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Bill Gates states in Business @ The Speed of Thought that "the 2000s will be about velocity." This "decade of velocity" is driven by the flow of digital information. Health care organizations should develop a "digital nervous system" that is distinguished from a network of computers by the accuracy, immediacy, and richness of the information it brings to health care workers and by the insight and collaboration made possible by this information. This article provides a clinical engineering perspective on technology in health care in an era of rapid change. It discusses how clinical engineers work with health care professionals to manage and adapt to technological, economic, social, and regulatory forces that are redefining our approach to health care delivery.

Clinical engineering is at a strategic inflection point. Technical, economic, regulatory, and cultural dynamics are at work shaping the future of healthcare delivery. As the nature of healthcare delivery is transformed by these forces, the types and mix of technology management and support services needed by the industry are changing significantly. Clinical engineering has a relatively short opportunity to adopt a service model that will meet these changing needs. Delay or failure to adopt an effective service model as we pass through the inflection point will result in a diminished role for clinical engineering in healthcare technology management as other technical professionals move in to fill the need. The question is: will clinical engineering rise to the challenge?

This article presents information on medical devices. Medical devices have become technically more sophisticated to the degree they are considerably more reliable and less susceptible to performance variations and component failures. Clinical engineering needs to move away from viewing most medical devices as discrete, physical objects and began viewing and evaluating them as components in an interconnected and interactive healthcare environment. The growing tide of integration and interoperability between medical devices and systems requires that clinical engineering takes a new "security oriented" approach in the services it offers.