that while patient specific solutions are still not in the centre of conferences such as Arab Health, they would pick up eventually as more research is invested.

The speakers also explained that 3D printing can help train surgeons, through for example having a 3D printed silicone heart where trainee surgeons can test the process on it.

“Training has actually changed dramatically in the last 10 years, with a limited number of hours now,” said Dr Parazynski. “We need to rely more on simulators, so that we replicate some of the common challenges and do that surgery over and over again”.

As part of the Blood Transfusion Medicine talks at Medlab Middle East 2022, experts gathered to share experiences on the topic of donors and donation, and in particular how the pandemic had impacted operations. Dr. Ranjita Sharma from the Blood Donation Centre in Dubai, the emirate’s central blood bank covering collection and supply of blood, discussed how policies changed pre-COVID-19 to the present day. 

The only blood bank issuing blood to both private and government hospitals in Dubai, it was critical to ensure operations continued as smoothly as possible during the pandemic. With 100 per cent of collection coming from voluntary donors and 80 per cent of that from blood drive campaigns out in the field, the pandemic would see operations massively affected in the initial stages.

Between 2017-2019, the number of campaigns had risen in Dubai, but with the start of COVID-19 in 2020, those were cancelled, though regained momentum in 2021. Communication with donors during the pandemic was vital in order to ensure continuity of services, said Dr. Sharma, who elaborated on the extensive process in place to ensure the safety of workers and patients. 

How COVID-19 impacted blood supply 

In January 2020 as the pandemic began to take shape, the blood bank deferred donors who had been to China in the previous month, the virus stemming from Wuhan. In February, the centre arranged educational sessions for staff and donors about the emergence of COVID-19 and by March 10, with the virus spreading, deferred donors who had been to a list of 10 countries.

Things would rapidly change, however, and by March 16 2020, 31 countries had been deferred as the UAE closed its borders. Eventually, anyone with a travel history of 28 days would be asked to defer donation by 28 days to ensure no signs of the virus.

Educational materials were distributed in three languages to staff and donors and a subsequent blood shortage emerged as limitations were placed on donors. To mitigate transmission, the centre took action according to the guidelines from local and international bodies and implemented new protocols which would evolve rapidly. 

Progress of COVID-19 and its impact

As the lockdown progressed, healthcare services were requested to reduce elective surgeries in government and private hospitals in March due to the shortage of donors and the ensuing staff shortage. Donors and staff were afraid to leave home and the shortage of blood moved into an amber phase of emergency level. Even today, the centre keeps a close eye on the situation to monitor collection and supply methods. 

Contingency plans 

Daily operations changed, such as working hours which were adjusted to manage staff shortages accordingly. Dr. Sharma explained that accommodating the donors in the centre was a big challenge because mostly the blood drives were the way donations were managed pre-pandemic. A nearby sports stadium was instead repurposed as a donation centre for a temporary period in April to accommodate the donors safely.

With the shortage of donors, the team began to encourage friends and relatives to donate in order to support efforts. The Dammi App, which was within the DHA app, allowed donors to register for emergency donation.

Additionally, it increased awareness of the new system in place to deal with the state of emergency. Time was spent educating donors with new protocols and reassuring them of their safety. Donors were also engaged by campaigns via social media, newspapers, direct communications, radio and the mobile app. 

Emergency donors and revised eligibility criteria 

During the pandemic’s first wave, between January and May 2020, these campaigns proved successful with 679 new donors registered. Deferral criteria for donors who had travelled remained in place even when lifted by the FDA, with new educational material produced for doctors and a toolkit implemented in March 2020.

Different measures were looked at for eligibility including donors with antibodies now eligible, though there were variabilities according to when someone had been vaccinated, leading to additional deferral criteria for those donors. Blood is kept for 28 days to ensure no signs of COVID-19 before it is allowed into the medical system.

