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Received February 2, 2018, accepted March 14, 2018, date of publication March 25, 2018.

Clinical Engineering/Health Technology 
Management 2015 Global Update

By T Judd,1 A Hernandez,2 W Gentles,3 and S Calil4

1IFMBE CED Secretary, ACCE, USA.
2WHO-PAHO / Former Senior Advisor Health Technology (HT), ACCE IC Chair, USA.
3BT Medical Technology Consulting / Past President, CMBES, ACCE, Canada.
4CEB-FEEC – UNICAMP / Professor, IFMBE CED Past Chairman, Brazil. 

ABSTRACT

Medical device systems Clinical Engineering (CE)/Health Technology Management (HTM) strategies and best prac-
tices are now well established in most first world and many developing countries (DC).
Progress is being made to address identified gaps in DC CE/HTM, such as appropriate equipment selection and life-
cycle management. One contributor to this progress is the 25 years of CE/HTM Seminars provided by WHO-PAHO, 
ACCE, and more recently, IFMBE CED, to 80 countries. There is also a new emerging challenge; the requirement for 
medical device (clinical data) integration (MDI) into electronic health records (EHRs) to improve care quality and 
safety (aka CE-IT).
This study will review CE/HTM progress, gaps, and new challenges since the last study in 2011. It will provide a 
framework to direct the global CE/HTM movement forward in collaborative fashion, alongside other initiatives in 2015, 
such as the 1st International CE-HTM Congress and the Global CE Summit held in Hanzhou, China, in October, 2015.

Keywords: Clinical Engineering, Health Technology Management, CE, HTM, CE/HTM seminars, medical device lifecycle 
management, CE education, CE-Information Technology (CE-IT), medical device integration, IFMBE CE Division.

INTRODUCTION
“In the 1980s, it became clear to the World Health 

Organization (WHO), academia, and various global non-
government organizations (NGOs) that there were many 
failed medical device technology transfer projects in the 
previous 2 decades, resulting in a large amount of inoper-
able sophisticated equipment and unmet healthcare needs 
in spite of significant financial investment.”1

“In 1988, WHO organized a virtual international 
roundtable with input from experts around the world and 

published the discussion in World Health Forum.2 The 
roundtable not only confirmed the 2 challenges identi-
fied earlier – acquisition planning and maintenance, but 
also pointed out fundamental underlying issues. First 
and foremost is the fact that unlike drugs and vaccines, 
medical equipment requires continual outlay of funds, on 
order of 6–15% of original acquisition price, for the life 
of equipment, often up to 10–20 years after acquisition.1 
Thus, it is useless for NGOs and financing organizations 
to provide equipment donations or investment loans if 
the recipient countries cannot pay for recurrent expenses, 

https://www.globalce.org
https://www.globalce.org


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

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

FigURE 1. The main elements of developing country HTM and its key health system relationships.

even if adequate planning and maintenance are available. 
Another serious deficiency is the lack of a framework 
for proper HTM in most developing countries. Without 
a framework defined and supported by policies, proce-
dures, defined responsibilities, and earmarked resources 
for HTM, it is difficult to perform technology planning in 
harmony with the country’s health policies and priori-
ties, ensure appropriate human and material resources 
necessary to operate the equipment, and maintain it in 
safe and operational conditions.”1

DEFINITIONS AND CONTExT

Definitions
Health Technologies (HT): The term refers to the ap-

plication of organized knowledge and skills in the form 
of devices, medicines, vaccines, procedures & systems 
developed to solve a health problem and improve qual-
ity of lives.3

Clinical Engineer: A Clinical Engineer (CE) is a pro-
fessional who supports and advances patient care ap-
plying engineering and managerial skills to health care 

technology. (Sometimes also referred to as a Biomedical 
Engineer [BME].)4

Health Technology Management (HTM): For USA CE 
certification, defined by the ACCE Body of Knowledge 
survey of CE practitioners, HTM is broadly defined as 
“lifecycle management of medical devices and systems.”5

