NESCE: CE-IT convergence proceeds apace

If clinical engineering is to succeed in converging with IT—and converge the two professions must—many clinical engineers need to overcome a hindering element of human nature: resistance to change.

So said Stephen Grimes, chief technology officer of Boston-based ISO Linc Health, in a presentation on CE-IT convergence at the Northeastern Healthcare Technology Symposium in Groton, Conn., Nov. 3 and 4. The event was sponsored by the New England Society of Clinical Engineering.

“One of the problems we have, particularly those of us who have been in this profession for a number of years, is that it’s easy to do things they’ve always been done,” said Grimes. “But if we’re to be effective and remain relevant, we need to be prepared to change. The nature of the technologies we’re dealing with is changing, and at an ever-increasing pace.”

Grimes pointed out that, as devices that used to stand alone have become networked, networks have become both simpler and more complex. Multiple network silos once confined to individual departments are disappearing as the enterprise-wide network rises to serve the entire hospital.

One of the problems such consolidation has brought is “single points of failure” that can take out significant subsets of connected capabilities. A failing physiological monitoring system, for example, could take down more than 100 physiologic monitors. “We’d lose anywhere from a week’s worth to a month’s worth of data associated with all those monitors,” said Grimes.

Hence the growth of the next generation in connectivity: cloud computing. “Right now you can put everything from your photographs to your music to your movies up on the cloud, and eventually we’ll be doing this with our clinical data as well,” said Grimes. The cloud allows users to run applications and store data over the Internet via multiple, redundant servers maintained by the likes of Amazon, Salesforce and Google—experts in ensuring uptime, security and backup.

Clinical applications will move to the cloud, too, eliminating the need for version control and patch management, said Grimes, adding that platform independence will allow access on any appliance with Internet access.

Meanwhile, device manufacturers “will migrate into becoming developers of medical software,” said Grimes. “And perhaps things like transducers, sensors, actuators—whatever will do the picking up of information from, or delivering therapies to, the patient”—will send and receive via the cloud.

For clinical engineers, this emerging area of IT stands as just one of the latest reminders of Grimes’ theme: “We have to be in a position to recognize and support not only these changes taking place now, but also be aware of where things are heading.”

Going forward, said Grimes, clinical engineers and biomedical technicians “cannot hope to support” such fast-forward technologies “without at least some basic understanding” of networking, cloud computing and other emerging technologies.

Grimes also described three hybrid CE-IT positions that, he said, are emerging to meet healthcare’s changing needs:

• the clinical systems engineer to lead interdepartmental risk-mitigation efforts;
• the clinical systems support specialist, already established in many hospitals in the form of PACS administrators, for example; and
• the radio frequency spectrum manager to guide the expanding influx of often-conflicting signals from Wi-Fi and other emitters of RF signals.

Grimes tipped his cap to IT for increasingly adjusting to the healthcare environment. “IT used to be technology-focused,” he said. “They were largely dealing with non-clinical applications. But today they’re more mission- and service-focused, as we should be. They’re less preoccupied with the technology itself, more involved with the critical aspects of healthcare and more occupied with results.”