INGIMED 2000–2014: Negoescu Construcţia unei profesiuni

Report
INGIMED XV
Masă rotundă sub auspiciile FRIB, ICPE-CA & ASM
Joi 4 decembrie 2014, ICPE-CA
INGIMED 2000 – 2014:
construcţia unei profesiuni
Radu Negoescu
Institutul Naţional de Sănătate Publică
[email protected]
Preliminariile Ingimed
 1993: U. AISTEDA, Institutul de Informatica Aplicata (IIA), Programul
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de informatica pentru medicina apoi Directie de aprofundare
1996: IIA primeste autorizare provizorie
1996-98: Proiectul Institutului de Inginerie Clinica “Ing Radu
Vrancianu” devenit ulterior Institutul Est-European de Inginerie Clinica
– cu misiune de cercetare si diseminare stiintifica via Ingimed
2000, februarie: Profesiunea de inginer clinic (demers U. AISTEDA)
este introdusa in Clasificarea Ocupatiilor din Romania (COR); in COR
2014 (armonizat cu ISCO 08) are codul 226301 (Grupa majora 2 –
Specialisti, Subgrupa majora 22 – Specialisti in sanatate)
2000, iunie: idem bioinginer medical (UMF Gr T Popa Iasi); cod COR
2014: 226904
2000, 22-23 septembrie: Polul National al Ingineriei Biomedicale,
reuniune de experti
 Comunicat de presa
 Conferinta de constituire a Polului Naţional al ingineriei
biomedicale
 Institutul de Sănătate Publică Bucureşti, 22 -23 septembrie 2000
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 Ingineria biomedicală cuprinde bioingineria – orientată spre descoperire în
ştiinţele vieţi cu armamentarium-ul ştiinţelor pozitive şi ingineria clinică –
orientată spre practica spitalicească – separate de o frontieră transparentă.
Tehnologiile biomedicale îşi au rădăcinile conceptuale în bioinginerie şi sunt
puse eficient în operă prin inginerie clinică, încorporând între aceste două chei
şi producţii ale altor interdiscipline precum electronica biomedicală, fizica
medicală şi biotehnologia. Recenta co-optare a inginerilor clinici şi a
bioinginerilor în nomenclatorul ocupaţiilor din România arată că a sosit timpul
organizării unei comunităţi chemată să susţină efortul specific în procesul de
euro-integrare.
 Conferinţa reuneşte experţi de înalt profil, şefi de departamente-organizaţiiagenţii guvernamentale sau neguvernamentale care deţin ştiinţa şi puterea de
a influenţa sau a decide asupra tehnologiilor biomedicale – domeniu esenţial
al reformei sistemului de sănătate.
 Prima reuniune a Polului Naţional de Inginerie
Biomedicală -15 decembrie 2000
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 Ordinea de zi
 Aprobarea versiunii revizuite (finale) a Cărţii Albe şi
a memorandumului
 Evaluarea tehnologiilor biomedicale în Canada
 Planul de Acţiune pe 2001
 Chestiuni organizatorice
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Primele conferinte Ingimed
 2001, 28 mai: Federatia Romana de Inginerie
Biomedicala (FRIB) - 7 membri fondatori
persoane juridice, unitati academice si de
cercetare; director general fondator Conf dr
Bedros Nae (Naianu).
 2001, 13 decembrie: primul INGIMED sub
acest nume, care devine II atribuind sufixul I
conferintei din decembrie 2000
 2002, 29-30 nov: INGIMED III; Acad Mihai
Draganescu – presedinte de onoare
 INGIMED II – 13 decembrie 2001.
 PROGRAMUL DINTR-O PRIVIRE
 Transfer cu microbuzul de la Hotel Sport/Tei la ISPB/Cotroceni, ora 845
Sesiunea plenara la Institutul de Sănătate Publică Bucureşti, Sala
Consiliu et. II
930 – Microconcert: Biblioteca Institutului de Sănătate Publică.
