Skill Sets A recent review of biomedical equipment information system specialist and related postings found 158 positions. Seven of these positions were located in Texas. Position descriptions included: 1. Biomedical (or Medical) Equipment Information System Specialists (BEISS or MEISS): Coordinate system installations, upgrades, and changes of connected medical devices between the biomedical engineering department, information systems, and the hospital department involved. In addition to medical equipment operation and troubleshooting skills, the BEISS should have computer hardware and software troubleshooting skills, application knowledge, and computer networking skills including server, VLAN, and VPN, as well as database knowledge. The BEISS should also have a good understanding of DICOM, HL7, PACS, and IHE. 4 4 2. PACS Field Engineers: Maintain PACS units at healthcare facilities and work for the manufacturer, vendor, or an independent service organization. Requirements include medical industry experience, strong IT skills including networking and troubleshooting, X-ray, DICOM, CR, PACS, and storage area network (SAN) experience, and database knowledge and troubleshooting experience. 3. Biomedical PACS Specialists: Coordinate, develop, install, and repair medical networking, imaging, and cardiology PACS. Serve as liaison with Information Systems department and all imaging services as well as physicians during installs, upgrades, and repairs.
Skill Sets For these positions, information technology experts should acquire skill sets in the field of clinical engineering/biomedical equipment technology such as those found in the certified biomedical equipment technician (CBET) and certified radiological equipment specialist (CRES) certifications offered through the International Certification Commission. Biomedical equipment technicians should learn skills normally belonging to information technologists. Suggested information technology education and training include: network and network architecture; database platforms and architecture; device interface including a working knowledge of network infrastructure (LAN, WAN, VLAN, and VPN); 7-layer OSI model; real-time data issues such as timing, bandwidth and frequency response; HL7, DICOM, IHE; RF and wireless communications; HIPAA and data security; high availability techniques such as RAID, UPS; and remote access and control. 5 Some field service positions list the Microsoft Certified Systems Engineer certification as a requirement. 5
PACS PACS : Picture Archiving and Communication Systems. A system based on the universal (Digital Imaging and Communications in Medicine) standard, which uses a server to store and allow facile access to high- quality radiologic images, including conventional films, CT, MRI, PET scans and other medical images over a network.
PACS PACS components: Imaging modality—e.g., X-ray, CT, MRI etc.; Secure network for transmitting patient information; Workstations for interpreting and reviewing images; Archives for the storing and retrieving images and reports.
CT VS MRI A CT Scan (or CAT Scan) is best suited for viewing bone injuries, diagnosing lung and chest problems, and detecting cancers. An MRI is suited for examining soft tissue in ligament and tendon injuries, spinal cord injuries, brain tumors, etc. CT scans are widely used in emergency rooms because the scan takes fewer than 5 minutes. An MRI, on the other hand, can take up to 30 minutes. An MRI typically costs more than a CT scan. One advantage of an MRI is that it does not use radiation while CAT scans do. This radiation is harmful if there is repeated exposure.
Trends Historically, biomedical engineering departments in hospitals worked under the guidance of the plant engineering or maintenance department, performing preventive maintenance, testing and repair activities to stand-alone medical devices. Over the last decade, more computer-controlled medical devices operate in enterprise networked environments, presenting new challenges and risks for patient safety and the security of patient information. Many biomedical engineering departments today are now under the management of IT departments, reporting to the chief information officer or vice president of information services. Because so many medical devices in the hospital are computer controlled and provide patient data over hospital networks, the Food and Drug Administration (FDA) has reconsidered the definition of a medical device data system. 6 “Since 1989, the use of computer-based products and software-based products as medical devices has grown exponentially. In addition, device interconnectivity and complexity have grown in ways that could not have been predicted in 1989. This growth and expansion have created new considerations for elements of risk that did not previously exist.” 6
Drivers Electronic medical record (EMR) initiatives are leading to a more integrated medical device environment. Patient monitors and other medical devices are now part of a larger, enterprise-wide information system. Clinical systems and applications using medical device interfaces are life- critical with specific requirements for infrastructure, availability, and performance. 7 7 A new voluntary standard, IEC 80001, Risk Management of Medical Devices in Networks, is being developed to apply risk management responsibilities to enterprise networks incorporating medical devices. The configuration and interaction of medical devices and the infrastructure of enterprise networks introduce new and unanticipated risks such as loss of patient data, inappropriate data exchange, corrupted data, inappropriate timing of data, and unauthorized access to data. Managing these risks requires cooperation and collaboration of both clinical engineering/biomedical engineering departments and information systems departments.IEC 80001 Integrating the Healthcare Enterprise (IHE) is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. IHE promotes the coordinated use of established standards such as DICOM and HL7 to address specific clinical need in support of optimal patient care. IHE, previously primarily focused on radiology applications, has expanded to include cardiology and other clinical specialties. Integrating the Healthcare Enterprise Applications such as RFID, patient alarm management, remote access, telemedicine, medical telemetry, Bluetooth devices, and wireless devices using IEEE 802.11x standards have also blurred the boundaries between information systems responsibilities and those of the biomedical engineering department.
