1. Careers, Roles, and Responsibilities

2. Duties and Responsibilities The role of CE started in early 1970s. The need for medical technology management arose in the early 1990s, creating several opportunities for CEs. Clinical engineering departments in smaller medical facilities typically do not have the resources to support medical technology assessment programs or functions associated with a chief technology officer. Duties and responsibilities are traditional, contemporary, and beyond contemporary.

3. Clinical engineering responsibilities— traditional: Equipment Acquisition Capital Budgets Strategic Planning (5-Year Plan) Equipment Maintenance PMs and Corrective Maintenance Incoming Equipment Testing Computer-Safety Testing Other Nonmedical Device Safety Testing Service Contracts and In-House Fiscal Accountability Personnel

4. Capital Equipment Operating Budget Building and Renovation Projects Writing Request for Proposal (RFP) State and Federal Codes Regulatory Compliance Risk Management Safe Medical Devices Act Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Management—Vision and Growth Clinical engineering responsibilities— traditional (cont.):

5. Clinical engineering responsibilities— contemporary: Academic affiliation/teaching Applications research and design Consulting Information Systems Support In-service training Technical/clinical investigation—Clinical Trials Support IDE compliance IRB participation Technology Management Technology Assessment

6. Telemedicine Virtual instrumentation Web-enabled devices and systems. Clinical engineering responsibilities— Beyond contemporary:

7. Clinical Engineering in the Middle East 1.Long lead-times are required, to obtain needed spare parts. Although most departments try to stock some recommended parts, often the parts needed cannot be found in stock. 2.To obtain a particular part, it may take from three months to a year, as sometimes it is not even in the vendor’s stock or in the manufacturer’s warehouse. 3.Sometimes service manuals are not provided or are not even adequate, thus resulting in longer times to repair. 4.Adequate support from some vendors, or even from manufacturers, is often not provided. For example, a vendor might not be prompt in solving the problem. Some local vendors might not even employ qualified service personnel to solve the problems. Problems and Concerns:

8. 5.Lack of full awareness of some clinical staff about the roles of clinical engineering departments could result in lack of proper communication between users and the clinical engineering staff. 6.Some types of equipment might have intermittent problems that could be caused by age, design problems, or the environment. This problem may occur in any health care institution and is addressed by technical departments throughout the world. 7.Difficulty in finding well-qualified technicians or engineers often occurs. 8.Difficulty in maintaining some equipment by in-house personnel because of the lack of standardization often occurs. Having many one-of-kind devices, each of which requires that the staff obtain special training for servicing, places an onerous burden on the training resources that are available to the department. Problems and Concerns:

9. 9.Sometimes there is a lack of competent in-house training programs offered for users and clinical staff. 10.Not enough trained local staff are necessarily available to meet hospital needs. 11.The process of training staff is long. Problems and Concerns:

10. Suggested solutions: Proper selection of equipment from cooperative vendors and manufacturers are crucial for long-term equipment support. Increasing clinical engineering awareness by clinical engineering departments presenting seminars to the clinical staff. Training programs for local clinical engineering graduates. Emphasis on standardization in the purchasing process. Cooperation among hospitals in terms of technical consultations, seminar presentations, and expertise exchange. International Conference on Health Technology Management.

11. Setting guidelines on agreements of sharing services, experience, and, possibly, spare parts among hospitals. Comprehensive service agreements with experienced major original equipment manufacturers (OEMs) for optimum service. Rationalizing the lists of recommended spare parts and by offering them at lower profit margins. The high technology equipment always should be maintained by major OEMs or sole agents, to minimize down time and to increase availability and productivity of technology. Suggested solutions (cont.):