Medical and biological engineering: Research strategies in the united states

Health care, including the quality of the care being delivered and the cost associated with this care, has become a major issue in many countries. This is certainly true in the United States, and included in this is the role of technology as related to the rising cost of health care. Equally important are the medical devices, diagnostic equipment, and pharmaceuticals as a factor in the U.S.'s trade balance. Intrinsic to these is the role of medical and biological engineering as related to our health care system, a role that ranges from basic biomedical research to clinical engineering in the hospital to the development and manufacturing of new products and devices. In order to chart a future course, the National Institutes of Health (NIH) a year ago embarked on a process to develop a strategic plan. The medical and biological engineering community has worked together to influence the development of this NIH plan, attempting to bring both recognition to the contributions of engineers in medicine and biology and more importantly to develop a strategy for fostering the field. Such a strategy must include research at the forefront of biomedical developments, but also directly related to furthering medical and biological engineering. Future directions will range from biosensors to bioactive materials to nanotechnol­ogy. It also will include advanced diagnostic techniques, and it will focus on the application of engineering to biotechnology, i.e. the making of products using living cells. The latter includes both tissue engineering, i.e. the making of biological substitutes, and bioprocess engineering as applied to the genetic engineering industry. As biomedical engineers have directed themselves to the cellular and subcellular levels and as bioprocess engineers have moved from microbial organisms to mammalian cell host systems, common intellectual interests have emerged, thus joining these two fields. However, it is clear that any strategy for biomedical engineering must go beyond advanced research. It also must include the assessment of health care technology, research into ways in which technology can be used to reduce health care costs, and efforts aimed at the enhancement of the country's competitiveness in the international health care technology marketplace. In any final analysis, the real issue is how can biomedical engineers contribute to the improvement of the health care system, not only in the United States, but worldwide. Any successful strategy must be motivated by this, and in these efforts the international community should work together.