Avinash Konkani: Striking a Balance Between BMETs and Clinical Engineers

Clinical engineers (CEs) and biomedical equipment technicians (BMETs) are not the same, though they are two sides of the same coin. It is important for healthcare delivery organizations to understand the difference between these professions. Even though we work in the same department, the nature of the work we do is different—yet interrelated.

For the smooth running of the CE department, it needs visionary leaders and a dedicated team of CEs and BMETs to translate that vision into applied work. In my experience, BMETs are part of the operations team and mainly take care of day-to-day medical equipment maintenance. CEs reside within the management team, working to manage the technology.

As CEs, we work closely with the operations team (the operations manager and BMETs). Most of a CE’s work impacts that of BMETs, including evaluating service contracts, reviewing and developing the medical equipment maintenance program, medical device incident investigation, follow-up work on medical device recalls, equipment planning and installation, and so on.

I have observed that many CE departments will have BMETs and managers or directors but no CEs. This structure makes me wonder: Who does the work of CEs in such departments, and how is the balance between CEs and BMETs kept? I am not saying that one is better than the other. But I do believe that to be a successful CE department, it is important for leaders to ensure that there is a balance between the CE and the BMET teams—the engineering and the operations.

With this understanding, I have a question for the healthcare technology management community. Have we established any benchmark of how many CEs are required in small, medium, or large hospitals? I understand that providing the required human resource is a challenge. By establishing the benchmark we can help the CE leadership team to maintain the balance between the CEs and BMETs.

Avinash Konkani, Ph.D., is senior clinical engineer at Beth Israel Deaconess Medical Center, a teaching hospital of Harvard Medical School. He is a member of AAMI’s Technology Management Council and the BI&T Editorial Board.

3 thoughts on “Avinash Konkani: Striking a Balance Between BMETs and Clinical Engineers

  1. Good morning,
    My local experience with smaller hospitals is that CE responsibilities are either assumed by BMET’s or are shifted to the IT department. BMET’s are known to understand medical instrumentation better and often a better understanding of clinical workflow. IT are seen as technology experts and have a proven record of project management. The need for CE responsibilities is often not enough to require a dedicated person. Smaller institutions may not even be aware of a role of Clinical Engineer. How the individual institutions choose is largely a matter of their needs, the talent they have, and whether that talent can be freed to fill the CE role. I have only seen CE as a separate role in 100 bed + academic institutions and large organizations with dozens of hospitals.
    I would be interested to see what guidance you arrive at. Since the introduction of IT and the definition of BMET as day to day service , Biomed departments have lost the reputation as in-house technical experts. It would be nice to see the role of Clinical Engineering gain a wider acceptance.

  2. In my experience, there needs to be a balance between day-to-day operations and strategic planning / projects. Title, role, education and work preferences all have bearing on this issue. At the end of the day, we need both operations AND management to be successful.

  3. The trap we get into is not being able to prove, as opposed to just assert, that academic accomplishments (assuming CE means someone with an engineering degree) are necessary attributes for someone to do the not universally defined role of CE. Any attempt to do so will be met with the argument “But Mary is great and she doesn’t have a degree”. Who is or can be a CE is a discussion of long standing. CE certification partially answers this question by requiring an engineering degree. We can note that you can’t be a nurse or doctor or many other kinds of healthcare professional based on OTJ training. Or is the question the job description/function rather than the qualifications?

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