NESCE panel: Where is clinical engineering headed?

What does the future hold for clinical engineers? That was the guiding theme of the panel discussion that closed out the Northeastern Healthcare Technology Symposium in Groton, Conn., Nov. 3 and 4. The event was sponsored by the New England Society of Clinical Engineering (NESCE).

Panel members were Barrett Franklin, chief of clinical engineering at Providence VA Medical Center in Rhode Island (and current NESCE president); David Harrington, PhD, managing director of engineering for SBT Technology in Medway, Mass.; Danielle McGeary, clinical engineer/project manager for Hartford Healthcare in Connecticut; and Athan Chekas, director of clinical engineering/telecommunications at the Hospital of Central Connecticut.

One of the questions the group took up: What should be the name of the field—clinical engineering, biomedical engineering or healthcare technology management? The group’s initial responses follow.

Franklin: My inclination would be toward healthcare technology management. Biomedical engineering has too much of a research tie, and when an individual is called a biomedical engineer, people instantly think he or she works in research. That really doesn’t encompass what we do. While clinical engineering in many respects does encompass what we do, it encompasses what we did. The fact is, we are no longer clinical engineers dealing just with medical technologies. We are now dealing with medical equipment, we’re dealing with medical information systems, we’re dealing with the interoperability of those systems. Healthcare technology management is more encompassing, and it more adequately or more closely reflects our true responsibilities.

Chekas: Truthfully, I don’t like any of those three names. The time is right to have a fresh name. Healthcare is an appropriate word, technology is an appropriate word, and management certainly seems appropriate, but something needs to be added in there on the patient[-care] piece. I’m not sure what the title should be, but when I look at those three titles, that’s the piece that’s lacking. If we think a little bit harder, and get that patient component in there, that would greatly benefit the profession.
 
Harrington: I agree. That's it.

McGeary: If I had to pick one of those three, I would say healthcare technology management because I think it sounds a little more suave. It adds a bit of sophistication to our role. With biomedical engineering, I hate when people say, Oh, go to biomed. It seems like a form of slang in the hospital, I feel at times. It doesn’t really encompass at all what we do. When you hear biomed, I think people just think, Oh, that’s this person with a screwdriver fixing an isolated piece of equipment down in the basement. When you hear healthcare technology management, you think of an office suite type area with some real professionals who are digging into technology.

Taking on titles
Healthcare Technology Management asked a follow-up question of the two panelists who favor healthcare technology management as a new name for the profession: What job title now under clinical or biomedical engineering would take on the title of healthcare technology manager?

Franklin: I actually had originally thought that all of your department heads would become chiefs of healthcare technology management. The interesting piece is, well, what happens to all of your subsets underneath that, all the individual titles? [My thinking now is that] you can still have your chief clinical engineer, who is your head of healthcare technology management, or your chief of healthcare technology management, and then you have clinical engineers and biomeds, biomedical equipment-support specialists, or biomed techs, depending on what flavor you go with. But those are the staff who fulfill (the duties of) that organization.

McGeary: If I had to describe what we do as a profession, we’re really the clinical interface between the medical device companies and the patient and user. I don’t know how we would put that into a specific title, but we really interface. The medical device companies, the people who create the medical devices, have maybe never even been in a hospital and seen the devices in their true application. And then the patient and the nurses speak clinical talk, so we need to really be able to be translators. We hold a lot of different titles and roles, and “biomed” just doesn’t cover the magnitude of what we do.

Where are the CE-CTOs?
Healthcare Technology Management also asked why most hospital chief technology officer positions are being filled by IT people—and nearly none by clinical engineering leaders.

Harrington: It’s because clinical engineers have a hard problem. They don’t get up into the hierarchy of the hospital. The IT guys are talking to the hierarchy all the time. The clinical engineer is keeping things running. He doesn’t blow his own horn. We’ve got to do this collectively, as a profession—get more publicity out on what we do. The other thing I’d like to point out about that is, the IT people will respond to a problem call from administration much faster than they’ll respond to a call from the floors. We don’t have that opportunity. We can’t go up and brown-nose, responding to that call quickly. The IT people have really developed that knack.

Franklin: Your senior-most administrators, your CEOs, don’t have an infusion pump or a ventilator or an anesthesia machine sitting on their desk. They’ve got a computer. So the fact is that their go-to person when something is wrong is the IT person. That’s the person they’re recognizing first and foremost, the person who comes to fix their problem. They’re not looking to the clinical engineer to fix their problem. There’s that, and then there are the dollars. At the end of the day, so many more dollars are put into IT infrastructure, by and large—not just within healthcare, but even outside of healthcare. That lends toward the CTO stemming from an IT background.