Biomedical Engineering's Role in Hospitals Shifting

Cats-and-Dogs

The other day I received a GE “SmartMail” announcing a new training program for biomedical and clinical engineers. The training focuses on PC hardware (components, ports, booting and setup), operating system basics, and lots on networking. The cost is $3,500 for the 5 day class. In reviewing the course outline, this looks like a great course. One thing that's not clear from the syllabus is which operating systems are covered – the descriptions sound Windows oriented, and there many Linux and Unix based medical devices out in the world. Perhaps someone from GE could enlighten us.

The mission, training and organizational structure of biomedical engineering was conceived when analog circuits made up most medical devices, and biomeds could get in and make component level repairs. Today, medical devices are mostly computers with signal processing front ends, and the “smarts” are found in the software rather than analog circuits. Many biomeds are sharp electrical engineers but lack an equally deep understanding of information technology – not that you'd want to hack medical device software.

The days of making component level repairs are fading. Advancing manufacturing technologies have not made it any easier for biomeds, as more products become single board devices with little or no opportunity to service the devices themselves. Besides testing equipment for safety and doing periodic maintenance, biomeds have been reduced to swapping broken devices with manufactures.

Biomeds are an undervalued and underutilized resource in hospitals today. The real value in biomeds lies not in their electronics service expertise, but in their understanding of what it takes to ensure patient safety when using medical devices for therapy delivery or surveillance – this is something that IT can't even begin to imagine. Biomeds pass JCAHO muster every time the hospital is reviewed, they deal with FDA regulatory issues, and most importantly, they understand clinicians and the care delivery mission. Biomed's patient safety expertise needs to be extended into IT and fully absorbed – and quickly.

Health care IT folks are pretty sharp too, but as they encroach into the clinical domain with CPOE, EMRs and other applications, it is clear they have lots to learn from biomeds about patient safety. The “scream test” does not work when clinical devices are involved. (The scream test is when one disconnects something, say a network patch cable, and waits to see if anyone complains – this is a not uncommon IT maintenace procedure.)

The days of the biomed as medical device repair man are fading, and working for the facilities VP no longer fits. One of the trends in hospitals is to put biomedical engineering “under” IT. I think that's a mistake. While biomeds don't command the budgets that IT does, their mission is every bit as important as IT; in fact, you can run a hospital without IT, but you can't run one (at least for long) without biomeds. In recognition of their true value, perhaps biomeds should report into Risk Management or some other patient safety department in the hospital.

The real question is if biomed and IT were dogs and cats, which would be the dog? I know that both biomeds and HIT types read this blog, what do you think?

UPDATE: I got a great email with some additional information about the GE training course mentioned above:

I am the course
developer for Essentials of Healthcare IT, or the training program you mentioned [in this post].  The course is built around Windows
XP.  At this time we do not discuss Citrix or Linux, since the focus of the
course is building and troubleshooting 4 types of networks.  Discussions of
multiple flavors of OS would push the class beyond one week.
 
Thanks for
mentioning the class, I happen to think it IS great.  As a 19 year veteran of
field service in operating rooms across the US, I realized our industry was
falling behind, very behind, in the networking game.

Thanks.

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