Context and Key Acronyms
The main elements of developing country HTM and its 

key health system relationships are outlined in Figure 1.1

The 60th World Health Assembly, convened by WHO in 
2007, passed the Resolution WHA60.29 relating to Health 
Technologies.6 This resolution urges Member States:

1. “to collect, verify, update and exchange information 
on health technologies (HT); in particular medi-
cal devices as an aid to prioritization of needs and 
allocation of resources”;

2. “to formulate as appropriate national, strategies and 
plans for the establishment of systems for the assess-
ment, planning, procurement and HT management 
in particular medical devices, in collaboration with 



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

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

personnel involved in health technology assess-
ment (HTA) and biomedical engineering” (BME);

3. “to draw up national or regional guidelines for 
good manufacturing and regulatory practices, to 
establish surveillance systems and other measures 
to ensure the quality, (risk,) safety and efficacy 
of devices and where appropriate participate in 
international harmonization” (HTR, Risk & Safety 
or R&S);

4. “to establish where necessary national and regional 
institutions of health technology, and to collaborate 
and build partnerships with health care providers, 
industry, patients’ associations and professional, 
scientific and technical organizations;” (e.g., MOH 
HT units); and

5. “to collect information that interrelates medical devices 
which deal with priority public health conditions at 
different levels of care and in various settings and 
environments, with the required infrastructure, pro-
cedures and reference tools;” (to improve Maternal 
Child Health (MCH), such as HT improving MCH 
care outcomes).

To illustrate these points, we include a figure from our 
previous article, which is a graphical representation of 
the main elements of Health Technology Management, 
and how it relates to other areas of the health system 
(see Figure 1).

As a capital investment, equipment needs to be man-
aged from deployment (strategic planning, acquisition, 
installation / acceptance) until retirement, guided by a 
country’s health technology policy (HTP).

During its useful life, proper maintenance and manage-
ment are essential to ensure safe, efficient, and cost-effective 
patient care. Often neglected, feedback provided by users 
and maintainers is essential to continually improve HTM 
within the country or system, and avoid mistakes made 
previously.

HTM is intimately related to but distinct from health 
technology regulation (HTR, and Risk & Safety), as the 
latter is focused on safety and efficacy, with little concern 
on costs and management challenges.

Health Technology Assessment (HTA) is a multidis-
ciplinary process that summarizes information about 

the medical, social, economic and ethical issues related 
to the use of a health technology in a systematic, trans-
parent, unbiased, robust manner. Its aim is to inform 
the formulation of safe, effective, health policies that are 
patient focused and seek to achieve best value. Despite 
its policy goals, HTA must always be firmly rooted in 
research and the scientific method.5–7 HTA provides the 
foundation for successful planning and subsequent use 
of health technologies.

HTM GAPS AND PROGRESS
Earlier HTM Study: Our prior article1 described prog-

ress in HTM in 51 countries, including Africa (11 countries) 
Asia (11 countries), Latin America & the Caribbean (19 
countries), and other (10 countries). In that article, the 
following gaps in HTM were identified:

• A lack of competent staff (Human Resource develop-
ment - HR)

• Limited access to technical documentation & spare 
parts (HTM)

• Poor planning and lack of commitment (HTM)
• Irrational HT incorporation and deployment (HTM)
• Limited influence with decision makers (e.g., <10 

countries then had designated Ministry of Health, 
Health Technology-HT Units)

• Donations provided that do not align with Ministry 
of Health (MOH) priorities

In addition, the article identified the following root 
causes of HTM challenges:

• Lack of: training to develop human resources-HR; 
experience; awareness; and influence with decision 
makers regarding HTM

• Equipment is often considered a status symbol in-
stead of a service production tool

• Greed and short-sightedness of manufacturers and 
distributors

• Selfishness of some “aid,” “cooperation,” and “do-
nation” programs that are actual sales-promoting 
schemes or publicity stunts

• Lack of vision and courage among HTM professionals



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

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

Global HTM Seminars: Further progress in HTM has 
been documented in a series of Seminars presented from 
1991-2015 by ACCE and WHO-PAHO.8

As a result of these seminars, progress was seen in 
the following areas (with aggregate evidence noted below 
summarized):

• HT Policy (HTP) developed, e.g., in 27 of 51 countries 
(>50%)

• HTM training provided (HR), e.g., 40+ of 51 countries 
(>80%)

• National professional societies created; e.g., in 20 
of 51 (~40%)

WHO Global Forums: Further progress in HTM was 
documented in the WHO 2nd Global Forum on Medical 
Devices, 2013 (2GFMD).9 This progress was documented 
in a series of country reports presented at the Forum, 
and is summarized in the following tables (Tables 1A-D).

