Biomedical Engineering Reference
In-Depth Information
1.0
Chapter 1.0
Introduction
Joseph D. Bronzino
Technological innovation has continually reshaped the
field of medicine and the delivery of health care services.
Throughout history, advances in medical technology have
provided a wide range of positive diagnostic, therapeutic,
and rehabilitative tools. With the dramatic role that
technology has played in shaping medical care during the
latter part of the 20th century, engineering professionals
have become intimately involved in many medical ven-
tures. As a result, the discipline of biomedical engineer-
ing has emerged as an integrating medium for two
dynamic professions: medicine and engineering. Today,
biomedical engineers assist in the struggle against illness
and disease by providing materials, tools, and techniques
(such as medical imaging and artificial intelligence) that
can be utilized for research, diagnosis, and treatment by
health care professionals. In addition, one subset of the
biomedical engineering community, namely clinical en-
gineers, has become an integral part of the health care
delivery team by managing the use of medical equipment
within the hospital environment. The purpose of this
chapter is to discuss the evolution of clinical engineering,
to define the role played by clinical engineers, and to
present the status of the professionalization of the dis-
cipline and to reflect upon its future.
''simple'' devices, such as recording electrodes and bio-
sensors that are used to monitor the activity of specific
physiological processes in a clinical setting. Furthermore,
these problems often involve addressing the many com-
plexities found in specific clinical areas, such as emergency
vehicles, ORs, and intensive care units.
The field of biomedical engineering, as it has evolved,
now involves applying the concepts, knowledge, and ap-
proaches of virtually all engineering disciplines (e.g.,
electrical, mechanical, and chemical engineering) to solve
specific health care-related problems (
Bronzino, 1995;
2000
). When biomedical engineers work within a hospi-
tal or clinical environment, they are more properly called
clinical engineers.
But what exactly is the definition of a ''clinical engi-
neer''? Over the years, a number of organizations have
attempted to provide an appropriate definition (
Schaffer
and Schaffer, 1992
). For example, the AHA defines
a clinical engineer as:
''a person who adapts, maintains, and improves
the safe use of equipment and instruments in the
hospital,''
(
AHA, 1986
).
The American College of Clinical Engineering defines
a clinical engineer as:
''a professional who supports and advances patient
care by applying engineering and managerial skills to
health care technology,''
(
Bauld, 1991
).
The definition that the AAMI originally applied to board
certified practitioners describes a clinical engineer as:
''a professional who brings to health care facilities
a level of education, experience, and accomplishment
which will enable him to responsibly, effectively, and
safety manage and interface with medical devices,
instruments, and systems and the user thereof during
patient care
.
,''
(
Goodman, 1989
).
What is clinical engineering?
Many of the problems confronting health careprofessionals
today are of extreme interest to engineers because they
involve the design and practical application of medical
devices and systems
processes that are fundamental to
engineering practice. Thesemedically relatedproblems can
range from very complex, large-scale constructs, such as
the design and implementation of automated clinical lab-
oratories, multiphasic screening facilities, and hospital in-
formation systems, to the creation of relatively small and
d
