INGIMED 2000 – 2014: construc ţ ia unei profesiuni Radu Negoescu

1. INGIMED XVMasă 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 radu.negoescu@insp.gov.ro

2. Preliminariile Ingimed • 1993: U. AISTEDA, Institutul de Informatica Aplicata (IIA), Programul 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

3. Comunicat de presa • Conferinta de constituire a Polului Naţional al ingineriei biomedicale • Institutul de Sănătate Publică Bucureşti, 22 -23 septembrie 2000 • 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-organizaţii-agenţii guvernamentale sau neguvernamentale care deţin ştiinţa şi puterea de a influenţa sau a decide asupra tehnologiilor biomedicale – domeniu esenţial al reformei sistemului de sănătate.

4. Prima reuniune a Polului Naţional de Inginerie Biomedicală -15 decembrie 2000 • 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

5. 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

6. 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

8. 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.

9. 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.

10. 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).

11. 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.science-engineering.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 ….

12. Branches or domains of biomedical engineering (BME) MEMS are micro electro-mechanic systems and MCT Engr is molecular, cell & tissue engineering, [cf. Akay, 2009].

13. 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/biomedical-engineers.htm]. • 2010 Median Pay$81,540 per year, $39.20 per hour • Entry-Level EducationBachelor’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

14. BME in Europe: an obvious gap vs US • Recommendations of the Expert Policy Workshop on BME under EU 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.

15. 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 […]. “ • In conclusion, “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”. [http://www.eambes.org/news/report-on-the-expert-policy-workshop-on-biomedical-engineering]

16. 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.

17. 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.

18. 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.

19. 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.

20. 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.

21. 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.