The 2013 WHO 2nd Global Forum provided an important 
update on the information presented in our prior paper.1 
We now see indications of further progress.

Africa (20 countries)
• HTM programs have doubled in the region.

• Increased NGO HTM involvement has helped, such 
as, THET-Zambia, MRC-Gambia, and CMBES-Ghana.

• Increasing HT involvement with MOH decision makers.
• Growing HTA and HTR initiatives.

• Earlier HTM programs now aggressively pursuing MCH.
• Limited CE-IT initiatives.

Asia (13 countries)
• Big 3: strong national programs in China, Japan, and India.

• MOH Unit in India comprehensively addressing HT.
• Continued growth of Japan and its national CE society.
• Rapid growth of China CEs, societies, & certification.

• Countries with prior HTM (2011) pursuing HTA and HTR.
• Increasing involvement with MOH decision makers. 

Limited CE-IT initiatives other than Big 3.

Latin & Central America (12 countries)
• PAHO investment in HTM and HR training anchored 

in academia.

• Freeing MOHs to work on HTA and HTR.
• Big 4: historical HT strength of Brazil & Mexico + Co-

lombia & Peru.
Brazil largest CE base; very multidisciplinary approach.

• Mexico MOH Unit; wide-ranging with decision makers.
• Colombia (strong HT history; introduced IHE to Re-

gion); & Peru (developed MOH Unit, key academia 
partnerships).

Others (26 countries)
• Group with extensive capabilities along HT continuum.

• Most have mature HTM & are pursuing HTA & HTR.
• Several key HTM contributors in region and or globally.
• Also among global leaders for CE-IT and MCH.

2015 HTM Seminar: In June 2015 another major 
HTM Seminar was organized by ACCE in collaboration 
with WHO-PAHO, with 32 HTM leaders from 22 countries 
represented, and one USA NGO.10 Table 2 lists the partici-
pants in this seminar, and their affiliations.

This table illustrates the following indications of prog-
ress: HT units now more frequently created at MOH level 
(15/22 countries) and HTM leaders are emerging with 
increasing influence at the MOH level.

Table 3 summarizes the gains and challenges in HTM, 
HTA, HTP, HTR, and CE-IT that were reported at the seminar.

The following detail the gains and challenges identified 
at the 2015 HTM seminar:

Africa (5 countries reporting)
• Tend to have established HTM, but need HR, HTP, and 

HTR

Asia (3 countries reporting)
• Rapid growth HT capabilities for 2 high population 

countries
• India MOH HT Unit leading country-wide initiatives
• Bangladesh increasing scope of HT work

Latin & Central America (8 countries reporting)
• Two in early stages of HTM; most mature pursuing CE-IT

• Mexico MOH HT Unit (CENETEC) a global best practice
• Most countries also need MOH HTP and HTR



