IFMBE-CED & DHCTA: A Possible Strategy for the Future

In the early 1990s the IFMBE created two special divisions in order to address delicate issues within the biomedical engineering field. These special divisions are: the Clinical Engineering and the Health Technology Assessment Division. The main issue to address was the management of the ever increasing use of technology, at that time seen as medical equipment, in the delivery of healthcare.

Each division had its own objective with the first (CED) referring more to the handling, utilization and repairing of medical equipment in the hospital environment and the second o (DHCTA) to the assessment and evaluation of the impact of technology in the delivery of healthcare. In both cases, in the definition of the objective, the encouragement to look for multidisciplinary collaboration was stated since management of medical technology required more than engineering background and knowledge.

In the more than ten years from the founding of the divisions, numerous activities have been carried out and the profession successfully promoted by both divisions. To name just a few of the activities:

Division of Health Technology Assessment:

  • Establishing collaboration with Health Technology Assessment International (DHCTAi) (formerly the International Society of Technology Assessment in Health Care (ISTAHC);
  • Sponsoring meetings, special tracks or short courses on DHCTA:
    • In co-operation with the IFMBE World Congress ( Kyoto 1991, Rio de Janeiro 1994, Chicago 2000, Sydney 2003)
    • In co-operation with ISTAHC annual meetings (Vancouver 1992, Stockholm 1995, Barcelona 1997, Ottawa 1998, Edinburgh 1999, Philadelphia 2001 and Berlin 2002)
    • In co-operation with other biomedical engineering regional events;

Clinical Engineering Division:

  • Promoting the creation of national and regional Chapters in Clinical Engineering;
  • Co-sponsoring Advanced Clinical Engineering Workshops around the world (managed by ACCE and sponsored by WHO, PAHO and other entities (1991-2003) to promote the principle of Clinical Engineering around the world;
  • Participating in the creation of INFRATECH - Internet discussion group (sponsored by WHO, hosted by PAHO and coordinated by ACCE - American College of Clinical Engineering) (1999-2003);
  • The creation of an Internet site (ICHTM) financed by the KaR-DfiD program and developed at the University of Cape Town (2003);

Despites the efforts devoted to these activities, the success achieved and the enormous work and time dedicated to all these activities by the past chairs and members of the two divisions, in recent years there has been a lack of interest in the divisions. Nevertheless, there are numerous initiatives around the world, at national level, where clinical engineers are called to participate in all kind of management activities regarding healthcare technology.

The result of all these activities in the past years was presented as part of the Healthcare Technology Management Track at the recent IFMBE World Congress. The track had sessions during the entire duration of the congress and engineers and other professionals from around the world presented numerous papers on all aspects of HT Management.

Nevertheless, from the reports of past chairs of both divisions and some studies carried out by the DHCTA in Brazil and from numerous personal contacts it appears that, as opposed to other professionals in the healthcare sectors, clinical engineers have little awareness of the need to integrate some specific activities like technology assessment in their practice, which is a problem considering the important role that BME has in the development and management of technologies in the health sector.

For the latter reasons, and as it was pointed out at the last meeting of the IFMBE Administrative Council in Sydney in 2003, there is a need for better integration between CED and DHCTA, now that clinical engineering is moving from the maintenance to management of health devices. Hence the members of both divisions had agreed to start a closer collaboration and, for this purpose, the two divisions are planning to work together in the organization of scientific events and board meetings to strengthen actions to reach their common goals. Therefore, there is a plan to have the next board meeting of both divisions in the 3rd CLAEB in Brazil in September 2004. At that meeting, the members will have the chance to discuss and decide about the possibility of merging the two divisions or creating a new one.

Both divisions, though, are already working on some strategic and operational activities in order to have a full proposal in the shortest possible timeframe.

Rosimary T. Almeida
Chair, DHCTA

Enrico Nunziata
Co-Chair, CED

Adriana Velasquez
Co-Chair, CED