What started as a trip through the BI&T archives became a reminder that many of HTM’s biggest conversations haven’t changed nearly as much as you might expect.
By Alyx Arnett
I’ll admit it: When I started flipping through Biomedical Instrumentation & Technology (BI&T) issues from 2006, I was half-expecting a time capsule—ancient tech and debates everyone had long since put to bed.
Instead, I found articles about clinical engineering (CE) and IT working together, wireless medical devices, cybersecurity, proving HTM’s value to hospital leadership, and workforce development. Sound familiar? Twenty years later, we’re still having a lot of these same conversations. HTM has absolutely changed—but not always in the ways, or at the pace, you might expect from two decades.
So I called up a few people who helped shape those 2006 conversations to find out how far things have actually come, what’s still stuck, and why some arguments just refuse to go away.
The Value Conversation Continues
One editorial in the 2006 issues made its point before you even read the first sentence. The title was: “Get Out of the Basement.”
Authored by Paul Kelley, CBET, AAMIF, it wasn’t really about the basement. It was a call for HTM professionals to get more visible and show their value went well beyond fixing broken equipment. As Kelley put it in 2006: “Just because you know your field does not guarantee that everyone else is aware that you have the ability to help them—unless you tell them.”
Kelley, who was BI&T’s editor at the time, told me, “I did push the theme of making sure your customers and administrators were well aware of what you were doing, in a factual and not boastful way.”
He wasn’t the only one saying it that year. James Fanning pushed biomeds to build real relationships with caregivers as a way to demonstrate their value. Robert Dondelinger went straight for the wallet, arguing HTM’s value isn’t what it fixes—it’s what it saves. “Our value as biomeds is not in the revenue we generate, but in the money we don’t force our facilities to spend,” he wrote.
Looking back, Kelley believes the conversation stuck. “I do want to believe it helped move the needle for HTM,” he says. “This is a big part of what I have promoted and taught throughout my career … I do see these subjects being taught and written about, so I think HTM does understand the value.”
One place those ideas were written about recently was 24×7. Earlier this year, Binseng Wang, ScD, CCE, FAIMBE, principal consultant at BSI Consulting, argued that the profession is still working to earn the recognition Kelley was advocating two decades earlier, writing that CE/HTM pros are “still mostly labeled as basement ‘wrenchies’ who are only called upon when things break down.”
The Technology Changed. The Questions Didn’t.
If one thing had obviously changed since 2006, it was the technology. Connected devices, wireless infrastructure, interoperability—back then, these were still the new kids on the block.
Case in point: In a 2006 BI&T interview, John Glaser, PhD, who was vice president and chief information officer at Partners HealthCare System at the time, laid out plans to connect roughly 5,000 infusion pumps across the system’s 17 campuses. At the time, that was a big, bold, slightly nerve-wracking undertaking. Now? That kind of connectivity is just part of the job.
Then there’s Rudy Amor, then-senior tech support engineer for GE HealthCare, who wrote in an article on PACS about a future where patients carry their scans and records around on a “flash memory stick” instead of lugging CDs or giant envelopes of film. The technology may not have evolved exactly that way, but the underlying idea—that patient information should move with the patient—absolutely did.
Put those two side by side, and you’ve got a profession realizing everything was about to get more connected, and that CE and IT needed to actually talk to each other because of it.
Glaser says that part hasn’t changed a bit: “Twenty years ago and today both organizations (CE and IT) have an overarching goal of applying technology to improve the safety, efficiency, and quality of patient care. [Because of that shared goal,] the need for effective collaboration between the two organizations was and is crucial.”
What has changed is the list of things they’re collaborating on. Today that list includes cybersecurity, AI, wearables, hospital-at-home programs, wireless networks, and an increasingly tangled digital infrastructure, says Glaser.
“The technology, location of care and the management of the shared digital infrastructure have seen significant changes,” Glaser says. “However, the importance of a strong working relationship between the IT and CE organizations remains a very important foundation.”
The Next 20 Years Are Up to Us
Looking back at the past two decades, Wang, who wrote several articles for BI&T in 2006, sees a profession that’s accomplished plenty—but hasn’t exactly sprinted toward its potential.
“I believe we have evolved rather slowly, if not very little, over the last two decades,” he says.
For Wang, the next chapter is about CE/HTM earning the recognition of a true profession. He believes greater recognition—licensure included—would give HTM a stronger, unified voice on everything from hospital leadership buy-in to right to repair to recruiting the next generation.
“Obviously, these challenges will not disappear overnight when we become a licensed profession,” he says. “However, it will be much more difficult for both HDO leaders and OEMs to ignore our demands when we speak up as a unified profession and not simply as those ‘tool bearing guys from the basement.'”
Skip that step, Wang warns, and today’s professionals just pass the same headaches down to the next generation. But he’d rather leave people with the opportunity than the warning:
“I hope my younger colleagues agree with me that this is not a boring profession but a worthwhile career that not only contributes to better and safer health care but also gives them the satisfaction that they will leave it much better than what they encountered when they started because they were willing to devote significant time and effort to find ways to improve the ways medical technology is managed and maintained.”
After reading those 2006 issues—and talking with some of the people who wrote them—I realized I hadn’t quite found the time capsule I expected. I found plenty of history—but I also found more of today’s profession than I ever expected. I’ll be curious what the next person finds when they flip through those 2006 BI&T issues for their 40th anniversary.
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