Constraints The previously different missions and cultures of information systems and biomedical engineering departments make communication imperative to successful collaboration. Biomedical engineering departments have a more patient-centric focus (life-critical) with an emphasis on patient safety. Response time for problem calls for biomedical equipment technicians (BMETs) is typically measured in minutes or hours. Information systems have historically had a more systems-centric (mission-critical) focus with an emphasis on the integrity of data and processes. Response time for information systems professionals is typically measured in hours or days. Certifications and education are also different for biomedical equipment technicians and information systems professionals. BMETs typically have associate of applied science degrees in biomedical equipment technology or are military-trained. BMETs may be certified by the International Certification Commission as certified biomedical equipment technicians (CBET), certified radiological equipment specialists (CRES), or certified laboratory equipment specialists (CLES). Education for BMETs has primarily been focused on electronics and troubleshooting skills as well as the operation and clinical application of medical devices. 8 8 Information systems professionals may specialize in network administration, computer hardware and software support, database administration, and others. Information systems professionals may have associate or bachelor degrees in information systems or computer science. Education for information systems specialists has focused on computer hardware, software, programming, networking, and database systems, depending on specialization. Dozens of certifications are available to information systems professionals, also depending on specialization and level of responsibility.
Timing Computer hardware, software, and networking courses as well as courses covering DICOM, HL7, and PACS should be included in biomedical equipment technology curricula. Information systems programs preparing students for work in healthcare should incorporate DICOM, HL7, and PACS into the curriculum. Programs to prepare BEISSs should focus on information technology skills such as computer hardware, software, networking, and database, along with DICOM, HL7, and PACS, and should include elements of biomedical equipment technology curricula such as applied medical equipment operation and troubleshooting, safety, and imaging modality operation and application.
Relevance Skills required of BEISSs are extensions of current biomedical equipment technology programs, medical imaging systems programs, and information systems programs offered at technical and community colleges in Texas and the U.S. Job postings for BEISSs, biomedical PACS specialists, and PACS field engineers require skill sets from each of these curricula. Opportunities exist for certificate programs to better prepare graduates for these specialized positions and to enhance the skills of working professionals.
Source Sources Grimes, Stephen L., Convergence of Clinical Engineering and Information Technology, August 24, 2006. ↩Convergence of Clinical Engineering and Information Technology ↩ Grimes ↩ ↩ Monegain, Bernie. Study points to need for 40,000 more healthcare IT professionals, Healthcare IT News. ↩Study points to need for 40,000 more healthcare IT professionals ↩ Vallely, Ian. Medical Equipment Information System Specialist, Sequoia Hospital, Redwood City, California. Personal email, June 6, 2008. ↩ ↩ American College of Clinical Engineering. Guidelines for convergence of clinical engineering and information technology. ↩Guidelines for convergence of clinical engineering and information technology ↩ Medical Connectivity. FDA issues new MDDS rule. March 1. 2008 ↩FDA issues new MDDS rule ↩ American College of Clinical Engineering ↩ American College of Clinical Engineering ↩ Association for the Advancement of Medical Instrumentation. ↩ Association for the Advancement of Medical Instrumentation ↩
Biomedical Information System http://ocw.mit.edu/courses/biological-engineering/20- 453j-biomedical-information-technology-fall-2008/ http://ocw.mit.edu/courses/biological-engineering/20- 453j-biomedical-information-technology-fall-2008/
Course Description This course teaches the design of contemporary information systems for biological and medical data. Examples are chosen from biology and medicine to illustrate complete life cycle information systems, beginning with data acquisition, following to data storage and finally to retrieval and analysis. Design of appropriate databases, client-server strategies, data interchange protocols, and computational modeling architectures. Students are expected to have some familiarity with scientific application software and a basic understanding of at least one contemporary programming language (e.g. C, C++, Java, Lisp, Perl, Python). A major term project is required of all students. This subject is open to motivated seniors having a strong interest in biomedical engineering and information system design with the ability to carry out a significant independent project. This course was offered as part of the Singapore-MIT Alliance (SMA) program as course number SMA 5304.Singapore-MIT Alliance