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March 19-22, 2009, Cairo, Egypt
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Computerized Clinical Engineering Management System
Walid Tarawneh
Ministry of Health
Amman Jordan
P.O.Box 1438
00962799049449
walidst@gmail.com
Majeda Ghannam
Ministry of Health
Amman Jordan
P.O.Box 1438
00962799049288
yaqout11@hotmail.com
ABSTRACT
This article describes a unique Computerized Clinical
Engineering Management System (CCEMS) designed, developed
and implemented at the Ministry of Health (MOH) in Jordan. The
system covers the automation of all related to medical equipment
(more than 30000 pieces of equipment) technical issues in 30
hospitals, 700 health centers, 420 dental clinics, 348 pediatrics
and mother care clinics, and 23 blood banks. Every medical
equipment was assigned an identity code that can be recognized
through a bar code scanning system, and similarly all other
involved parameters, such as hospitals, personnel, spare parts,
workshops, and others, are also coded comprehensively. The
system presents a powerful software package designed based on
Oracle and implemented using a network covering different
locations of the Directorate of Biomedical Engineering (DBE) at
the MOH all over Jordan (20 location including the DBE- center)
and through Web-based interactive connection. The CCEMS
includes major subsystem regarding the Clinical Engineering
(CE) activities such as; maintenance management, planning
management, contract management, purchasing and material
(spare parts) management and quality control management. The
system proves to be invaluable tool to manage, control, and report
all different parameters concerning the CE activities. The system
can read and report in both Arabic and English languages. All
system components were designed based on system requirement,
international standards [4] and MOH regulations in Jordan. The
system is implemented since 2004 and was evaluated and found to
be reliable effective, and unique compared with internationally
available systems.
Categories and Subject Descriptors
J.2 [Computer Applications]: Physical Sciences and Engineering
- Engineering
General Terms
Management and Design.
Keywords
Computerized Clinical Engineering Management System
(CCEMS), Ministry of Health (MOH), Directorate of Biomedical
Engineering (DBE), Clinical Engineering (CE).
1. INTRODUCTION
During the medical equipment life cycle an enormous amount of
data needs to be collected, stored, recovered, analyzed, followed
up and used to improve all related to medical equipment issues
and activities. Just gathering data for medical equipment will not
serve any purpose. In healthcare facilities the clinical engineers
are swimming in data, exerting great effort to get information,
knowledge and to perform action in base of medical equipment
data. Figure 1 shows the different sources of medical equipment
data, where too many data needs to be collected, managed,
analyzed and used. The computerization of medical equipment
data can save time, money and can minimize the human errors.
The rapid development in information technology and computer
science offers many solutions, programs, systems to computerize
the medical equipment data and information [1]. In the market,
there is a wide range of ready-made software packages that are
flexible enough for different clinical engineering management
systems [2]. Most of these systems present a complete solution to
all issues associated with a certain clinical engineering system.
Those packages mainly concentrate on equipment maintenance,
spare parts management, can't be customized to certain clinical
engineering needs and apply single language. Our aim was to
design a CCEMS that cover all aspects related to the CE
management system in Jordan MOH.
Figure 1. Sources of medical equipment data
2. SYSTEM DESCRIPTION
Figure 2 shows the main component handled by the system. The
whole software system was constructed using Oracle 8i, 1.7,
Developer 6 on the operating system windows 2000 NT. The
system is basically constructed from 63 interlinked data entry
screens distributed as shown in Table 1. The screens were
designed and interlinked according to actual workflow after
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detailed analysis of the implemented at DBE - CE procedures.
The web based application of the system is done by using ASP
NET, which read / write from the same date base using SQL. As
shown in Figure 3, which represents the complete configuration of
the designed and implemented CCEMS, it covers all DBE
locations all over the country (departments and workshops),
where all CE departments have multiuser with simultaneous
access to the system. The system generates more than 90 reports
regarding all related to medical equipment matters and CE
activities. This reporting mechanism can be extended to cover
wider range of reports according to demand.
Figure 2. Main system components
Table 1. System data entry screens
No Screen Type No. Screens
1 Coding screens 15
2 Equipment inventory and tracking 3
3 Preventive and Corrective Maintenance 6
4 Purchase operations 5
5 Equipment planning 6
6 Spare parts control 4
7 Contract management 4
8 Equipment warranty 3
9 Training control 2
10 Quality control 4
11 Manuals and test equipment control 2
12
Personnel control Archiving and
document follows
9
Figure 3. The complete configuration of CCEMS
3. SYSTEM COMPONENTS
3.1 Standardizations and Coding
As an important factor in data collection we paid high attention to
standardizations and coding. All key data has been codified
instead of using hand writing text to avoid any sort of typo errors.
The following data has been coded: equipment names,
manufacturers, suppliers, equipment locations, models,
employees, equipment service priorities, spare parts, equipment
groups, technical groups, workshops, test equipments, DBE
stores, medical departments & units, countries and towns, files
and document references, document locations. Every piece of
medical equipment is assigned with 2 types of codes, the
inventory number and the class number. The inventory number is
an identity number that assign each unit in the medical equipment
inventory list, which shall be identified by the information
system. This was set to be a 6-digit number starting with letter M.