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

J Global Clinical Engineering Special Issue 1: 4-14; 2018  8

TABlE 1A. Africa – 20 Countries/Entities Presented at 2GFMD

Country Major Accomplishments References

AFRO-WHO HTM Ndihokubwayo (AFRO), 2013

Benin HTM Adjaratou et al (MOH), 2013

Burkina Faso HTM Emmanuel et al (MOH), 2013

Cameroon HTM, CE-IT Ngaleu-Toko et al, 2013

Cote D’Ivoire HTM YriéUDenis (MOH), 2013

Ethiopia HTM, MCH Mulegeta et al (MOH), 2013

The Gambia HTM, MCH Nyassi et al, Faye et al, 2013

Ghana HTM, HR, HTA, MCH Adjabu, THET & MOH, 2013

Kenya HTM, HR, HTA, HTR, MCH Owino, Anyango, Mwaru et al (MOH), 2013

Malawi MCH Mwanza et al (MOH), 2013

Nigeria HTM, HTR, MCH Ilonze et al (MOH), Fatunde, 2013

RSA HTM, HTA, HTR Poluta, Khalaf et al, Mueller, 2013

Rwanda HTM Mukama et al (MOH), 2013

Senegal HTM Sow et al (MOH), 2013

Sierra Leone HTM Kabia (MOH), 2013

South Sudan HTA Lilford et al, 2013

Tanzania HTR, MCH Kijo et al (MOH), 2013

Togo HTM, MCH Tsolenyanu et al (NGO), 2013

Uganda HTM, HR, HTA, MCH Wanda et al (MOH), Ssekitoleko et al, 2013

Zambia HTM, MCH Mullally, Machbani, Musiwa (MOH), 2013

Other (2 countries reporting)
• Albania HT Unit a global best practice for small countries

WHO
• WHO desires the following global Surveys in 2016:

• Value of Donations, e.g., percent implemented and 
in use

• Number BMETs needed at country level, for MOH plans
• HTM outcome measures; influence MOH decision 

makers

• WHO facilitating BME/CE global recognition in 2018 
by ILO
• Causing WHO to annually track key CE/HTM measures

The 2015 Seminar Participant Recommendations were:
1. Increase Awareness of CE/HTM Influence on HT Policy

• WHO can assist countries to develop/implement 
HT policies

2. Communicate global HTM point of view to help countries
• How to address when government not involved in HTM



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

TABlE 1B. Asia - 13

Bangladesh HTM, HTA, HTR Hasan, Rabbani et al (MOH), 2013

China HTM, HTA, HTR, CE-IT Zhong et al, 2013

India HTM, HTA, HTR, CE-IT, MCH Sharma et al (MOH), Khambete et al, 2013

Japan HTM, HR, HTA, HTR, HTP, CE-IT Fukuta (MOH), Nakazaki, Sugiura, 2013

Korea HTA Hwang et al, 2013

Laos HTM Insal (MOH), 2013

Malaysia HTR Rahman (MOH), 2013

Myanmar HTM Lin (MOH), 2013

Philippines CE-IT Mojica et al, 2013

Singapore HR, HTR, HTA Goh et al (MOH), 2013

Sri Lanka HTA Galappatthy et al (MOH), 2013

Thailand HTA Tantivess, Wibulpolprasert (MOH), 2013

Vietnam HTM, MCH Dajer, 2013

TABlE 1C. Latin & Central America - 12

Argentina HTM Giles et al, 2013

Bolivia HTM Urioste (MOH), 2013

Brazil HTM, HR, HTA, HTR, HTP, R&S Garcia, Calil, Conto (MOH), 2013

Colombia HTM, CE-IT Quintero, Hernandez, Castaneda, 2013

Chile HTA Duarte et al, 2013

Cuba HTR Pereira et al (MOH), 2011

Ecuador CE-IT Silva et al, 2013

Haiti HTM Judd et al, 2013

Mexico HTM, HTA, HTR, HTP Cardenas, Moreno (CENETEC) 2013

PAHO-WHO HTM, HTA Lemgruber, Jimenez, 2013

Peru HTM, HTA, HTR Rivas et al, Pinedo, 2013

Uruguay HTP, HTA Galan et al (MOH), 2013



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J Global Clinical Engineering Special Issue 1: 4-14; 2018  10

