Name: ROBERTO AYALA Affiliation: Biomedical Engineering Director at CENETEC, Mexico MOH.

1. Submitted by Name: ROBERTO AYALA Affiliation: Biomedical Engineering Director at CENETEC, Mexico MOH. National association (if exists): Colegio de Ingenieros Biomédicos de México A.C. Location: México E-mail address for contact: rap6701@gmail.com

2. Country Estimates in Brief Global CE / HTM Success Stories

3. Country's Health Technology ProgramKey Success Story Establishment of a biomedical engineering center (CEDIB) in the organizational structure of the 32 state public health services (state ministries of health) in the México, to assure the safe, efficient and rational use of medical equipment through the processes of HTM, with lineament, guidelines and tracing from CENETEC. The HTM responsibilities of the CEDIB will cover all of the medical equipment from all the hospitals under the jurisdiction of the state ministry of health. Global CE / HTM Success Stories

4. Country's Health Technology ProgramKey Success Story When the initiative was launched in 2008 there were only 11 states that had someone in charge of the HTM tasks at the state ministry level, and it was not necessarily a biomedical engineer. Nowadays 29 states have incorporated a professional that it’s in charge of HTM or participates in the team that takes care of it. Two of those states (Baja California Sur and Guanajuato) have an official position in the structure of their ministries of health, as Sub Directions of Biomedical Engineering, with personnel to cover the HTM responsibilities. Even though they’re not officially named CEDIB, the strategy and model used to their implantations was based on this initiative. • Since the incorporation of biomedical engineers at the state ministry of health level, several benefits have been achieved: • Participation in medical equipment planning, using tools generated by CENETEC to help making better decisions for this process, and thus assuring that the technology it’s the right one for the needs of healthcare in the state. • Use of proper technical specifications for medical equipment for the acquisition process. • Establishment of preventive maintenance programs and vigilance of the service provided by vendors. • Continue training programs for medical equipment users. Global CE / HTM Success Stories

5. Conclusions and Action Plan In terms of saving costs, there are reports that show that, since the incorporation of the biomedical engineer, there been savings in maintenance costs as much as ten million pesos (645,000 USD) annually. Such savings have been achieved by taking care of non-critical medical equipment, reducing unnecessary spare parts stocks and, mostly, by supervising third-party service contracts, reducing costs without compromising the service to the equipment. At least four BE departments at state ministry of health level had the support to get tools and test equipment in the past two years, in order to improve the quality of the in-house service. In some cases more BE were hired to give technical support to the coordinator in chief. One issue, however, it’s that their salaries are from honorary fees and not from official payroll, something that some authorities are trying to fix. The CEDIB guideline for HTM processes also proved to be of much help for any biomedical/engineering department in hospitals, regardless of its sector (public or private) and it has been consulted from other latinamerican countries as well. Recently in a PAHO conducted workshop, all the countries from the Central America region accepted the use of this guideline for their local HTM strategies. It’s also to be noted that since the initiative began, the educational offer of BE programs have increased exponentially. At the beginning of 2000 there were no more than 10 universities giving the program, and nowadays there are more than 45 universities across the country with a BE program or equivalent. Many of them have approached to CENETEC to get advice on how to improve their educational programs to strength the knowledge on HTM, recognizing the importance of the subject and the leadership of CENETEC in the matter. Global CE / HTM Success Stories