034 - Clinical Engineering
Autor(s): P. Derrico, L. De Vivo, T. Franchina, M. Ritrovato
Issue: RIMeL - IJLaM, Vol. 3, N. 3-S1, 2007 (MAF Servizi srl ed.)
Page(s): 34-41
In the last years, the evolution of the health system mission has modified the judgment on biomedical technologies, making it much more linked not to the instrumentation cost but to its intrinsic value. The technology is the practical application of a knowledge and with terms “biomedical technologies” we refer to the knowledge applied for preventing, diagnosing, treating and curing a pathology. The assessment of biomedical technology based only to its own cost results much more unsatisfactory because the technology core is in its value, in the benefit derived by its employment for health improvement and patient outcome increase. In this assessment process, Clinical Engineering is a coactor because it cares about the whole and careful technology management, for which a systematic and analytic method is required to take into account both biomedical equipment management technical factors and the overall parameters related to the whole technology life. HTA methodology enters in Clinical Engineering processes as an efficacious and non-replaceable tool for appropriate technology acquisition in a heath system, attending and advising stakeholders in the health policy decisions, (at national, local or enterprise level) and realizing a comprehensive and systematic multidisciplinary assessment of the clinical, economical, social and ethic consequences that arise directly and indirectly from existing and innovative health technologies. Clinical Engineering Services, steadily present in hospital and local health agencies, not only play as guarantor of patient/user safety and technology servicing/upgrading but also as advisor, jointly with clinical and economical professionals, for health policy planning related to the purchase and use of biomedical technologies. In the specific case of the IRCCS Children Hospital Bambino Gesù, because of its organization and the presence of a well-established Clinical Engineering Service (CES), the direction of the health technology assessment process is due to the above mentioned service, also because of its visibility and leadership. Moreover it has been judged the CES most suitable to lead HTA activities, as coordinating several professionals from the health facilities each time involved with the use, purchase, maintenance and installation of the technology, in order to guaranty a consensus assessment. Different HTA projects have been completed in our hospital, i.e. fRMI stimulation equipment, planning and reorganization of the whole Bioimaging Department, re-organization of hemodynamic activities and related technological up-date, chemical analysis laboratory automation. The latter is a work in progress project and it is a really comprehensive example of the utility and the efficacy of the expertise integration within a health technology assessment team.