Dr. Anthony C. (Tony) Easty has been inducted into the Clinical Engineering Hall of Fame in recognition of his significant contributions to Clinical Engineering. Dr. Easty was a Clinical Engineer at the University Health Network/Mount Sinai Hospital in Toronto for several decades. In addition to his role as Head of the large Clinical Engineering (CE) department, Tony made groundbreaking developments related to patient safety. For example, the Human Factors team established by Tony investigated the risks associated with multiple intravenous drug infusions, improving the safety of intravenous chemotherapy, improving the safety of home-based care, and investigating incidents related to medical devices. In this work, Tony trained dozens of new professionals in Human Factors Engineering.
Dr. Easty revolutionized clinical engineering, particularly in patient safety, technology evaluation, and risk management. By integrating human factors into health technology assessment (HTA), he reshaped traditional approaches to medical device evaluation, focusing on usability, safety, and human-centered design. His pioneering work with technologies such as multi-slice CT and Automated External Defibrillators (AEDs) has established methodologies that are now widely adopted across the field, helping to position clinical engineering at the forefront of healthcare technology advancements.
Tony grew up in London, England, and from an early age was fascinated by all things technical. His parents were very tolerant and put up with him dismantling various appliances around the home, to try to figure out what made them tick. It took him a while to progress to the point where he could put them back together again. In school, he loved sciences and math, so it was no surprise when he enrolled at the University of Sussex to study electronics and physics. He then enrolled for a PhD studying the measurement of humidity and light in microclimate conditions in the Department of Zoology at the Imperial College of Science and Technology, part of the University of London. His future wife Beth was there from Canada doing a PhD in Entomology, and after they graduated, they moved to Toronto to pursue their careers.
Tony decided to focus his work on the emerging field of biomedical engineering since he enjoyed combining the rigor of engineering and physics with the uncertainties of biological systems. Soon after his arrival in Canada, he was hired into the Department of Medical Engineering, at the Toronto General Hospital. Shortly thereafter, he was promoted to Manager of that Department. It was a time when the use of medical technologies in health care was increasing rapidly, and Tony found himself immersed in understanding the strengths and weaknesses of various categories of devices, such as infusion pumps and electrosurgical technologies.
The role of the department at that time was mainly one of equipment repair, but Tony believed strongly that as an engineer working in a health care facility, he had an obligation to try to move beyond just the repair of equipment, important though that is, to understand how the equipment was performing in the clinical environment, and to bring his physical sciences knowledge to bear in helping to ensure that patients being treated with medical devices had safe and effective outcomes. He became very involved in working with clinical colleagues on issues such as extravasation injuries from infusion pumps and burns from the use of electrosurgical systems. He carried this philosophy over to the structure of his department, encouraging his team members to work closely with clinical colleagues and to provide support where needed in the clinical environment directly. This was not so much a desire to “get out of the basement” as a recognition that the role of engineers and technologists in clinical engineering environments should be to ensure the safe and effective application of the technologies under their control by understanding their environment of use and the needs of their users and patients.
The Canadian health care system is a publicly-funded not-for-profit system, and so pressure to contain costs is key. This opened up possibilities for new areas of service, where expensive external service agreements could be replaced with proper training and parts available for in-house staff, providing on site repair at a fraction of the cost. Tony championed the department’s moves into maintaining and supporting medical lasers, imaging equipment, and surgical instrument repair. Right to repair and service training discussions were an integral part of purchase negotiations with shortlisted vendors, many of whom were willing to make these supports available to ensure the purchase of their product.
Tony was cross-appointed to the Institute for Biomaterial and Biomedical Engineering at the University of Toronto, which allowed him to supervise graduate students and teach in the emerging Clinical Engineering Program there. Many of the senior clinical engineers now practicing in Canada attended Tony’s lectures and were supervised by him as rotating interns or thesis students. It was exciting to see clinical engineering emerging as a recognized scientific discipline, and one which requires a broad knowledge of science with an ability to quickly grasp the clinical demands placed on technologies.