Lessons learnt 

The pandemic helped spur many lessons including the need for healthcare professionals to continuously update knowledge and systems. The team are continuously identifying ‘at risk’ donors and doing all they can to ensure business continuity through a structured plan.

Donor education is critical, said Dr. Sharma, who explained that the pandemic has inevitably reduced the supply of blood and blood components and adversely affected blood system activities. “Blood services have to assess and plan and respond to the situation appropriately and proportionately to the threat of COVID-19,” she said. “This is not just a public health crisis but it touched every sector.”

Malaffi is the first Health Information Exchange platform in the Middle East and North Africa, connecting public and private healthcare providers in Abu Dhabi safely and securely. Malaffi provides the meaningful, real-time transmission of critical patient health information amongst healthcare providers, resulting in a centralised database of unified patient records that improves healthcare quality and results. 

Celebrating its three-year anniversary, Malaffi is exhibited its next strategic solutions targeted at bolstering the digital transformation of the healthcare sector at the 47th Arab Health Congress, from January 24–27 at the Dubai World Trade Centre. 

Malaffi featured a data quality dashboard at the Department of Health – Abu Dhabi (DOH) stand, which highlighted issues with the existing application of clinical data standards when healthcare professionals record clinical information in their EMR systems, which is gathered and available in the platform. Furthermore, Malaffi demonstrated an image exchange solution that is completely linked with the Provider Portal and will provide users access to diagnostic radiological pictures such as X-rays, CT scans, MRIs, and ultrasounds from patients. 

Atif Al Braiki, CEO of Abu Dhabi Health Data Services, has been a key figure in the development and execution of Malaffi. Malaffi has been known as one of the fastest-rolled out HIEs in the world. 

In an interview during Arab Health, he discussed future plans for Malaffi and its vital role in shaping digital transformation through developing an essential health information exchange platform. 

Malaffi yesterday marked its 3rd anniversary, what did you see as main advantages of having a Health Information Exchange in Abu Dhabi? 

One of the key advantages for Malaffi is really improving care coordination that's happening between the different stakeholders in Abu Dhabi. As you know, Malaffi allows the safe and secure exchange of medical record between all the healthcare facilities in Abu Dhabi that allows healthcare providers to coordinate the care better, which eventually then improves healthcare outcomes for the patients. 

Abu Dhabi has done exceptionally well in handling the pandemic- can you please let us know what was the role of Malaffi?  

Malaffi has played a vital role during the pandemic in consolidating and aggregating all the covered related data points from the medical record of the patients.  We started with the PCR tests, all of them were consolidated under a central database, as it allows the different stakeholders or the public health department at the DOH to get near real time visibility on the spread of the disease. This also allows them to practice and execute early interventions within the community, and protect the community in Abu Dhabi, while healthcare providers will have access to Malaffi and see the previous report of that patient. During the vaccination rollout program, we have also been able to consolidate all the vaccine data into a central clinical data repository and combine it with the medical data record of the patients, which also provide better visibility on the rollout of the vaccine program. 

What is Malaffi showcasing at Arab Health this year? 

During this year, we're showcasing our next strategic project which is the image exchange across the healthcare sector in Abu Dhabi. Previously, Malaffi users had access to the radiology reports, and through this new enhancement they will be able to access and view the images taken at a different site in Abu Dhabi, including CT scans, MRIs, X-rays and other. This further prevents the need to duplicate these costly investigations which save patients from exposure to unnecessary radiation. 

On Wednesday, you will be part of the Healthcare Transformation Talks – how does Malaffi support digital transformation of healthcare. What is next for Malaffi? 

Malaffi was one of many digital health transformation programs of the Department of Health - Abu Dhabi. The ability to collect and centralise clinical data and draw significant population health insights using AI and predicative models is fundamental to digital transformation.  As a pioneering project we learned a lot of lesions that we are looking forward to sharing with other projects being executed in Abu Dhabi, the region and wider at a global level.