TABlE 1D. Australia, Europe, Middle East, NGOs - 26

Australia HTA, HTR, CE-IT Babige, Kearney, Tang, Mcewan 2013

Belgium HTM, HTR Demade, Bogg, Merlevede 2013

Bulgaria HTA Dimitrova (MOH), 2013

Croatia HR Magjarevic, 2013

Egypt HTA Salem, ElSaadany (MOH), 2013

EWH HTM Malkin, 2013

EURO-WHO HTA, CE-IT Pedersen et al (EURO), Kulkarni, 2013

Greece HTM, HTP, R&S Pallikarakis, Stavrianou, 2013

Hungary HTA Szacsky, 2013

Israel MCH Mayaan, 2013

Italy HTM, HTA, CE-IT Iadanza, Pecchia, Musi, 2013

Jordan HTM Rahim, Dalou, 2013

Kuwait HR, HTR Alzawadhi, 2013

KSA HTA, HTR, CE-IT Hassanain, Al Tayyar, 2013

Laerdal MCH Laerdal et al, 2013

Lebanon HTA Rihana, 2013

Netherlands HR, HTA Hurts/Hansen (MOH), Linnenbank, 2013

Norway HTA Lauvrak et al, 2013

Portugal HR, HTA, HTR Secca, Da Silva, Madureira et al, 2013

Slovakia HTA Jadud (MOH), 2013

Spain HTA, CE-IT Falcon et al, 2013

Switzerland HTM, HTR Zaugg, Werlein, Voelksen, 2013

Tunisia CE-IT Ouhichi, 2013

Turkey HTM, HTA, HTR, R&S Copur, Demirbas, Turgut/Kuru, Ozdemir, 2013

UK HTM, HTR, R&S Murray/Gammie/Wasmuth/McNerney 2013

Yemen HTA Mujamal (MOH) et al, 2013



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

TABlE 2. 2015 HTM Seminar Participants

Albania MOH Health Technology (HT) 
Director

Argentina MOH HT Coordinator

Argentina Private Hospital CE Director

Australia / Egypt WHO BME Intern

Bangladesh University BME Professor

Bangladesh University BME graduate student

Bhutan MOH Director HT Unit

Botswana MOH Regional HT Director

Brazil MOH HT Manager

Brazil Private CE Company COO

Canada WHO BME Intern

Colombia MOH Director HT Unit

Colombia MOH Laboratory CE Director

Colombia University BME Professor

Cuba MOH Hospital CE

Ethiopia MOH BME Advisor

Haiti National Hospital CE Director

Haiti / USA Medical Device Consultant

India MOH WHO HT Center Director

India MOH Consultant

Kenya MOH Hospital CE

Kosovo Telecommunications Engineer

Mexico MOH Hospital Coordinator

Mexico University CE Professor

Mexico University CE Professor

Nigeria MOH Director HT Unit

Peru MOH Consultant, University CE 
Professor

Sierra Leone/USA University CE Professor

Suriname MOH Hospital CE Director

Uganda MOH Director HT Unit

Uganda MOH Senior BME

USA NGO BME Leader

• How to enable, using resources & influence to help 
drive HTM

• WHO needs data from specific case studies to bet-
ter assist

3. Develop Regional Training Centers (RTC) – Improves 
HR & HTM
• Need Key HTM Process Standardization
• Lessons learned to be applied: (1) create RTC for 

maintenance; (2) Training that is university-based 
is more sustainable

• Incorporate CE/HTM in health care clinical & busi-
ness courses, such as for physicians and health 
administrators

• Share different methods of risk management across 
countries

4. Develop standard medical equipment procurement 
documents
• Incorporate Life Cycle Cost (LCC) Analysis, as World 

Bank has done for Information and Communication 
Technologies

• Make use of WHO resources on Device Specifications
• Consider central/national Public-Private-Partnership 

(PPP)

5. Consider how to best facilitate “our group” ongoing 
communications and networking – e.g., INFRATECH 
and WHO Listservs

6. Maintenance Management
• Need inventory management system on line with 

history (CMMS); such as, basic inventory, then layers
• India is working on a national CMMS that can be 

made available on line for free
7. WHO & Medical Equipment Manufacturers

• How to improve interactions?
• WHO: Has created a Forum for manufacturers

8. Improve Domestic production of Medical Devices
• Affects HTM, making best use of Technology Transfer

9. Organize professional societies to extend influence
• Many benefits to join locally, nationally, regionally, 

globally



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J Global Clinical Engineering Special Issue 1: 4-14; 2018  12

