Where does the problem come from?
The right to repair is a clear challenge faced by our modern technological societies, where sustainable development seems to have lost its appeal. Technology developers will refer to increasing complexity and miniaturization to explain the growing challenge of repairs. Companies looking for new sources of revenue will either take advantage of a shortened product life to increase sales (replacement) or develop a monopoly for their repair (reducing access to spare parts, manuals, or technical training, add passwords or protections to activate diagnostic and repair modes). On the consumer side, despite growing awareness of environmental impacts, goods are increasingly seen as disposable, particularly when they are financed (leased, purchased as a subscription, or included as a benefit with a purchased service).
For hospitals: a growing challenge
With the growing awareness that goods should be designed to be repaired in a circular economy context, We have seen the emergence in France of the notion of reparability index and the introduction of legislation in the United States and Canada (Bill C-244) to reframe the notion of copyrights, allowing the owner of a good to modify its content (e.g. computer code) or repair it following a breakdown or failure.
Repairing, maintaining, and ensuring the performance and safety of medical technologies are the main concerns of our hospital biomedical engineering workshops. The practice has greatly evolved with the introduction of electronic surface-mounting inserts, which have made component-level repair virtually impossible. Virtually all modern medical technology now has a computerized component protected by password access, and increasingly we must refer to the original manufacturer for parts, support, and service. The way in which the technology is acquired and financed also influences the level of involvement of the BME in the repair (equipment provided with supply or chemical contracts, leasing, or purchase under a technology management contract, e.g. MES ).
For the healthcare establishment, the service value ratio (SVR), which represents the % of maintenance costs over the replacement value of equipment, can vary from 4% for in-house management to 12 or even 20%, depending on the type of technology, when maintenance is entrusted to the manufacturer. Even if the establishment is not able to assume full responsibility for the maintenance of its equipment, its “right to repair” can be expressed by the choice to introduce independent service providers, third parties who could be viable alternatives, if they are not themselves limited in their access to parts, manuals and ultimately manufacturer support.
For example, for a CISSS with a typical medical equipment inventory value of $200M, the difference between an in-house maintenance strategy and one entrusted solely to the manufacturer could easily represent a $15M annual increase in BME maintenance costs!
Our establishment BME: champions!
Whether through the use of clauses ensuring access to manuals, parts and technical training, or the negotiation of long-term service agreements, our establishment BME have always succeeded in protecting their right to repair despite the trends observed. Despite the current challenges of staff turnover and recruitment, which have had the effect of accelerating a return to dependence on original manufacturers. Can they stay on course? Will legislative changes and consumer pressure have an effect in the mid-term? How do you maintain the expertise you’ve acquired at great cost? These are just some of the questions that will be topical for years to come!
Do you need help?
This trend should in no way be seen as irreversible. The biomedical engineering team at CIM Conseil can help your biomedical department by carrying out audits and reviewing your maintenance and technology acquisition strategies and practices to help you maintain your ability to repair and maintain your medical technologies and maximize the resources at your disposal.
