By Andrew Tunnicliffe
It’s a career more than four decades young, and one that will most likely impact the role HTM managers play in the future. Matthew (Matt) F. Baretich, PE, PhD, is a man on a mission for truth, with the aim of creating a safer world.
From looking up to the stars to becoming a star of HTM, Baretich has rightly won acclaim. During his more than 40 years working within and supporting the profession, his significant contribution to HTM is undeniable, even though you’d be hard-pressed in getting him to accept that.
His name is likely, and unsurprisingly, not unfamiliar. Baretich has shared with the profession much of his learning: authoring books, articles, reviews, and speaking for, and on behalf of, the industry countless times. Indeed, the list of the aforementioned runs almost the length of his professional life.
It’s a magnificent achievement for a man who, in his earlier years, had a passion for space. “Early on, I was convinced I should be an astronaut,” he says, laughing. In fact, he cannot recall the time his focus shifted to engineering—but it did and thus began his professional story.
A Career Written in the Stars
As an undergraduate in electrical engineering, Baretich heard about biomedical engineering and took some interest. “Those were the days of wanting to be socially relevant and contribute to the wellbeing of the world. So, biomedical engineering sounded good,” he explains. It was then he took his first tentative steps into the world of HTM, although not knowing it at the time. “I read somewhere about this new, odd, field called clinical engineering, where you apply some of that engineering knowledge at the patient bedside.”
The profession, being only young itself, was finding its place in the world. In fact, his faculty hadn’t heard of it; there was no defined coursework to which he could turn his attention and, as such, no real path. “So, the faculty and I just sort of made up some coursework and research and I was off and running. I guess I’ve always thought it was fortuitous that I landed on that track.”
Well, his self-determined good fortune became the good fortune of the profession, the patients’ lives he’s touched, and the healthcare providers he’s helped. After working in several senior positions across biomedical and clinical engineering, he founded Baretich Engineering Inc. in 1997, providing clinical and forensic engineering services to healthcare organizations across the U.S. and internationally.
Baretich offers his expertise through HTM program assessments with the aim of helping identify “cost-effective” compliance strategies, as well as advising on “alternative equipment maintenance programs,” under the clinical engineering banner of his business.
While Baretich’s passion is for that strand of engineering, his fascination in what he calls the “forensic engineering” element of his consultancy is where you really see his spark. So, what is it? “When there’s some kind of adverse incident, when someone gets hurt and there’s a possibility that a piece of medical equipment was involved in that incident, I do some work,” he explains.
A Profession Built for Patient Safety
If an incident occurs, Baretich might be called upon to conduct incident investigations and perhaps expert witness work. “I try to bring some engineering knowledge into the situation and hopefully contribute to having some kind of an appropriate outcome in a legal case,” he says.
For instance, Baretich recently investigated an incident where an operating table malfunctioned and performed undirected movements while a patient was on it—an error that resulted in serious injury. In a recent blog post, Baretich wrote: “Efforts to stop the movement by using the standard control pendant or override switches were unsuccessful. The table continued to move, even after the power cord had been unplugged from the electrical receptacle. Eventually, the head and foot sections folded up to their extreme positions and the table tilted fully to one side.”
Baretich says this was probably the biggest case he’s ever worked on. “It was very clear from the onset that this shouldn’t have happened. But trying to understand what was the underlying problem and how it might be avoided in the future was fascinating.” Ultimately, the table was found to be damaged, thus leading to the patient incident. Determining what caused that damage then became Baretich’s focus.
“I find that when I’m involved in these cases, there’s clearly a technical component that I can draw on my engineering background. But there’s also just an understanding of how technology is used in hospitals and other patient care settings,” Baretich says. In his experience—and as confirmed by conversations he’s had with peers—medical devices rarely fail to work as they were designed. “So, what I find is, most often there are related issues. For example, it may work as designed—but maybe it was not designed very well,” he says.
Difficult-to-use devices may similarly be attributable to design flaws, Baretich asserts. However, other elements also come into play, such as devices being poorly selected. That’s why HTM professionals must always be on a journey of discovery, Baretich says, regardless of their career stage. “Understand the whole context [when investigating equipment errors]. You’ve got to know your stuff, technically. But you also need to think more broadly. I would say it’s a multidisciplinary question with a multidisciplinary answer as to what went wrong.”
An Evolution in HTM
Baretich’s insatiable quest for knowledge and understanding—evident in his early interest into what lies beyond our atmosphere—is a defining quality he’s taken into the profession. To him, understanding is key—and to understand, you must be equipped with the right knowledge. “It’s an awfully trite phrase, but you’ve got to stay abreast of what’s happening in HTM literature.” He adds that when HTM professionals see something new coming along, they should prepare, using the resources available: “There’s a tremendous wealth of information out there, available in person, online, via webinar, etc.”
Wealth of information, yes, but also challenges. One that concerns him is medical device cybersecurity. “Hackers could pull patient information out of devices—now not just standalone devices, but connected to the hospital’s computer network. So, the hazards have changed.”
He says while the sector “struggles” to keep up with technological advances of that nature, it continues to focus heavily on less-critical areas, such as electrical safety testing; there, Baretich says, the standard of products, supported by a mature and robust regulatory environment, are much safer than in years gone by. His challenge to the profession, therefore, is clear: “We need to keep our eyes open, keep learning and be sure that what we’re doing is based on actual evidence that we are doing something worthwhile.”
Suffice it to say that Baretich has done many things that are worthwhile. In addition to working heavily with AAMI, he has received fellowships from numerous industry bodies and has won several HTM awards. In 2017, he accepted AAMI’s prestigious “HTM Leadership Award,” as well as the American College of Clinical Engineering Patient Safety Award, along with Marvin D. Shepherd, in 2008. Baretich also has numerous industry certifications and is a certified exam reviewer.
Then and Now
It’s a career bursting with accomplishment, but not one that he ever planned for. Indeed, Baretich laughs off that proposition. After working in an industry he described as an “oddity” in the years following its creation, he says he was simply following a conventional path. “I did that and learned some things along the way,” he says.
“But I remember one time somebody, for some reason, looked at my CV and said, ‘Well, it looks like your whole career has been this well charted path of progression.’” Baretich continues. “I laughed internally because, for me, I just pursued whatever looked interesting. It may look like it was planned, but that’s an artifact. It’s not how it happened in the moment.”
But after four decades in the industry has Baretich’s passion for knowledge and desire to contribute dwindled? Not in the slightest. “I’m very happy with where I am and plan to keep doing it for as long as I can,” he says.
That energy doesn’t leave him when he leaves the office, either. Baretich is an avid cyclist and backpacker, as well as a loving father and husband to his wife, whom he says, “keeps him grounded.” So, you can expect to keep on seeing his name in print, his face at industry events, and his findings and thoughts helping to support the profession he loves.
Even so, he acknowledges that this profession is continually changing. That’s why he says it’s essential to stay on top of those changes and understand how they impact what you do. One piece of advice from Baretich: “Keep up to date on what the questions are and think about what your answer will be.” But in doing so, he warns, cut through the nonsense and speculation and find what is “really based on evidence.” For many of his peers in HTM, listening to Baretich is a great place to start.
Andrew Tunnicliffe is a contributing writer for 24×7 Magazine. Questions and comments can be directed to chief editor Keri Forsythe-Stephens at firstname.lastname@example.org.