TABlE 3. Summary of Participant Gains/Challenges [A-Y]

Country (Pop. in M) Key Gains Key Challenges

Albania (2.9) HTM, HTP, HTR HR, CE-IT

Argentina (43) HTM, CE-IT

Bangladesh (157) HTM, HTA, HTP, CE-IT HR

Bhutan (0.74) HTM, HTA HR, HTP, HTR

Botswana (2.2) HTM HR, HTP, HTR

Brazil (202) HTM, CE-IT

Colombia (48) HTM, CE-IT HTP, HTR

Cuba (11) HTM, HR CE-IT

Ethiopia (92) HTM, HTP Wider HTP, HTR

Haiti (10) HTM HR, HTP, HTR

India (1,250) HTM, HTA, HTP, HTR, CE-IT Wider CE-IT

Kenya (44) HTM, HR HTP, HTR

Kosovo (1.9) HTM, CE-IT HR, HTP, HTR

Mexico (122) HTM, HR, HTP, HTA, HTR, CE-IT Wider CE-IT

Nigeria (140) HTM HR, HTP, HTR

Peru (30) HTM, HR, CE-IT HTP, HTR

Suriname (0.57) HTM HR, HTP, HTR

Uganda (40) HTM HR, HTP, HTR

CASE STUDIES / SUCCESS STORIES

Ghana
Improved HTM and HR: In 2009, 2 HTM Seminars 

were organized by ACCE in collaboration with WHO, In-
ternational Aid, and the Ghana Health Service. Essential 
HTM topics were covered. The curriculum for the HTM 
workshop was based on the WHO-adopted “How to Man-
age” series for HT.11 The seminars were well attended, 
with 135 at the first and 83 at the second. Participants 
identified a number of HTM challenges including: (1) A 
lack of training on HTM topics. (2) Inadequate tools and 
test equipment. (3) Poor availability of spare parts. (4) 
A lack of communication between government policy 
makers and HT stakeholders affected by policies (HTP). 

This indicates a need for future seminars to include more 
content for government policy makers.

Results
Professional Society: At the conclusion of the second 

seminar, the attendees initiated the Ghana Biomedical 
Engineering Society (GBES). An email listserv was set up 
to facilitate communication among workshop attendees.

Global Partnerships: In addition, the faculty members 
from Canada initiated a formal partnership between the 
Canadian Medical and Biological Engineering Society 
(CMBES) and GBES. There is also opportunity for CMBES 
and GBES to partner more closely with WHO via regional 
African societies under development and through joint 
WHO and IFMBE CED global initiatives.



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

The CMBES-GBES partnership has resulted in the 
successful application for a research grant to examine 
medical equipment donation practices in Canada, and 
the experiences of recipients of such donations in Ghana. 
Members of the 2 societies are in frequent communication. 
Such ongoing partnerships are considered an important 
factor in the strengthening of HTM programs.

AlBANIA
Improved Access and HTM: Before September 2014, 

MOH Albania had no maintenance strategy for its hos-
pitals’ highest technology diagnostic equipment – linear 
accelerators, magnetic resonance imaging, computed 
tomography scanners and angiography – resulting in 
higher costs, significant downtime, and poor vendor rela-
tionships. They then implemented a new approach based 
on global best practices: full risk, 2-year service contracts 
via negotiation; vendor meetings to present our new ap-
proach and for authorized distributor confirmation; then 
open tender procedures for international participation, 
to avoid speculation of monopoly.

MExICO

Role Model: Established MOH Unit in 2004, CENETEC; 
has become a global CE-HTM role model with country-
wide HTP, HTM, HTA, HTR, HR, and Practice Guideline 
development.

BRAzIl
First MOH Unit – established at São Paolo state level 

in 1980s. Key leader in global HTP, HTM, HR, and CE-IT.

