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Received July 28, 2022, accepted August 27, 2022, date of publication September 1, 2022

Global Clinical Engineering Status: Post-COVID19 Review 

By Tom Judd1, Yadin David2, Fabiola Martinez3, and Kallirroi Stavrianou4 

1 GCEA Liaison officer 
2 GCEA Interim President
3 CED Chairperson
4 University of Warwick, UK

ABSTRACT

Many colleagues have written about the global reliance on health technologies whose innovation, deployment and support 
continue to improve worldwide healthcare and its delivery. The World Health Organization’s-WHO 2007 Resolution WHA60.29 
called for the effective use of health technologies (HT), in particular medical devices, through proper planning, assessment, 
acquisition and management. 

The community of professional clinical engineering (CE) practitioners’  pre-COVID19 stories are captured in the Global Clinical 
Engineering Journal. An article from 2022 shows the reasons for the increased contributions of this community especially dur-
ing the pandemic in  The Growing Role of Clinical Engineering: Merging Technology at the Point of Care. 

This article will answer questions such as to how this global reliance was demonstrated during the COVID19 period. How the 
status of the Clinical/Biomedical Engineering (CE/BME) profession that serves at the point of care changed as the world emerges 
from the huge stresses of the pandemic. The article reviews the evolution of the CE profession since 2020, how it partnered 
with WHO between 2020-2022 and what lessons were learned in the process. It reports future CE priorities to improve country, 
regional, and global practice in 2023 and beyond. This timely preliminary report shares important findings related to patient 
care support services.

Keywords – COVID 19, Clinical Engineer, Technologist, Devices, Patient, Outcomes, Engineering, Global

Copyright © 2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY): Creative Commons - Attribu-
tion 4.0 International - CC BY 4.0. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) 
are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is 
permitted which does not comply with these terms.

Engineering Report

http://www.globalce.org
http://globalce.org
http://globalce.org
https://apps.who.int/iris/bitstream/handle/10665/22609/A60_R29-en.pdf
https://globalce.org/
https://globalce.org/
https://globalce.org/index.php/GlobalCE/article/view/146/87


J Global Clinical Engineering Vol.5 Issue 2: 2022  30

Judd, David, Martinez, Stavrianou : Global Clinical Engineering Status: Post-COVID19 Review

INTRODUCTION

Clinical engineering professionals (CEs) support and 
advance patient care experience and outcomes by ap-
plying engineering, life sciences, and managerial skills 
to optimize healthcare technology during its life cycle 
deployments. CEs are sought for their system thinking 
expertise, to conduct independent validation of healthcare 
products, to identify technical support requirements, to 
ensure that medical device users’ needs are met and that 
products are accessible and ready for patient care. They 
assess and manage the use of health technologies, which 
WHO defines as “the application of organized knowledge 
and skills in the form of (medical) devices, medicines, 
vaccines, procedures, and systems developed to solve a 
health problem and improve quality of care and/or life,” 
including both traditional medical devices and emerging 
digital health tools.1

During 2020-2022, WHO’s World Health Assembly (in-
cludes Ministers of Health-MOHs from WHO’s 194 member 
states) focused on the need for intensive care mechanical 
ventilators (2020) and medical oxygen production (2021).2 
WHO has specifically recognized the clinical engineering 
community for expertise to optimally manage assets such 
as medical devices, personal protective equipment, oxygen, 
and digital health tools, particularly in low-resource set-
tings.3 Two CE organizations, the International Federation 
of Medical and Biological Engineering Clinical Engineering 
Division4 (IFMBE CED) and the Global Clinical Engineering 
Alliance5 (GCEA), add different expertise to meet global 
challenges, grew tremendously during the pandemic fol-
lowing a surge in the need for their members’ expertise. 
In partnership with WHO, these organizations are now 
networked to colleagues in 200 countries, sharing best 
practices and solutions to common complex challenges. 

Today, CED and GCEA together form a global CE commu-
nity & network (Fig. 1). One key pandemic lesson learned 
was that this community needed to better understand how 
practitioners are not only distributed around the world, 
but how CE practice differed from country to country to 
help drive relevant improvement, with regional focus, and 
specific training. This was supported by the opportunity  
to build on our earlier CE practitioner Body of Knowledge 
(BoK) – Body of Practice (BOP) survey from 2017. 