The first equipment is then given the inventory number M00001.
Within the software, the inventory number is assigned as a
primary key that is linked to basic equipment information. The
basic equipment information screen contains all basic information
about any equipment in the system (Figure 4). In addition to these
information's the screen shows the working condition, service
responsibility and priority, availability of manuals, current
running parts orders, the local agent of manufacturer, warrantee
status and the current unit price. For the class number (code
assigned to every type of medical equipment) the Universal
Medical Devices Nomenclature System (UMDNS) code from
ECRI [3] was adjusted and implemented. Every spare part was
assigned a unique 3-part code that is linked with store location,
equipment model number, and type of spare part. The code for
every spare part looks like the following model:
Spare part code = AA /BB / CCC
, where AA represents the location (store code); BB represents the
equipment group that part belong to (x-ray, sterilizer, dental,
suction …etc) and CCC, the serial number of part in the group.
Also every personnel working within DBE departments was
assigned with a unique 5-digit code, which is a serial number
starting with a ‘‘1’’ for biomedical engineers, ‘‘2’’ for biomedical
technicians, and ‘‘3’’ for others. The location coding is done

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according to national geographical standard code and the assigned
by MOH coding tables, where every health facility is also
assigned with a 5-digit code. The coding system has also included
all other related parameters, including technical groups,
manufacturers, local representatives for manufacturers, and so on.
Figure 4. Basic information screen
3.2 Logging into System
Each employee was assigned a user name and pass word through
which he could enter to the system (Figure 5). According to the
job descriptions, some limitation has been implemented for
entering, changing and viewing data. The electronic signature is
made active according to the individual staff logged into the
system.
Figure 5.Employees coding screen
3.3 Users' Screens
The system, similar to other international systems, comprises
several users' screens. Some users' screens consist of sub screens.
All data entry screens are constructed as simple oracle forms with
fields linked to database system tables. Each screen depends on
the type of the procedure performed by the CE employees. As
mentioned before these screens were designed in accordance to
certain CE-procedures. For example a typical corrective
maintenance procedure is shown in Figure 6. The main
requirements to these users screen are to be: easy for use data
entry screens, have help menu, generate error messages/screens,
have on-line indicators that shows which fields can or can’t be
edited, "Pop-up" users facilities and that system should generate
some sub screens and messages to help the user for quick, correct
, better usage of the system. The help screens are obtained by
clicking F9 button while searching for certain code of equipment
type, location, part manufacturer, supplier, employee, model
…etc. The help messages are obtained: when a certain sequence is
needed, some fields are not allowed to be used by some users, or
when certain format of data is needed, information about some
fields...etc.
Figure 6. Typical maintenance procedure
The working order data entry screen is illustrated in Figure 7. The
screen allows the user to identify facility requesting equipment
service, type of service requested, whether the equipment
warranted or under contract, if so the user can contact the local
vendor or contractor via his fax or e-mail address. After finishing
certain maintenance job, the user writes the technical report, time
spend on job (including transport time) and sign
Figure 7. Working order data entry screen
electronically for completing the job. To follow up all incoming
working orders the CE open the shown in Figure 8 follow up
screen, which allows users the see pending jobs, clicking on

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certain job number will transfer the user to the working order
screen. The quality control approval of each job is done after
completing and if approved the job will disappear from the follow
up screen, if not the quality control staff had to write reason for
not approving in the quality control field in the working order.
The spare parts used in certain job are discharged via anther user
screen (Figure 9) where the job number is used as a primary key.
Any jobs done by vendors or contractors engineers are filled in
the same manner. The preventive maintenance users' screen are
divided to two type: one for scheduling the time of inspection for
certain type of medical equipment in different location within a
year (Figure 10.) and one to control the performed periodic
preventive maintenance jobs. All jobs and activities performed on
certain equipment are summarized on so called history card
screen (Figure 11), which analysis the time break for certain
equipment ,the repair cost, type of failure ,spare parts used
repairing time and preformed preventive maintenance jobs for
certain equipment. In the planning process the user receive all the
requests for new equipment form certain location in the screen
illustrated in Figure 12. After technical evaluation in respect to
the available units within that location and after
Figure 8. Working order follow up screen
Figure 9. Parts discharge screen
Figure 10. Preventive maintenance scheduling screen
Figure 11.History card screen
Figure 12. Registration screen for new requested equipment
approving the request, the system calculates the estimated cost of
such request and auto planned it for purchasing depending on
predetermined criteria (priority, available yearly budget and
others). The system also provide the responsible CE-department
to plan the location of each piece of equipment within certain
medical department or hospital as shown in Figure 13.and to
extract the technical specifications and purchasing condition from

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the data base for each item in the project. The purchasing users'
screens are divided to two general types: equipment purchasing
screens and spare parts purchasing screens. Each of these screen
consist of sub screens, which allows the user to follow up the
purchasing processes at each stage. The ordering of certain set of
spare part is performed by e-mail or fax messaging the local or
international vendors (figure 14). The illustrated in Figure 15 user
screen represent the final result of a purchasing process from
certain tender. The system contain many other user screens that
deal with different CE tasks and activities, but one of the most
interested applications toward the paperless work ,
communication, document flow tracking is the screen shown in
Figure 16, which present the documents archiving screen based on
a pre-scanned documents. The system codes these documents,
saves them in jpg file form, where they can be use later in CE
electronic messages/memos or communications via other screen.
