Diana Hall, president and CEO of ActivArmor, tells Design News that the evolution of orthopedic patient care is not just about saving money for both the clinic and patients, but it is also about precision medicine and providing the latest and most advanced technologies and treatments. 

Hall will be giving a keynote address at MEDevice Boston to delve further into this evolution. In “The Next Generation of Orthopedic Precision Medicine—Point-of-Care 3D Printed Exoskeletons,” Hall said she plans to talk about how patient-centered care and value-based care, plus precision medicine, can come together through 3D printing design and on-site fabrication in orthopedics. 

Hall’s company, ActivArmor, provides a solution for creating custom exoskeletons for orthopedic patients. Customizing these devices involves considering many factors, she said, such as how the patient is going to use the device, what their interaction will be over time and through the healing phases, what should be changed during the healing phases, and how the number of devices and appointments can be minimized, as well as the time and energy that both the providers and the patients are spending on the treatment process. 

ActivArmor’s technology starts with a digital 3D scan using an iPhone, which then goes into custom design software and to a web browser–based interface. Using the scanning app does not require extensive training, and most people can master it in 30 minutes. “It has five different design options—hand, wrist, fingers, elbows, ankles—you pick the one that you want to fit,” Hall said. A 3D-printable design file can then be downloaded to a thumb drive and plugged into the 3D printer. The custom exoskeleton is produced in a matter of hours, Hall said. 

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The browser-based interface is designed to incorporate AI, and Hall said it is evolving in that direction, where the user can put in a diagnosis and the scan, and it will offer templates for positioning the patient for ideal healing or for design options. “For example,” she said, “if you put in a specific type of wrist fracture, it will offer templates that show potential designs for healing that the NFL team doctors are using, or one St. Luke’s Hospital physicians have been recommending.” Anyone anywhere will have access to a myriad of treatment insights.

The template can then be modified, if needed, Hall said. “It’s all custom, but it could eliminate potential human error,” she said, especially in situations where the casting tech might not have a lot of experience or training. 

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The design software is where the value is, Hall said, because the 3D printing technology and scanning technology are constantly evolving. “New printers come out all the time and that's why the design software needs to be cross-compatible with all of the 3D printing and scanning technologies that come out,” she said. 

Despite the innovations, there are some challenges that come with creating custom devices, Hall said. One is that exoskeletons are billed to insurance companies as durable medical equipment instead of as a casting procedure code. “There are a lot higher revenues to be had because you can bill higher for a custom splint than you can for a casting procedure,” she said, “but that also changes the clinic flow a little bit with the billing.”

The second thing is the turnaround time, she said. “You're used to having some materials sitting there right there in your cabinet and you just wet them and you stick them on their arm and the patient is gone in 20 minutes [with the cast] to be sawed off for every future exam or x-ray,” Hall explained, noting that a 3D scan takes only a moment, but printing it currently takes a couple of hours. “So now you're going to have a different flow where the patient's going to get scanned and then you're going to put them back in their trauma splint for another couple hours or even until the next day but it eliminates the follow-on casting or splinting.”

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Last, Hall cites clinic culture changes as the clinical flow moves to a digital process instead of analog, with staff being open to embracing using their iPhones and running 3D printers. 

Hall encourages anyone in the field of orthopedics to attend her session, to learn more about this digital technology and how it can be used in the medical space. “Also anybody who just wants to see what the evolution of treatment is in not just orthopedics, but for exoskeletons in general, and the next-generation bespoke devices,” she said. 

When asked what she hopes her attendees will take away from her session, Hall said she would like to raise awareness that these new technologies exist for orthopedics, and that consumers and physicians alike do not have to rely on the traditional methods. “Anyone who needs immobilizers has access to this technology today, because it's already available as a turnkey package,” she concluded. 

Hall will present her keynote on Wednesday, September 25, from 1 to 2 p.m. ET, at Center Stage. MEDevice Boston, an MD&M event, will take place on Sep. 25-26 at the Boston Convention Center.

Later this year, MEDevice Silicon Valley will be held Nov. 20-21, 2024.