BACKGROUND

Prior to the pandemic, CED and WHO had been partner-
ing closely, particularly since 2009 when Dr. Yadin David 
became CED Chair and Ms. Adriana Velazquez became 
WHO’s Medical Devices/Health Technologies (HT) leader. 
Together, a series of International CE-Health Technology 
Management (HTM) Congresses (ICEHTMC) began to 
convene in 2015 in China, 2017 in Brazil, and 2019 in 
Rome. The Rome Congress had 1000 attendees from 70 
countries. During these meetings, Global CE Summits 
events were conducted to identify and prioritize action on 
global CE-HTM challenges, with 15 countries participating 
in 2015, 30 in 2017 and 48 in 2019. A virtual Congress in 
2021 drew 2100 registrants from 128 countries and had 
a virtual Global CE Summit with attendees representing 
51 countries (Fig. 2). 

During the period between 2015-2019, consensus 
priorities such as increasing professional recognition, 
improving training opportunities, creation of the dedicated 

FIGURE 1. Global Clinical Engineering Leadership Teams

FIGURE 2. Clinical Engineering Global Summits

https://globalce.org/index.php/GlobalCE/article/view/70
https://globalce.org/index.php/GlobalCE/article/view/70


31 J Global Clinical Engineering Vol.5 Issue 2: 2022

Judd, David, Martinez, Stavrianou : Global Clinical Engineering Status: Post-COVID19 Review

Global CE Journal (Fig.3), and considering professional 
credentialing approaches began to be addressed. This re-
sulted in an enhanced CED website, the startup of relevant 
projects with an Awards program (Fig. 4), promotion of 
country and regional events, and a Global CE Day focus 
on October 21, 2015 and following years.  

Global CE Day is an annual recognition of contributions 
CEs make to healthcare in their countries daily. The pro-
gram over the years grew from 1 day to 1 week, and most 
recently in 2022, more than a dozen streamed events in 
several countries over two weeks (Fig. 5). For example, 
the October 2020 program broadcast from China had 22 
hours of streaming global content from 50 countries, had 
over 500,000 social media views, and introduced GCEA 
as the new global CE partner organization. 

That same week in October 2020, WHO engaged 
with GCEA who utilized CED’s global CE network to lead 
the Engineering and Management section of the WHO 
Compendium of Innovative Health Technologies for low-
resource settings. 

Since 2020 GCEA has been growing globally, has of-
fered over a dozen global best practice webinars, and has 
enhanced its website - GCEA website.

Pandemic Era Results

Prior to COVID19, the Global CE community consisted 
a team from 100 countries. Following CED's and GCEA's 
60 best practice webinars6,7 that assisted in the global 
pandemic response, today the team has grown to over 
560 collaborators from 200 countries with connection 
to 110 national CE societies (Fig. 6). 

A key focus of over half of these webinars was implement-
ing a global CE COVID19 Knowledge Network. The other 
area of focus was detailing various country approaches to 
demonstrating CE competencies and leadership qualities 
(Fig. 7); and increasingly, showing how CE competencies 
have had a unique COVID19 impact.

FIGURE 3. Global Clinical Engineering Journal Issue covers

FIGURE 4. Clinical Engineering community projects

FIGURE 5. Global Clinical Engineering Day and week.

FIGURE 6. Global Clinical Engineering footprint

https://ced.ifmbe.org/
https://www.who.int/publications/i/item/9789240032507
https://www.who.int/publications/i/item/9789240032507
https://www.who.int/publications/i/item/9789240032507
https://www.globalcea.org/home
https://ced.ifmbe.org/who-we-are


J Global Clinical Engineering Vol.5 Issue 2: 2022  32

Judd, David, Martinez, Stavrianou : Global Clinical Engineering Status: Post-COVID19 Review

2022 Global CE Priorities, Teams and Results

At the 4th ICEHTMC (International Clinical Engineering 
and Health Technology Management Congress) Virtual 
Congress in 2021 – besides giving voice to both the tra-
ditional competencies and to the increasing global scope 
of CE-HTM practice during COVID19 – e.g., digital health, 
PPE, facility design and oxygen management, (Fig. 8), the 
Global CE Summit/Community decided on the 2022-2023 
Priorities as follows:
1. Capacity Building

• Sufficient volume of the right people with the right 
education, training, and appropriate management 
skills. 

