Page 3 - Vol0_No01_2018

T Judd et al.: Clinical Engineering/Health Technology Management 2015 Global Update

personnel involved in health technology assess- the medical, social, economic and ethical issues related
ment (HTA) and biomedical engineering” (BME); to the use of a health technology in a systematic, trans-

3. “to draw up national or regional guidelines for parent, unbiased, robust manner. Its aim is to inform
good manufacturing and regulatory practices, to the formulation of safe, effective, health policies that are
establish surveillance systems and other measures patient focused and seek to achieve best value. Despite
to ensure the quality, (risk,) safety and efficacy its policy goals, HTA must always be firmly rooted in
of devices and where appropriate participate in research and the scientific method. 5–7 HTA provides the
international harmonization” (HTR, Risk & Safety foundation for successful planning and subsequent use
or R&S); of health technologies.

4. “to establish where necessary national and regional
institutions of health technology, and to collaborate HTM GAPS AND PROGRESS
and build partnerships with health care providers, 1
Earlier HTM Study: Our prior article described prog-
industry, patients’ associations and professional, ress in HTM in 51 countries, including Africa (11 countries)
scientific and technical organizations;” (e.g., MOH Asia (11 countries), Latin America & the Caribbean (19

HT units); and
5. “to collect information that interrelates medical devices countries), and other (10 countries). In that article, the
which deal with priority public health conditions at following gaps in HTM were identified:
different levels of care and in various settings and • A lack of competent staff (Human Resource develop-
environments, with the required infrastructure, pro- ment - HR)
cedures and reference tools;” (to improve Maternal • Limited access to technical documentation & spare
Child Health (MCH), such as HT improving MCH parts (HTM)
care outcomes).
• Poor planning and lack of commitment (HTM)
To illustrate these points, we include a figure from our • Irrational HT incorporation and deployment (HTM)
previous article, which is a graphical representation of
• Limited influence with decision makers (e.g., <10
the main elements of Health Technology Management,
countries then had designated Ministry of Health,
and how it relates to other areas of the health system
Health Technology-HT Units)
(see Figure 1).
• Donations provided that do not align with Ministry
As a capital investment, equipment needs to be man- of Health (MOH) priorities
aged from deployment (strategic planning, acquisition,
In addition, the article identified the following root
installation / acceptance) until retirement, guided by a
causes of HTM challenges:
country’s health technology policy (HTP).
• Lack of: training to develop human resources-HR;
During its useful life, proper maintenance and manage-
experience; awareness; and influence with decision
ment are essential to ensure safe, efficient, and cost-effective
makers regarding HTM
patient care. Often neglected, feedback provided by users
and maintainers is essential to continually improve HTM • Equipment is often considered a status symbol in-
within the country or system, and avoid mistakes made stead of a service production tool
previously. • Greed and short-sightedness of manufacturers and
HTM is intimately related to but distinct from health distributors

technology regulation (HTR, and Risk & Safety), as the • Selfishness of some “aid,” “cooperation,” and “do-
latter is focused on safety and efficacy, with little concern nation” programs that are actual sales-promoting
on costs and management challenges. schemes or publicity stunts
Health Technology Assessment (HTA) is a multidis- • Lack of vision and courage among HTM professionals
ciplinary process that summarizes information about

J Global Clinical Engineering Special Issue 1: 4-14; 2018 6