Panel - International network of medical engineering

A panel on the 'International network of medical engineering' concluded OIMEF '97. Its charge was to give guidance to the Okayama Prefecture on how to proceed in setting up international collaborative links.

This panel was interesting and provided some good ideas. After an introduction by the moderator, Prof. Masao Saito (President of IFMBE 1979-82) each panelist was given a few minutes to explain her/his views. The floor was then opened to questions and comments from the audience with concluding comments by the chairman of OIMEF '97, Prof. Kajiya. Five themes emerged from the panel:

Social context

Several of the speakers focused on the societal barriers to collaborative research. Dr. Kirsner's opinion was that we must set up a framework so that these barriers are accounted for and considered in the context of international collaborative activities. He cited a few examples of technologies which are not acceptable to users, although from the technology view point they are very advanced and well-functioning. In some countries the cochlear implant is argued to be an improper technique for the deaf. The basis of the argument is that sign language is considered an adequate and effective way of communication between the deaf people. Similarly, the use of the lithotripter has been questioned because of the after care it requires and the effects it causes. Robots that feed disabled people are percieved as an insult to the users who do not wish to be served by or cared for by technology artefacts.

Dr. Fouke considered partnerships as a necessity if we really want to attack the problems and develop solutions. This includes the whole chain from basic to applied to strategic research and finally to product development. She pointed out that the real technology transfer mechanism often is through the young researchers that we educate and train and who find employment in other institutions and industries.

Also Dr. Murray expressed his concern that medical devices and technologies used in healthcare are far from optimal. They are often too complicated to be used inside a hospital let alone in the patient's home. The increasing automation adds to the complexity and users are not always able to determine the reliability of the outputs that these devices produce. The calibration of certain technologies like pulse oxymeters is unsolved. He pleaded for devices that are simple to use, reliable and less expensive.

Priorities

Dr. Fouke spoke about the need to set priorities. This is both extremely difficult and important. The astronomy community is a beautiful example where the international community has agreed on priorities. She cautioned against letting governments set priorities.

Dr. Spaan elaborated on priority setting on a worldwide scale and focused on the danger of making wrong choices. In his opinion instead of 'megascience' we need to provide the infrastructure for profitable research and withhold any wishes to set global priorities. He strongly supported international links and stated several reasons why they are important. Firstly, for a given research topic there exists a diversity of ideas. International links are a way to pit these ideas against each other. Human and material MBE resources are scarce and collaboration is a way to make more effective use of these. Finally, he underlined that these links are a wonderful way to build human relations across cultures.

Dr. Jaron argued that areas for global collaboration need to be selected on a pragmatic basis. If a field is close to industry, global activities are not the proper approach, whereas in basic research the interests and intellectual results are more easily shared. Drs. Thevenin and Hutten underlined the need to identify your strengths and build your strategy on that.

Education

Dr. Fouke pointed out that there is no international agreement on what MBE education needs to contain! One task for Okayama could be to define the contents and implement this using the modern tools of e.g. interactive multimedia on the Internet Dr. Kitney emphasised the need to take full advantage of the Internet and the multimedia capabilities which have emerged within it. Both in research, education and in medical practice these technologies are changing our environment. Dr. Nalecz pointed out that an international network is an attractive way to engage good students in MBE research.

Clinical engineering

Drs. Kanai and Murray focused on the improvement of the safety and reliability of medical equipment in healthcare institutions. Dr. Kanai stressed the importance of establishing local, national and international mechanisms, including standards, regulatory measures, accident reporting and technology assessment. He considered that industry is working quite well along the guidelines of ISO 9000 and GMPs. In healthcare institutions the situation is not as good. Nurses, medical doctors and other medical professionals need to be trained in the use and maintenance of medical devices. In these tasks clinical engineering staff are necessary. Some countries have established certification schemes for clinical engineering staff. International links have been established most notably by the Clinical Engineering Division of IFMBE. For instance, in Japan the government requires that a clinical engineering technician (CET) is certified. Consequently 14 000 CETs have a certificate. However, for clinical engineers no such scheme exists as yet in Japan. One of the reasons for this is that there are only 400 CEs in Japan and therefore such a scheme is very expensive to set up and maintain. Dr. Oberg suggested that this be a priority for Okayama.

Funding

According to Dr. Atsumi, in Japan new research priorities are also being established for biomedical engineering. The new 'basic plan of strategic research' in Japan aims at a move towards more practical research. He also mentioned that the possibility of setting up a National Institute of Biomedical Engineering is being discussed and it might be located in Okayama. He cited the International Institute for Applied Systems Analysis (IIASA) research centre in Luxemburg as an example of an international centre where researchers can get together and work on common prioritised topics.

Dr. Nalecz spoke from the perspective of his country, Poland. He gave a number of examples where the participation of Polish scientists in international activities is difficult. For example, Poland is not yet eligible for participation in the current 4th Framework R&D Program of the European Union (EU) as Poland has no official agreement on this with EU. The same applies for the national programs run in USA. Therefore MBE people in Poland and in similar countries are looking for other means to be involved. Within UNESCO a 'World Academy of Biomedical Technology' is being considered. Another avenue is to be recognised as a Collaborating Centre of the World Health Organization (WHO). The question is, however, how to find the financial resources for implemention. He suggested that the Okayama network is started with selection of topics and collaborating centres with excellence. The activities could start with seminars which can then be developed into study groups. A central issue to solved is the financing of such a network.

International links

In his closing address Dr. Kajiya indicated that the Okayama region is going to set up formal international links. They intend to carefully select topics and partners which together with Okayma form a collaborative entity focused on a research topic. The role of IFMBE in this context could be to foster such networks and to work for their funding on a global scale.

NIILO SARANUMMI