1000 - Alocutiuni de deschidere:
Conf. Dr. Bedros Naianu - Director FRIB
Conf. Dr. Octavian Luchian - Director ISPB
Acad. Mihai Draganescu – Academia Romana, Sectia Stiinta si Tehnologia
Informatiei
Prof. M. Zamfirescu - Academia de Stiinte Medicale
Conf. Dr. Mircea Beuran – Consilier de Stat, Administratia Prezidentiala
Conf. Dr. Gabriel Nastase – Ministerul Educatiei si Cercetarii
Dr. Radu Dop – Spitalul de Urgenta Floreasca
Prof. Dr. Radu Negoescu - Institutul Est-European de Inginerie Clinica,
Universitatea AISTEDA
Alocutiunile presedintilor societatilor membre FRIB
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Ingimed 2003 – 2009: conferinte mari,
participare internationala, 1½ zile
 2003: ISPB & U Politehnica
 2004 – 2006: ISPB, UMF, U Politehnica, ICPE
 2007: ISPB & U Politehnica
 2008: U. AISTEDA
 2009: UMF & ICPE
 Participarea la INGIMED s-a extins pe masura
cresterii FRIB-ului, astăzi cu 19 membrii titulari, si a
caluzit pasii catre afirmare si progresul in carierele
stiintifice si didactice ale multor tineri inzestrati; Hariton
“Tony” Costin, asistent la inceputurile INGIMED,
astăzi profesor la Bioinginerie Medicală la UMF Iaşi,
poate da bună mărturie.
Ingimed 2010 – 2014: mese rotunde
de ½ zi gazduite de ICPE-CA
 Pierderea prematura a Prof Bedros Petru Naianu in
2008 si restrangerea consecutiva a activitatii U
AISTEDA, criza, precum si concurenta - salutara - a
centrelor de inginerie biomedicala din tara, conduse
de ex-sperantele Ingimed dar si de alti colegi, au
afectat amplitudinea Ingimed.
 Generozitatea ICPE-CA, Director General Prof dr
Wilhelm Kappel – membru in Consiliu Director FRIB, a
permis totusi mentinerea regularitatii, a standardelor
de calitate si post-publicarea gratie Bulletin of Micro &
Nano Electrotechnologies – redactor sef Dr Mircea
Ignat.
Biomedical Engineering worldwide
 Aspiration to health and life, an inexorable
datum of humans propels healthcare industry
as the world's biggest industrial sector, with a
turnover approaching £100 billion per annum
and an expanding rate of 7% per annum
[www.science-engineering.net/.../medical-engineering, UK, visit Nov, 2012].
 Healthcare industry includes 15,000 registered
manufacturers, about 10,000 generic devices and
> 1 mil. products & brands. About 50 percent of
the 2007 diagnose & treatment technologies
pertained to the last 10 years (GMDN Ag., Med. Techn. Brief 2007,
cf. Sontea et al, Int. Conf. Nanotechn. & BME, Chisinau 2011).
Biomedical engineering is central
into healthcare industry
 Biomedical engineering (BME)
occupies a central place in healthcare
industry and it is one of the few areas
of engineering that is expected to
continue to grow for many years,
despite any crisis* [www.scienceengineering.net/.../medical-engineering, UK]
•
* Acc. To B. Obama the recent crises was brought about
by greed, egoism and abhorrence to the others,
evident in some leaders of the financial establishment. If
such data would also inexorably characterize the human
being, health & life are meaningless and BME has no
future ….
Branches or domains of biomedical engineering (BME)
MEMS are micro electro-mechanic systems and MCT Engr is molecular, cell &
tissue engineering, [cf. Akay, 2009].
BME: medium term prospects in USA
 US: Quick Facts on Biomedical Engineers
[cf BLS, Occupational Outlook Handbook, 2012-13 Edition, on the Internet
at http://www.bls.gov/ooh/architecture-and-engineering/biomedicalengineers.htm].
 2010 Median Pay $81,540 per year, $39.20 per hour
 Entry-Level Education Bachelor’s degree
 Work Experience in a Related Occupation None
 On-the-job Training
None
 Number of Jobs, 2010 15,700
 Job Outlook, 2010-20 + 62% (Much faster than
industry average)
 Employment Change, 2010-20
9,700
BME in Europe: an obvious gap vs US
 Recommendations of the Expert Policy Workshop on BME under EU
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Parliament aegis , March 27th 2012 (excerpta from 9 items):
“ 1. […] It is thus important, that the European Union recognises the full
potential of BME and consequently promotes collaborative research in this
field. Furthermore, Biomedical Engineering should be understood as a
stand-alone discipline […]
2. […] promoting growth and well being, including ad Active and Healthy
Ageing.
3. Biomedical Engineering research should be made an explicit priority by
introducing it into European Union policies and legislation […].