Each user has a mail box to view the incoming messages /
memos, the attached documents to each message, to write his
comments and to follow up actions taken by others.
Figure 13.Equipment planning screen
Figure 14. Spare parts ordering screen
Figure 15.Equipment purchasing order registration screen
Figure 16. Documents archiving screen
4. SYSTEM'S REPORTS AND MESSAGES
The reporting capability of any system is a major indicator as to
the overall system performance. The CCEMS generate More than
90 reports. These reports can be classified to the following
categories : assets inventory reports (equipment, spare parts, test
equipment, maintenance tools, manuals and accessories available
within certain location), equipment status reports (faulty,
warranted, scraped, new installed, requested and planned for
purchasing equipment, equipment needs to be replaced next year
or during the next three year and equipment required to be
transfer to central workshop), equipment performance reports
(equipment up time and down time , mean time between failures,
failure analysis, equipment load, equipment level of utilization
used parts in certain equipment and others ), CE performance
reports (mean time to repair, the preventive maintenance
compliance, CE man hours analysis, CE work load analysis, jobs
and tasks performed by certain clinical engineer, technician,
working group or department during certain period of time,
pending jobs and others), cost analysis reports (cost effectiveness,
total cost of ownership, maintenance cost, parts cost,
transportation and man hours cost, contract cost, penalties
implemented to certain contractors or vendors, available or
released warranty bank security and performance bank security,
completed equipment or parts tenders and purchasing

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orders…etc), training reports (CE training programs, medical
staff training schedule, manufacturer training programs, user
faulty equipment training program, preformed service or user
training in certain model , type equipment) quality assurance and
control reports(pending jobs, frequently faulty equipment,
equipment safety, delays in jobs, performance working analysis of
certain engineer, working group or department, engineering down
time, customer complaints and satisfaction analysis ,quality
control yearly inspection plan, spare parts, manuals and test
equipment monitoring reports…etc), administrative and personal
reports(incoming or outgoing letters memos in certain subject,
waiting mails, vendors, local agent companies , service providers
and manufacturers address and field of work, staff assessment
staff vacations, leaves, sickness, salary, allowances, incentives
and position …etc). Figures 17 & 18 illustrate some example of
the system reports. On the other hand the system generates a
number of messages to warn and help user for further actions. The
help massages are obtained when a certain sequence is needed,
some fields are not allowed to be used by some users, certain
format of data is needed, information about some fields….etc,
while the warning messages are obtained to inform the user for
certain condition (time to perform preventive maintenance plan,
reaching the minimum stock level for certain spare part or group
of parts, exceeding certain time for an equipment without
servicing, equipment that will be out of warranty within one
month, exceeding the acceptable maintenance cost percentage,
purchasing of available in stock parts, warning when in-house CE
intends to service warrantees or contracts equipment and many
others messages. Figure 19 shows an example of these warning
messages.
Figure 17. Equipment failure analysis report
5. CONCLUSIONS
The CCEMS is implemented since July 2004 and was evaluated
and found to be reliable effective and unique tool for in-house CE
departments compared with internationally available systems. It is
a tailor made (designed) software system in accordance to DBE
procedures, activities and rules. It exactly match the requirements,
processes and terminology, which in-house staff and departments
know better than the outside vendors, more easy to be
customized, implementation the CCEMS was developed and
continue to be developed. Screens and reports are formed with
aesthetic look, user friendliness, and easy for use. Since the first
time of system developed upon the request of the DBE-
departments and staff. The system implementation has shown the
following results: achieving the ISO 9000/2001 certifications to
perform all different activities of CE by a computerized system, it
shows simplicity and immediate adaptation by all employees, it
has the ability to deal with the huge data and parameters
associated to CE.
Figure 18. Down time equipment report
Figure 19. Example of warning messages
6. ACKNOWLEDGMENTS
Our thanks to all DBE clinical engineers, technicians and others
employees for their help and support.
7. REFERENCES
[1] Cram N. Computerized maintenance management systems: a
review of a available products. J Clin Eng. Spring 1998.
[2] Cohen T. Computerized maintenance management systems.
J Clin Eng. Summer 2001.
[3] Emergency Care Research Institution (ECRI), Universal
Medical Device Nomenclature System, 2003 and 2007
Product Categories Thesaurus.
[4] Association for the Advancement of Medical
Instrumentation, Medical device software- Software life cycle
processes American National Standard ANSI/AAMI
SW68:2001