I recently had the pleasure of speaking at the Third Arab Biomedical and Clinical Engineering Conference. (Learn more about the conference at The conference was held in Beirut, Lebanon, and attracted attendees from all over the Middle East. Each Arab Biomedical and Clinical Engineering conference takes place in a different Middle Eastern country—and I hope to be invited back, as the large conference was filled with energetic, forward-thinking engineers, technicians, and students from thoughout the region.

You may be surprised to know that each Lebanese hospital is required to have one biomed/clinical engineer on staff. (And this is in addition to the normal BMETs and others that are tasked with repairing hospital equipment.) In fact, Lebanon places a tremendous emphasis on prepurchase evaluation, technological assessment, and HTM involvement in the decision-making process to help ensure that the hospitals’ extra-scarce financial resources are not wasted by purchasing the wrong or inappropriate technology.

To me, the inclusion of HTM is very refreshing and I would like to see U.S. hospitals take a similar approach.

Outside-the-Box Thinking

During the conference, numerous presenters explored other groundbreaking subjects, as well. Among the most interesting: A paper by Riad Farah, the medical engineering manager of Saint George Hospital University Medical Center in Lebanon. It in, Farah presented the results of an ongoing project to create a system to help hospitals decide whether to repair or replace medical equipment.

His system, which is highly researched and documented, is based upon replacing a device if its repair cost is a certain percentage of the original purchase price. Specifically, Farah has identified 26 factors which may favor either equipment repair or equipment replacement, depending upon how the questions are answered. After these factors are weighed and the scores are tallied, the final sum determines whether to recommend repair or replacement.

The goal of the project is to automate the answers to the questions via a computerized maintenance management system with very little manual intervention. Although the final recommendation would still require human consent, most decisions would stand as per the formula.

Some of the 26 factors that are weighed include: No.1: Equipment obsolete (not available on Internet, no spare parts); No.12: The end user is not satisfied with its performance; No. 21: Rate of occurrence of failures this year is greater than in previous years; No. 22: Operational cost is high and there is more economical equipment available; and No. 23: The item cannot be repaired in-house and must be covered by an expensive service contract.

Even though more input is required to place objective quantification to the 26 factors, Farah has already made great strides with this project. If you would like a copy of his paper and the factors he developed, simply e-mail me at [email protected].

Following Lebanon’s Lead

Other topics of concern at the conference were cybersecutity, the impact of user error, the accreditation of individuals and departments, the relationship of HTM to quality healthcare, and international standards for HTM and healthcare, such as AAMI, the International Organization for Standardization, and the World Health Organization.

Although Lebanon is a small country, with just 4 million people, the conference drew more than 200 attendees—many of whom were students in Lebanon’s engineering, biomedical, and clinical engineering university programs.

In contrast, there are an estimated 30,000 HTM professionals in the United States. However, I worry that we are underrepresented in the areas related to real equipment management—and, instead, are being relegated to mere repair and scheduled maintenance functions. Unlike in Lebanon, hospitals and employers in the U.S. seem to be ignoring the contributions we can make to patient safety, the future of healthcare, and the financial future of the business through proactive assessment—as well as participating in the decision-making processes related to the strategic nature of medical devices.

After all, our insight into our customers, technology, safety issues, the workflow in patient care areas, and the problems with specific companies can help prepare the hospital for a smooth future and reduce negative technological issues. It seems as if, in this very crucial area, our friends in the Middle East are getting that part right.

Patrick Lynch, CBET, CCE, CHTM, CPHIMS, FACCE, is a biomedical manager with 40 years’ experience. Questions and comments can be directed to 24×7 Magazine chief editor Keri Forsythe-Stephens at [email protected].