By Carolyn Clancy, MD, and Ryan Vega, MD
Innovation within the Department of Veterans Affairs is not a new concept. The pacemaker, nicotine patch, bar coding for medication administration, and many other veteran and public lifesaving breakthroughs have origins within the VA. Accelerated operationalizing of employee-driven innovation and private/public innovative partnerships within the VA are also no longer new concepts within the VA due, in part, to the VHA Innovation Ecosystem.
Using the vast accumulated experience and immense passion of the employees within America’s largest integrated healthcare system in the country, VHA IE engages employees to design and diffuse innovation. In addition, we also collaborate strategically with the external innovation community to solidify partnerships that save veteran lives and fulfill VA’s Fourth Mission: to improve the nation’s preparedness for response in national emergencies.
In 2020, COVID-19 changed all our lives. While much of the world moved to a standstill in March, VHA IE and partners were revving up.
On a (Fourth) Mission with 3D Printing
In 2017, VA invested initially in 3D printing as part of an employee-focused innovation competition, which supports early-stage ideation. What started as piloting 3D printing for pre-surgical planning in one VA medical center, grew—and rapidly. In three years, we had built a 3D printing infrastructure within 30+ VA facilities across the country and offered our 3D printing engineers and teams the experience and organizational knowledge they needed to be successful. We were ready for a big leap forward. In March 2020, the time came to transform 3D printing to augment supplies of personal protective equipment so VA employees and their families could be protected from exposure to COVID-19. We had the people, processes and technology to deploy 3D printing to meet critical needs in record time, like shields, masks and now, nasal swabs. In short, our ability to move expeditiously is a direct result of investing in people and establishing infrastructure that can be adapted to system priorities.
Not only has the 3D printing response to COVID-19 impacted VA, but also the prototyping and testing of PPE and swab designs in coordination with the National Institutes of Health and Food and Drug Administration have helped VA fulfill its Fourth Mission. In March 2020, VA entered a Memorandum Of Understanding with the FDA and NIH 3D Print Exchange to share data and coordinate on open-source medical products for the COVID-19 response. VA and fellow partners also entered an MOU with America Makes to provide resources that will connect healthcare providers and 3D printing organizations to fill necessary gaps in needs. Together with NIH, FDA and America Makes, VA’s 3D Printing Network team has tested 33 PPE designs optimized for clinical use, 28 designs optimized for the community, and have rallied makers across the country to submit 685 total submissions to the NIH 3D Print Exchange for review. The actual printed product count, according the America Makes, is nearing 1 million in total, including 348,361 non-N95 masks and 540,470 face shields. VA’s 3D printing response to COVID-19 and partnerships, has protected VA employees, and inevitably, saved American lives.
In April 2020, we partnered with a veteran nonprofit, Challenge America, to host a series of make-a-thon events, aptly named the COVID-19 Maker Challenge, to rally federal agencies, private industry, leading research universities and nonprofits to rapidly design innovative solutions to challenges identified directly by essential workers on the front lines of the coronavirus pandemic. During each COVID-19 Maker Challenge event, diverse teams, including stakeholders from VA, academia, engineers, makers and private sector partners, engaged in a week of rapid prototype design, ending in a closing ceremony where solutions were presented and judged for different awards (e.g., Feasibility Award).
Prototypes designed during these events have ranged from a handheld tool for custodial workers featuring a retractable door-opening and touch point device that sanitizes surfaces each time it retracts to minimize touching hotspots; a tessellated UV-C light box to almost instantly clean large objects; and a portable parallel bar device, which enables physical therapy to be done in a patient’s room.
The camaraderie and excitement these events fostered are fantastic, as are, of course, the solutions themselves. But how do we further the designs, test the solutions and put them in the hands of those who need them? Follow-up after each event is quick; some solutions are being shopped to venture capitalists for funding, others are added the NIH 3D Printing Exchange for immediate availability. Other solutions are gathering further design feedback and being piloted within VA facilities. With the help of so many partners, VHA IE has no doubt risen to the challenge of COVID-19.
During this unprecedented time, VA has answered with powerful examples of how innovation can save lives and renew hope. We are extremely proud of this work and hope you’ll join us Oct. 27–29, to soak up the excitement of innovation at VA during the 2020 VHA Innovation Experience. Thank you to the countless individuals and organizations whose innovative work and dedication have impacted and saved lives throughout the fight against COVID-19.
Carolyn Clancy, MD, is deputy under secretary for discovery, education and affiliate networks (10X), Veterans Health Administration, and Ryan Vega, MD, is executive director, Veterans Health Administration Innovation Ecosystem