FUTURE: 2015–2020
What is needed for CE/HTM profession?10

• CE-IT: need education for MDI seamlessly into EHRs7

• Technical, Management, Leadership, Health IT (CE-
IT) Standards, and Regulatory (HTR) framework

• Global Drivers: eHealth, Patient Safety & Risk Man-
agement, Medical Device Cybersecurity, Patient & 
Population Health Outcomes

• Clinical workflows: CE/HTM leaders provide improved 
design

• Leading edge initiatives: CE/HTM leading telehealth, 
smartphone/mHealth, in their countries and regions 
to improve quality, safety, access and affordability.

• Maternal and Child Health (MCH), e.g., Neonatal and 
Newborn Care, using WHO-vetted Evidence-Based 
Interventions & Practice Guidelines

• Influence: Stronger leaders, with wider impact on deci-
sion makers

CONClUSIONS
This study showed steady improvements globally in 

most indicators for Health Technology. Health Technologies 
will play an increasing role in global health care delivery 
with the emerging spread of CE-IT (EHR-enabled care) 
to improve quality and continue to make care affordable.

ACKNOWlEDGMENT
The authors wish to acknowledge the invaluable contri-

bution made by dozens of volunteers from less-developed 
countries who provided information and suggestions in 
various means. They also want to apologize to countries 
from which no information was obtained, mostly due to 
their limited knowledge of those countries and their key 
stakeholders.

CONFlICT OF INTEREST
The authors declare that they have no conflict of interest.

REFERENCES
1. Wang B, Judd T, Cordero I, Hernandez A, Velazquez Berumen 

A, “HTM in Less-Developed Countries:  An Untold Success 
Story” (50+ countries, 110 references), 2011, Unpublished 
personal communication.

2. Bloom G. The right equipment... in working order. World 
Health Forum 1989;10:3–27.

3. World Health Organization (WHO). Medical device defini-
tions. Geneva: Author; 2007. Available at: http://www.who.
int/medical_devices/definitions/en/.

4. American College of Clinical Engineering. About ACCE. 
Plymouth Meeting: PA; Author; 1992. Available at http://
accenet.org/about/Pages/ClinicalEngineer.aspx.

communication.Bloom
communication.Bloom
http://www.who.int/medical_devices/definitions/en
http://www.who.int/medical_devices/definitions/en
http://accenet.org/about/Pages/ClinicalEngineer.aspx
http://accenet.org/about/Pages/ClinicalEngineer.aspx


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

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

5. American College of Clinical Engineering. ACCE 2010 BOK 
Summary. Plymouth Meeting: PA; Author; 2011. Available at: 
http://accenet.org/publications/Newsletters/ACCENews-
Summer2011.pdf.

6. World Health Assembly. WHA 60.29 Resolution on Health 
Technologies. Available at: www.who.int/medical_devices/
resolution_wha60_29-en1.pdf.

7. Sloane E, Welsh J, Judd T. White Paper: New Opportunities 
for BME/CE Health IT Education; 2014. Available at: http://
accenet.org/publications/Pages/ReferenceMaterials.aspx.

8. American College of Clinical Engineering. ACCE-WHO Inter-
national Workshops (aka ACEW or HTM Seminars); 1991-
2015. Plymouth Meeting: PA; Author; Available at: http://
accenet.org/International/Pages/PreviousWorkshops.aspx.

9. World Health Organization. Second global forum on medical 
devices. Geneva: Author; 2013. Available at: http://www.
who.int/medical_devices/global_forum/2nd_gfmd/en/.

10. Judd T, Hernandez, A Gentles W, Calil. S. 2015 Denver – Toronto 
ACEW Report. ACCE Newsletter: Available at: http://accenet.
org/publications/Newsletters/ACCENewsMayJune2015.pdf.

11. Health Partners International. How to Manage series. East Sussex: 
UK. Available at: http://resources.healthpartners-int.co.uk/
resource/how-to-manage-series-for-healthcare-technology/.

12. David Y, Judd T, Medical technology management. BioPhysical 
Measurement Series, SpaceLabs Medical Inc., Washington, 
USA; 1993.

13. Wang B, Acquisition Strategies for Medical Technology-MT, 
International Forum for Promoting Safe and Affordable MT in 
Developing Countries, The World Bank, Washington, DC;2003.