4. Strengthening of funding for Biomedical Engineering research, by
dedicating specific research programmes and by supporting the
commercialisation of research results, is essential.
5. More emphasis should be given to covering the full innovation cycle and
focus on the “missing mile”, the gap between the end of a research project
and the provision of sufficient (clinical) evidence to attract private money.
BME in Europe: an obvious gap vs
US (continuation)
 7.
Biomedical Engineering should be included into Horizon 2020, in the
section on Key Enabling Technologies, as a distinct and separate field
from biotechnology […].
 8.
A fair balance between biological, medical and technological
research should be struck in EU research and innovation programmes
[…]. “
“given the societal challenges facing the
EU Member States the current situation regarding
Biomedical Engineering is unacceptable! The
European Parliament would have to make sure that
from now onwards Biomedical Engineering will
receive adequate funding and support”.
 In conclusion,
[http://www.eambes.org/news/report-on-the-expert-policy-workshop-on-biomedical-engineering]
BME in Romania: the gap yet larger
 Despite some historically favorable premises, and early 2000
introduction of professions of Clinical Engineer under code
no. 221401 and Medical Bioengineer code no. 222907 into
the Classification of Occupations in Romania (COR 2000) by
diligences of Bucharest AISTEDA U. and Iasi U. Med. &
Pharm./Fac. Med. Bioengng. respectively, setting is
precarious not because of schooling capabilities and total
number of practitioners but for the very weak absorption into
the health public system the majority of Romanians rely upon.
 All these on a background of a modest technological
endowment of most hospitals & clinics and under-usage of
high-tech equipments available in big towns and university
hospitals.
BME education in Romania
 As a rough guide, in 2012 universities were qualifying
about 200 people at the undergraduate or master
level, as follows: Bucharest, undergrad., master –
75; Iasi, undergrad. & master – 50; Cluj, undergrad.
specialty & master – 25; Brasov, undergrad.
specialty – 25; Timisoara, undergrad. specialty &
master – 25. Grosso modo (see also next case study)
one can count one thousand BME-trained people.
 Partition between clinical engineers and bioengineers
seems to be fairly balanced. No accurate date on
those working for the health public system are
available but general perception is that absorption is
very weak.
BME education & jobs in Timisoara:
a case-study*
 Politehnica Univ., Dept. Mechanics, Major of Med. Engng:
 2012: undergrads -19; masters (implants/prostheses/biomechanics) – 12
 Total undergrads (since 2007) - 181; total masters (since 2010) – 42
 Main jobs: service engineers – 17 %; technical sale agents – 11 %;
medical device manufacturing – 5 %
 Practitioners in the health public system (PHS): 3 %.
 Steps seen as necessary to encourage absorption in the PHS:
1. new personnel chart regulations in hospitals, e. g. requiring 1
technologist for every 5 – 8 medical staff depending upon
technical endowment (US norms are 1 per 4-6);
2. incentives for development of indigenous manufacturing of
medical devices beyond a few prostheses/ortheses and gait–aid
devices offered nowadays by small companies mainly involved in
imported equipment retail.
* Courtesy of Prof. Mirela Toth-Tascau, coordinator of Med. Engng. Major.
The Academy of Medical Sciences
pledge concerning BME in Romania
 Novel regulations concerning the technological support
of medical care in Romania, as:
 - establishing BME departments in big hospitals (county,
university) starting from an 1/8 ratio between the
specialized technical personnel (including bioengineers
with research labs) and the medical staff (T to M ratio),
with gradual evolution towards 1/5 until 2015;
 - establishing clinical engineering departments with
medium size hospitals or small hospital networks
starting from an 1/10 T to M ratio with gradual evolution
towards 1/6 until 2015;
 - when updating hospital technological endowment,
mandatory appropriation of 20 percent of the investment
for biomedical engineers’ remuneration.
Conclusion
 Propelled by inexorable aspirations of human
being, Biomedical Engineering resists to crisis
and progresses across the world under the
impetus of the US scientists and practitioners.
 Europe unfortunately trails, while Romania
presents an undesirable contrast between
educational capabilities and the level of
intervention in the public health system the
majority of Romanians rely upon.
 As a whole, Biomedical Engineering holds one of
the best promise to improve health and save
lives on medium and long terms.
A final message for younger fellows
Qualify as a biomedical
engineer and strive to put
your competence in
service of suffering or
still-healthy people in one
of the most salutary ways !
 Thanks.

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