• Framework: CE-HTM Capacity Building Model.
2. Impact Measurement

• Measurable impact on clinical outcomes. 
• Framework: CE-HTM Theory of Change (TOC) 

Model, utilizing WHO defined Access, Quality, 
Safety, Coverage, and Efficiency. 

3. Credentialing
• Credentialing typically means ensuring minimum 

competencies and experience for the CE profession, 
expressed through registration and/or certification.

4. Policy
• CEs show value to MOH at national level
• As a result, CEs assist in writing National HT Policy
• CEs educate healthcare decision-makers, both 

public and private healthcare leaders

5. Ongoing WHO Partnership
• WHO Medical Devices Unit primary focus, but other 

relevant units, eg, Emergency response
• WHO Compendium of Innovations for Low-Resource 

Settings 
• WHO COVID19 Training – Training in multiple 

languages over HT lifecycle of pandemic-specific 
devices

During 2022, the CE community organized priority 
teams, ensuring perspectives from the following HT experts:

1. Senior Advisors – At least one highly experienced Priority 
area expert to advise the team

2. Champion/leaders – Typically at least 2-3 experienced 
area leader/champions

3. Hospital-based 
4. Health system-based
5. MOH-based
6. Academic-based
7. Industry-based 
8. Regional understanding-Perspective across a WHO Region 

for a CE with multi-country experience
9. National CE Society or Institute-based

Other considerations for these teams was to ensure 
balanced input across the 6 defined WHO Regions, from 
the CED-GCEA network. These include the Americas, 
Africa, Eastern Mediterranean, Europe, Southeast Asia, 
and Western Pacific, and utilizing CED-GCEA Board and 
Collaborator members. 

FIGURE 7. Clinical Engineering Competencies

FIGURE 8. 4th ICEHTMC (International Clinical Engineering 
and Health Technology Management Congress), October 2021

https://www.who.int/health-topics/medical-devices#tab=tab_1
https://www.who.int/publications/i/item/9789240032507
https://www.who.int/publications/i/item/9789240032507
https://www.who.int/teams/health-product-policy-and-standards/assistive-and-medical-technology/medical-devices/management-use/trainings


33 J Global Clinical Engineering Vol.5 Issue 2: 2022

Judd, David, Martinez, Stavrianou : Global Clinical Engineering Status: Post-COVID19 Review

The teams met periodically and reported results at 
Townhall sessions during 2022 Global CE Week, agree-
ing on next steps for 2023, focusing on sharing results 
from the Capacity Building (CB) / Impact Measurement 
Townhall; the other priority areas are currently analyzed. 

POST-COVID19 GLOBAL CE COMMUNITY NEXT STEPS

In determining the optimal process to follow, realizing 
that the Body of Practice (BoP) had increased significantly 
during the pandemic, the teams decided upon the fol-
lowing primary data sources for examining progress and 
determining next steps:

2022 Body of Knowledge (BoK) & Body of Practice 
(BoP) Survey , September-December 2022

Current Results of the BoK-BoP (Capacity Building-CB) 
Survey, as of end of 2022 are shown on Figure 9. 

A preliminary review of BoK-BoP data is shown in 
Figures 9-12. Figure 13 shows the resulting Capacity 
Building Framework model. 

A quick summary follows:
• CE practitioners as defined by WHO serve in a va-

riety of roles shown on Figure 11; the survey was 
particularly focused on those serving in the CE or 
BME role ‘at the point of care’ managing HT. 

• This is a young profession globally, well-educated, 
needing the recognition of skills that formal creden-
tialing provides (as in most healthcare professions).

• CEs are undergoing rapid growth in Digital Health-
related responsibilities. 

• An early comparison of global data with African 
Region data shows important regional differences. 

• There was an outstanding response to the survey from 
29 countries in Africa, and a statistically significant 
response across all Global Regions. The 2022 survey 
provided over 4 times the input of the 2017 survey 
(35 countries, 199 responses) with its 865 responses 
so far from 124 countries.