APPENDIx
The following listing is the country-level presenta-

tions made during the 2015 HTM Seminar in Denver, CO 
USA, and Toronto, Canada. They can be obtained from the 
authors and or the presenters.

A.  Picari L, Albania HTM Seminar Country Update, & MOH 
HT Unit Maintenance of Medical Devices (high technology 
systems), 2015

B. Giles G, Lencina M, Argentina HTM Country Update, 2015

C. Abir AR, Rabbani KS, Bangladesh HTM Seminar Update, 2015
D.  Penjore T, Bhutan HTM Seminar Country Update, 2015
E. Tlhomelang B, Botswana HTM Seminar Country Update, 2015
F. Contó M, Katz Z, Brazil HTM Seminar Country Update, 2015
G. García Ibarra AR, Rojas Morales JM, Colombia HTM Seminar 

Country Update, 2015
H. Castro Medina J, Cuba HTM Seminar Country Update, 2015
I. Mideksa M, Ethiopia HTM Seminar Country Update, 2015
J. Valliere M, Chery J, Haiti HTM Seminar Country Update, 2015

K. Sharma Dr. JK, Arora P, India HTM Seminar Country Update, 
2015

L. Anyango Amoko P, Kenya HTM Seminar Country Update, 2015
M. Abazi N, Kosovo HTM Seminar Country Update, 2015
N. Cardenas Alanis C, Leon de Alba F, Orencio E, Moreno ME, 

Mexico HTM Seminar Country Update, 2015
O. Bukola E, Nigeria HTM Seminar Country Update, 2015
P. Rivas R, Peru HTM Seminar Country Update, 2015
Q. Jie G, Suriname HTM Seminar Country Update, 2015
R. Mulepo S, Edward K, Uganda HTM Seminar Country Update, 

2015
S. Castañeda M, Business Opportunities in Health Technology 

Projects, 2015 (outcomes of August 2013 ACCE HT Seminar, 
Barranquilla, Colombia)

T. Clark T, Lemgruber A & Caccavo F (PAHO), Molina Velasquez 
T (Universidad CES Colombia), Graciá F (Universidad National 
Tech. Argentina), Rivas R & Vilcahuaman L, (Universidad 
PUCP Peru), Biomedical Technology Online Courses for the 
Americas, 2015

U. Hernandez A, Trends on IT and Health Technology (CE-IT), 
2015

V. Painter F, Risk Management, 2015 (outline of device Risk 
& Safety issues)

W. Quintero Dr. V, IHE Colombia Crash Course on Interoperabil-
ity (CE-IT), from Universidad Simón Bolívar, Barranquilla, 
Colombia, 2015

X. Sloane Dr. E, Medical Device and ICT Convergence (CE-IT), 2015
Y. European Network for Health Technology Assessment. 

Common Questions. What is Health Technology Assessment 
(HTA)? Accessed Dec. 1, 2015 at: http://www.eunethta.eu/
about-us/faq#t287n73

http://accenet.org/publications/Newsletters/ACCENewsSummer2011.pdf
http://accenet.org/publications/Newsletters/ACCENewsSummer2011.pdf
www.who.int/medical_devices/resolution_wha60_29-en1.pdf
www.who.int/medical_devices/resolution_wha60_29-en1.pdf
http://accenet.org/publications/Pages/ReferenceMaterials.aspx
http://accenet.org/publications/Pages/ReferenceMaterials.aspx
http://accenet.org/International/Pages/PreviousWorkshops.aspx
http://accenet.org/International/Pages/PreviousWorkshops.aspx
http://www.who.int/medical_devices/global_forum/2nd_gfmd/en
http://www.who.int/medical_devices/global_forum/2nd_gfmd/en
http://accenet.org/publications/Newsletters/ACCENewsMayJune2015.pdf
http://accenet.org/publications/Newsletters/ACCENewsMayJune2015.pdf
http://resources.healthpartners-int.co.uk/resource/how
http://resources.healthpartners-int.co.uk/resource/how
http://www.eunethta.eu/about-us/faq
http://www.eunethta.eu/about-us/faq