A series of mergers of hospitals in the Toronto region led to the formation of what is now the University Health Network, including Toronto General Hospital, Toronto Western Hospital, Princess Margaret Hospital, with a total of ten sites and over 20,000 staff. University Health Network is Canada’s pre-eminent teaching and research hospital and is currently ranked third in the world in the Newsweek hospital ratings, behind the Mayo Clinic and the Cleveland Clinic. Tony took on responsibility for providing clinical engineering support at every site and was also asked to take on Mount Sinai Hospital as well. The department grew from an initial eight staff to over eighty, with a wide range of expertise available across the system.
Recognizing the need to ensure that Canada maintained a high-quality approach to clinical engineering, Tony joined forces with Dr. Bill Gentles of Sunnybrook Hospital in Toronto at the request of the Canadian Medical and Biological Engineering Society to develop clear, usable standards of practice for clinical engineering in Canada. This work also included a process for periodic peer review, to ensure that the standards were being met. These Standards are in everyday use in Canada and have helped departments across the country develop their programs to a high level.
Again, in collaboration with Dr. Gentles, Tony helped to set up a not-for-profit insurance reciprocal called the Canadian Medical Equipment Protection Plan (CMEPP) across Canada to provide support for complex medical devices by pooling funds across participating institutions and paying for support on a time and material basis. This plan is flourishing today, with over 80 institutions participating at over 300 sites in Canada. Tony chaired the Board for a period of nine years.
At around the year 2000, Tony became aware of the work of Professor Kim Vicente at the University of Toronto Department of Mechanical and Industrial Engineering. Kim is a world-recognized expert in human factors engineering, and it quickly became clear that Kim’s combination of human factors methods and cognitive psychology knowledge would provide an excellent framework for analyzing the performance of medical technologies in clinical environments. At the same time, Toronto General Hospital set up a lab facility called the Centre for Global eHealth Innovation, equipped with several simulation rooms capable of recreating complex clinical environments such as an operating room and a patient’s bed in an ICU. Using sophisticated video and audio techniques, it was possible to capture in great detail the interactions between users of medical technologies and the technologies themselves. Critical analysis revealed areas of difficulty, complexity and error for users, and led to recommendations to reduce these problems. These analytical techniques were also applied to the design of new technologies, to critical reviews of existing technologies, and to understanding and improving areas such as workflows in complex clinical environments.
From 2005 to 2015, Tony led teams that conducted research studies in live clinical and simulated settings, including home-based care. Team members had backgrounds in clinical engineering, human factors engineering and cognitive psychology. These studies were conducted at local, provincial, national and international levels, and many of the outcomes were adopted as best practices by professional organizations.
The team received research grants from provincial, national and international funding sources. Its work has been published widely, and it has supported the training of numerous Masters and PhD students at the University of Toronto. Internationally, this work has helped to establish teams with similar foci in Brazil, Germany, Malaysia and Spain, as interest in this cross-disciplinary approach has grown.
Education, Certification, Registration & Peer Recognition:
- BSc (Hons) Electronics, University of Sussex, Falmer, Sussex, UK, 1973
- PhD, DIc, Department of Zoology, Imperial College of Science and Technology, University of London, UK, 1977
- Professional Engineer, Province of Ontario, 1980
- Canadian Medical and Biological Engineering Society (CMBES) Outstanding Young Canadian Biomedical Engineer, 1982
- Certified Clinical Engineer, Canadian Board of Examiners for Certification in Clinical Engineering, 1982
- EXCEL Award for Excellence in Clinical Engineering, Health Technology Foundation, American College of Clinical Engineering, 2008
- Fellow, Canadian Medical and Biological Engineering Society, 2008
- Inaugural Chair, Baxter Chair in Health Technology, University Health Network/University of Toronto, 2010
- Emeritus, Canadian Medical and Biological Engineering Society, 2016
- Fellow, Canadian Institute of Engineering, 2017
- Fellow, American Institute of Medical and Biological Engineering, 2018
- Fellow, International Union for Physical and Engineering Sciences in Medicine (IUPESM), 2022