FIGURE 9. Global 2022 BoK-BoP Survey



J Global Clinical Engineering Vol.5 Issue 2: 2022  34

Judd, David, Martinez, Stavrianou : Global Clinical Engineering Status: Post-COVID19 Review

FIGURE 11. Global 2022 BoK-BoP Survey results

FIGURE 10. Global 2022 BoK-BoP Survey results



35 J Global Clinical Engineering Vol.5 Issue 2: 2022

Judd, David, Martinez, Stavrianou : Global Clinical Engineering Status: Post-COVID19 Review

2022 Global Theory of Change (TOC) / Impact 
Measurement Survey

Current Results of the TOC (Impact Measurement-IM) 
Survey (TOC explanation video):

• Number of responses: 34
• Number of countries that sent specific case studies: 16
• The main focus was to ask about the areas of health-

care delivery or health systems generally where our 
global Community of CE-BME felt they have had the 
most influence.

• So far, the category that was noted in most instances 
as being an area of impact for health systems was 
Patient Safety (n=24 instances were noted of this 
type of impact), followed by improved Diagnostics 
(n=17), and improved health Access (n=16), Cost 
savings (n=15), and hospital capacity (n=15). Given 
the recent pandemic, there is also evidence that 
Emergency Preparedness is another area where 
impact has been achieved (n=12).

FIGURE 12. Global 2022 BoK-BoP Survey results

FIGURE 13. Capacity Building Framework

https://youtu.be/h49gPGcWRLY


J Global Clinical Engineering Vol.5 Issue 2: 2022  36

Judd, David, Martinez, Stavrianou : Global Clinical Engineering Status: Post-COVID19 Review

CONCLUSIONS

Next Steps: Besides continuing to analyze the Cre-
dentialing and Policy Townhalls and related next steps 
as well as assess our partnership with the World Health 
Organization, GCEA and CED will begin to implement 
findings for Capacity Building and Impact Measurement.

The pandemic has made our CE/BME profession 
highly visible globally, e.g., with WHO and with Min-
isters of Health and private health system leaders. How 
will we take advantage of this opportunity utilizing CE 
best practices? We have presented and published many 
strategies regarding how the profession can assist MOHs 
and other health leaders to address their key national 
health priorities.

The Global CE Community encouraged the develop-
ment of individual professional society and country 
heroes during the pandemic. The Community needs 
to continue to work with national CE/BME societies to 
raise up current and future leaders, as were recognized 
by CED-GCEA in 2022 (Fig. 14).

The BoK-BoP survey, the Capacity Building Frame-
work, and TOC survey: Countries can begin to drill down 
on their practices they provide compared globally and the 
gaps they will need to address to continue to expand their 
role and services for healthcare delivery improvement. 
The accepted global CE role expanded during COVID19, 
and the global Community can help each country and prac-
titioner with the skills necessary to meet this increased 
demand. CED-GCEA can help prepare the messages and 
communication packages to assist this work.

Individual Site and Country Clinical Engineering 
Status: The data sources identified share many country 
best practices for CE competencies and COVID-19 CE-
related solutions. The current five priority projects address 
the top global CE concerns and opportunities. Consider 
first the CE Capacity Building Framework. Analyze how 
your country fits in this Framework and to prioritize 
what gaps you want to pursue. Work with the global CE 
community partners and your national CE Society to 
determine next steps.

We have many tools, networking within, and potential 
external alliances available; how will each practitioner 
and how will the CE global community use these to fur-
ther grow in our profession? CE use of the social media 
tool has also been very helpful; how will these tools be 
incorporated into going forward? Figure 15 describes 
the overall international track record of the utilization 
of these tools by CE between 2020-2022.

The authors intend to conduct further analysis of the 
collected data and report their final findings in a future 
publication in the Global Clinical Engineering Journal.

REFERENCES

1. WHO Health Technology definition 
2. WHO World Health Assembly 2020-2022 
3. WHO Priority medical devices list for the COVID-19 

response and associated technical specifications
4. IFMBE CED 
5. GCEA  
6. IFMBE CED webinars, 2020-2022 
7. GCEA webinars, 2020-2022  

FIGURE 14. Global CE Community Emerging Leaders

FIGURE 15. Track record of Social media and educational 
platforms impact

https://en.wikipedia.org/wiki/Health_technology
https://www.who.int/about/governance/world-health-assembly
https://www.who.int/publications/i/item/WHO-2019-nCoV-MedDev-TS-O2T.V2
https://www.who.int/publications/i/item/WHO-2019-nCoV-MedDev-TS-O2T.V2
https://ced.ifmbe.org/
https://www.globalcea.org/home
https://ced.ifmbe.org/courses-webinars
https://www.globalcea.org/webinars

