While demand for medical imaging constantly pressures radiologists, technical specialists are quietly working in the background under pressures of their own -- preventing disruptive and unplanned imaging equipment downtime.
Like radiology, the healthcare technology management (HTM) field faces a growing shortage of HTM leaders as job growth outpaces the rate of professionals entering the field. At the same time, extending the life of existing medical imaging equipment, such as CT, MRI, and x-ray machines, means that field engineers are troubleshooting aging medical imaging equipment and often amid software barriers.
About 30% of hospital service-related diagnostic imaging spending is with third-party service providers versus original equipment manufacturer (OEM) or in-house maintenance and service staff, according to research published in October 2025 by AuntMinnie's sister company IMV.
Field engineers
Brian Wilson, a Colorado-based field engineer for Avante Health Solutions, has worked in HTM since 1987. His career began with a two-year degree in biomedical technology, but he has spent the past 18 years servicing imaging equipment.
Brian Wilson, a Colorado-based field engineer for Avante Health Solutions, has worked in healthcare technology management (HTM) since 1987.
Now, in addition, Wilson mentors up-and-coming biomedical and clinical engineering professionals seeking next-level knowledge and, in particular, radiology equipment specialist certification.
A certified radiology equipment specialist (CRES), Wilson for the past 15 years has led a study group for students preparing to take the CRES certification exam. The study group originated in Denver with the Colorado Association of Biomedical Equipment Technicians, he explained.
"There wasn't really any kind of study group for people," Wilson told AuntMinnie. "They would take the time to learn on their own. We came up with the biomed study group. That took off and was a big success."
Wilson first obtained biomed certification, but when it came to radiology certification, he said he noticed a significant gap in educational support. Having worked as part of an in-house hospital HTM team, for independent service organizations (ISOs), and OEMs, Wilson was inspired to develop study material for the CRES exam.
"IT, anatomy, and physiology, safety, and electronics were already built into the biomed study group," Wilson said. "I focus on modality-specific information that a person would experience in their day-to-day job."
CRES certification
Radiology equipment specialist certification provides opportunities to work with medical device manufacturers, hospitals, clinics, medical device repair companies, regulatory agencies, software manufacturers of electronic medical record, or device integration providers, according to the Association for the Advancement of Medical Instrumentation (AAMI).
AAMI partnered with Wilson to formalize and launch his CRES study group starting in September 2025. Wilson's job involves maintaining medical imaging equipment, troubleshooting and repairing equipment failures, and assisting radiologists and radiologic technologists with image quality issues. That lends itself well to those interested in taking the CRES test, as they must accumulate two to four years of verified practical experience servicing medical imaging equipment.
"The study group gives students a map to focus on areas that are more relevant than ones that are more abstract," Wilson said. "A lot of people have a good amount of experience, and they want to take it to the next level. Having [CRES] certification gives them a leg up. I try and anticipate what areas the test might cover and reveal areas where they might need to spend more time."
Wilson's study group consists of five two-hour classes conducted over Zoom.
"I emphasize to students that it's going to take a lot more than just those 10 hours' worth of face-to-face study," he noted. "For myself, I spent six months studying for the test, which was probably a little overkill, but I didn't have a study group. I didn't have anyone saying, hey, focus on this or maybe you need to hit these topics."
Healthcare technology management
HTM professionals are essential to the safe and effective delivery of patient care in healthcare, Danielle McGeary, AAMI's vice president of healthcare technology management, explained for AuntMinnie.
"They ensure that medical equipment is safe, functional, secure, and available when patients need it most, and they work with nurses and clinicians to help educate them about medical equipment," said McGeary, who spends much of her time leading HTM conversations across the U.S.
Danielle McGeary, vice president of healthcare technology for the Association for the Advancement of Medical Instrumentation (AAMI).
An HTM professional's work can involve equipment acquisition, cybersecurity, integration (such as with PACS), testing to make sure the equipment is working properly, and repairing the equipment when it breaks. This can also include conducting multidisciplinary root cause analyses when a patient incident occurs, McGeary added.
"Within HTM, there are many different specialties with high-level modalities and equipment," she noted. "Imaging is just one subset of what technicians can focus on in the hospital. These technicians are highly trained and highly specialized."
Workforce development
HTM professionals seeking certified radiology equipment specialist (CRES) certification are expected to have experience in a wide range of medical imaging modalities, electromechanical devices, computers, networks, and software used in the delivery of healthcare. Above, MRI.Danielle McGeary and AAMI.
Fostering the future workforce, McGeary, with the College of Biomedical Equipment Technology, has launched a biomedical equipment technician (BMET) educational track within HOSA-Future Health Professionals, a student-led organization recognized by the U.S. Department of Education and Department of Health and Human Services Administration for Strategic Preparedness and Response.
The new BMET program is off and running with students in 16 states, according to McGeary. CRES is an option for BMETs gaining specialization in imaging and radiology equipment, McGeary said.
"Many technicians start out as a general BMET, and then they start specializing in imaging equipment as they're working throughout the field," McGeary continued. "So, there are a lot of opportunities to get that experience and learning."
To qualify to sit for the exam, individuals need an associate's degree or higher in an electronics, technology, or science program or from U.S. military biomedical equipment technology program, as well as two or three years of BMET work experience, depending on the degree. Without a degree, individuals need four years of work experience.
"But with that, 40% of their time -- of their full time -- needs to be spent working on imaging or radiology equipment and that needs to be proven," McGeary said.
In its overview, AAMI explained that HTM professionals seeking CRES certification are expected to have experience in a wide range of medical imaging modalities, electromechanical devices, computers, networks, and software used in the delivery of healthcare.
"Everything is really a networked medical device system these days," McGeary told AuntMinnie. "Rarely will you find a standalone medical device that's not networked, especially in imaging."
Radiology equipment specialist work
According to AAMI, CRES candidates typically perform some of the following duties on a daily basis:
- Test and calibrate medical devices (preventive maintenance).
- Troubleshoot medical devices in a clinical setting and/or bench/depot setting (corrective maintenance).
- Manufacture software, parts, or devices for use in patient care, especially imaging systems.
- Ensure compliance with all regulatory processes necessary (i.e., CMS, FDA GMP, etc.).
- Manage medical software/hardware systems (i.e., PACS administrator, integration specialist, etc.).
- Educate on the proper use, care, and maintenance of medical devices.
- Review technical manuals.
- Document any and all maintenance and repairs, and maintain records of maintenance activities.
- Troubleshoot medical device networks.
The CRES curriculum was updated in June 2025 to better reflect the day-to-day duties of a radiology technician specialist, McGeary noted. The CRES exam is a three-hour closed-book exam consisting of 165 multiple-choice questions.
Passing the CRES shows that individuals meet a minimum knowledge competency, and they can functionally work as a radiology specialist. Thirty hours of continuing education are also required, along with recertification every three years.
