CLINICAL ENGINEER: PLACE, ROLE AND FUTURE CHALLENGES A Presentation To The 1 st Joint East African Scientific Conference (AMEK & UNAHME) By: Gordon A. Agalo (Lecturer, Kenya Medical Training College Nairobi – Kenya) November 2008

WHO ARE WE IN THE ENGINEERING PROFESSION? ( Ancient definition of engineering: “the facility to direct the sources of power in nature for man’s use and convenience.” Today, modern engineering involves: “the application of scientific techniques, theories, and technology for the solution of societal needs”

Engineering issues: Skills that are appropriate to the problem being addressed. Solutions proposed do not impose new and more serious problems on society. Meet the real needs of society and must be instrumental in defining those needs.

Issues cont…. “These issues are of particular relevance for biomedical engineering (clinical engineering) as well because all aspects of engineering & technology are applicable”

What factors have influenced CE development? Rapid influx of technology and its resulting instrumentation into the hospitals (1960’s/70’s) Recognition of electrical safety issues associated with the increase in clinical instrumentation coming in contact with the patient Move to develop a certification process for engineers in hospital clinical settings

Modern Clinical Engineering: The application of engineering techniques, technology, and theory to the solution of health care problems and management of technology in health care

Clinical engineer..? Is a….’professional who supports and advances patient care by applying engineering and management skills to health care technology’

ROLE OF CLINICAL ENGINEER: (C. A. Caceres (ed.). (1980), Management and Clinical Engineering) 1. Education Training and education associated with technology and instrumentation used in the hospital Education of clinical engineering staff Education of health care facility staff

Roles cont Participation in research/development Design of new equipment, patient aids, and techniques to aid in patient care Assistive devices i.e design or modification of assitive technologies or customized devices.

Roles cont Facility Planning Advising and consulting with administrative and health care staff on matters related to the impact of technological developments in health care facility planning Standards and regulations

Roles cont… 4. Systems Management Systems analysis and synthesis Design and evaluation of health care systems Quality management

Roles cont Equipment Management Consultation with other health care staff in the planning and purchase of equipment Maintenance and modification of equipment

Roles cont... Equipment management will entail: a) Planning i.e. Functional progamme review  New equipment planning  Renewal equipment planning

Roles cont... b) Acquisition i.e definition of clinical requirements. Survey of available equipment Specification writing Equipment evaluation Generation of purchase documents Vendor selection Acceptance testing

Roles cont... c) Control i.e. inventory management Maintenance Repair Test and calibration procedures Scheduled inspection Safety program

Roles cont Patient safety / Risk management i.e. safety of medical equipment and systems in patient care 7. Regulation activity Codes National / international standards Regulation and accreditation

FUTURE CHALLENGES (Robert F. Rushmer et al: Medical Engineering, Projections for Health Care Delivery) The future role may still be looked at in the way it will address the three issues of: Defining and meeting societal needs Ensuring that technological solutions are responsible solutions Continuing development of required professional skills

Future challenges cont... It is important to recognize that the field of clinical engineering will need to continue to develop as health care develops both in sophistication and scope Issues to address will include: – Rapid development of new technology – Incorporation of computer technology – Communication and information technology

Future challenges cont... External factors to address: Internalization of science and technology Integration of technology Communication technology (storage, transfer, protocols) Regulation of healthcare technology (med. elec. stds IEC 60601,ISO quality management stds ISO & ISO risk magmnt stds ISO14971)

FUTURE ROLES: Strategic planning ie. understanding of resource, economic & technical implications Technology management (managed in the best interest of patient, users & hospital) Information technology (computing support, network support, storage, sustainability) Effective use of standards and regulation activities

CONCLUSION: Health care and the technology supporting health care will continue to develop. This accelerating trend in scientific developments in health care will continue, and this will, in turn, drive the development in clinical engineering. Active development in clinical engineering will be required if the field is to continue to thrive.

REFERENCES Dolan, A. M., Wolf, H. K., and Rautaharju, P. M. (1975), Medical engineering: Past accomplishments and future challenges,Professional Engineer 15(4):11. Gordon, G. F. (1990), Hospital technology management: The tao of clinical engineering, Journal of Clinical Engineerin 15:111. Robert F. Rushmer, (1972), Medical Engineering, Projections for Health Care Delivery, Academic Press, New York. C. A. Caceres (ed.). (1980), Management and Clinical Engineering, Artech House Books, Norwood, Mass.

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