Introduction to Clinical Engineering, 1st ed.
Edited by Samantha Jacques and Barbara Christe, Academic Press, 2020, ISBN: 9780128181034, X + 270 pages, $100 (paperback, list)
This text, in seven chapters (167 pages), gives an overview of the field of clinical engineering as generated by two practitioners in the field. Five reprints, each with a “questions to consider” section, comprise an additional 91 pages and serve to give a modicum of historical information regarding the field. An overview of the body of the text follows.
Chapter 1, titled “The profession,” defines the profession of clinical engineering, covering such aspects as levels of involvement (from two-year technician entry to more advanced preparation and associated levels of responsibilities), relevant societies and ethical constructs, and future considerations. A brief mention regarding the history of the field, with reference to some of the appendix material, is also given. This chapter, as are all others, concludes with a list of abbreviations used in the chapter and a short list of relevant references. Chapter 2, “Health care technology basics,” defines “medical devices” and their class levels, and discusses general uses in diagnosis, treatment, and preventative medicine. An overview is the given of the many clinics (names and uses) that exist in a typical health care facility, followed by a brief discussion of the many phases of technology (life cycle) support that exist for the devices used in the facility. “Health care technology management” is overviewed in Chapter 3, and includes a discussion of systems engineering, a mention of human factors and biomedical informatics, etc. Also discussed are such necessities as asset tracking, work orders, parts management, service agreements, preventive maintenance, and the like.
Chapter 4, “Safety and systems safety,” very quickly overviews regulations, codes, and standards, as well as mentions the various agencies responsible for their enactment and/or enforcement, such as the Joint Commission for the Accreditation of Hospitals (JCAH), the Food and Drug Administration (FDA), Association for the Advancement of Medical Instrumentation (AAMI), and similar groups. Some relevant examples of safety considerations are given, such as infection control and laser safety. Examples of incident investigation are given (such as root cause analysis), as well as reporting needed (MAUDE, the manufacturer and user facility device experience database and topics also include Institutional Review Boards, risk management, and quality management). “Information technology” is nicely overviewed in Chapter 5, with sections on information technology interfaces (medical records, lab data systems, decision support, etc.), with mention of telemedicine and cybersecurity considerations.
Chapter 6, “Facilities management,” touches on topics that may be in the purview of the clinical engineering department, such as power systems maintenance and backup, water quality systems, disaster planning, infection control considerations (such as positive pressure maintenance in a patient room), gas system maintenance, and anesthetic gas disposal. Lastly, Chapter 7, “Human resource management,” details potential career tracks in clinical engineering, with a discussion of the responsibilities and preparation of each of several career levels, as well as the evaluation of same.
As mentioned above, the text concludes with an Appendix, which is labeled “additional readings.” This section contains five reprints, which are as follows:
Article 1: An Assessment of industrial activity in biomedical engineering. National Academy of Engineering (1971).
Article 2: Human resources for medical devices, the role of biomedical engineers. Geneva: World Health Organization (2017).
Article 3: Nader, R., Ralph Nader’s Most Shocking Expose. Ladies Home Journal. April 24, 1971. 176–179.
Article 4: Building a better delivery system: A new engineering/health care partnership. National Academy of Engineering and Institute of Medicine (2005).
Article 5: Managing the Lifecycle of Medical Equipment, Tropical Health and Education Trust (THET), London (2015).
Each reprint is followed by a brief “Questions to consider” section, which asks the reader to consider or expand upon various points discussed in the reprint.
As written, this text will serve many interested in the field of clinical engineering with a useful overview of the field and some of its history in the United States. As is evident from the text, further reading and experience is needed for one to be able to contribute to this valuable field of endeavor.
—Review by Paul H. King, Vanderbilt University