By David Francoeur
Every minute a critical medical device sits idle, patient care is at risk.
Most patients never see the equipment behind their care and rarely think about what happens when it fails. But across healthcare systems today, delays in repairing essential devices are becoming more common. And the impact is no longer just operational – it’s clinical.
Behind every functioning MRI, ventilator or surgical system is a network of biomedical equipment technicians (biomeds) and healthcare technology management (HTM) professionals working to keep systems safe, reliable and available. They are the invisible backbone of modern healthcare.
It is a backbone under strain.
New data and recent industry discussions make one thing clear: the ability to maintain and repair medical equipment is becoming more constrained and the consequences are extending to patient beds.
PERSISTENT BARRIERS, REAL CONSEQUENCES
A 2026 update from U.S. PIRG Education Fund highlights how manufacturer-imposed repair restrictions continue to affect hospitals nationwide. Surveying more than 100 repair professionals, the findings point to a consistent pattern:
• 83% report increased equipment downtime because of repair barriers
• 70% experience delays tied to restricted diagnostic tools
• Rural hospitals face even greater challenges because of limited resources
These barriers typically involve restricted access to proprietary software, service manuals, specialized tools and replacement parts. The result is predictable: slower repairs, increased dependence on manufacturers and delayed patient care.
Despite ongoing debates around safety, 94% of respondents believe that Right to Repair reforms would improve outcomes – not compromise them.
WHAT THE FIELD IS SAYING
Recent industry discussions reinforce that this issue is more complex than access alone.
Polling from a national HTM audience revealed:
• The top barrier to safe in-house repair is insufficient training and certification pathways (44%), closely followed by lack of access to OEM tools and documentation (37%)
• There is no clear consensus on minimum qualifications, though most support structured education and training
• 85% agree that understanding OEM repair limitations before purchase is critical to cost, uptime and long-term usability
The takeaway is clear: access matters, but so does infrastructure. Tools alone are not enough without trained professionals and defined pathways to support safe, effective repair.
INDUSTRY PERSPECTIVE: INSIGHTS FROM MD EXPO
That reality was on full display at MD Expo Baltimore, hosted by TechNation and parent company MD Publishing. MD Expo provides one of the few forums where the industry comes together to have honest, practical conversations about challenges like Right to Repair.
Events like this matter. They move the industry forward.
This year, that perspective became personal.
I was originally scheduled to participate as a session host. Instead, I experienced the system from the other side – as a patient undergoing a significant surgical procedure. Fortunately, the outcome has been positive. But it reinforced something we often say, yet rarely feel firsthand:
When equipment works, patients don’t notice.
When it doesn’t, everything changes.
Reliable, well-maintained equipment is not just an operational goal. It is central to the patient experience.
At the conference, a featured panel discussion titled “Right to Repair in Clinical Engineering: Challenges, Opportunities, and the Need for a National Approach” was moderated by Chris Nowak. It brought together leaders from across health systems, government and HTM/clinical engineering.
Audience polling during the session highlighted several realities:
• No clear agreement on minimum BMET qualifications, but strong recognition of the need for defined pathways
• Barriers to in-house repair remain split between limited OEM access and gaps in training and certification
• Overwhelming agreement that evaluating OEM service limitations before purchase impacts cost, uptime and long-term flexibility
But the most important takeaway wasn’t in the polling results.
It was in the direction of the conversation.
Topics like certification, workforce development and standardization are no longer optional discussions. They are becoming necessary conversations.
And they won’t resolve themselves.
Progress will require the right people, across all parts of the industry, to come together with focus, urgency and a shared commitment to patient care.
This is not about blame. It is about reality.
It’s important to be clear: this is not about pointing fingers at manufacturers.
Every segment of the healthcare technology ecosystem is under pressure.
OEMs answer to shareholders. ISOs (whether privately held, publicly traded or backed by private equity) face their own financial and operational demands. Hospitals and in-house HTM teams are being asked to do more with less while still delivering high-quality, state-of-the-art care.
There is no single model that can carry this system alone.
Manufacturers are essential to innovation and technology development. ISOs and in-house teams are essential to maintaining uptime and extending service capacity.
If any one group were expected to fully absorb the responsibility for maintaining every device in every healthcare setting, the system would break.
It’s not a question of preference – it’s a question of feasibility.
A SHIFTING POLICY LANDSCAPE
At the same time, policy decisions are adding new layers of complexity.
Legislation under consideration in Colorado (SB26-090) proposes exempting certain IT equipment used in critical infrastructure – including healthcare – from existing Right to Repair protections.
While not directly targeting medical devices, the implications are clear:
• Medical devices are increasingly software-driven and interconnected
• Restrictions on IT repair can limit access to diagnostic and service capabilities
• Vendor control over integrated systems may continue to expand
Without careful consideration, these policies risk reinforcing the very barriers the industry is trying to address.
WHY THIS MATTERS FOR PATIENTS
At its core, this issue is not about equipment. It’s about access to care.
When devices cannot be repaired quickly:
• Procedures are delayed
• Patients are transferred
• Costs rise
In rural and underserved communities, the impact is even greater.
These are not abstract challenges. They are patient-facing realities.
A GROWING WORKFORCE CHALLENGE
Layered on top of these issues is a workforce problem that cannot be ignored. The HTM field is already operating with an estimated 20% labor deficit and the gap is growing.
Each year:
• 3,000 to 5,000 professionals leave the field
• Only 1,000 to 1,500 enter, many through military pathways
None of the current service models (OEM, ISO or in-house) can scale fast enough to offset this trend alone. Without a coordinated approach, the strain on the system will continue to increase.
And eventually, those pressures will show up where they matter most – in patient care.
THE PATH FORWARD
The path forward is not about choosing sides. It’s about alignment. The data, the discussions, and the lived experiences all point to the same priorities:
• Expand access to service manuals, parts and diagnostic tools
• Invest in workforce development and certification pathways
• Increase transparency around OEM repair limitations before purchase
• Ensure policy reflects the interconnected nature of modern healthcare technology
Most importantly, it requires collaboration. Manufacturers, ISOs, and in-house HTM teams each bring essential strengths. The future depends on how well those strengths are aligned – not divided.
CONCLUSION
The landscape of medical device repair is changing. The pressure on the system is increasing. And the margin for error is shrinking. There is no single solution and there never will be. But there is a clear choice. Continue down a fragmented path or move toward a more coordinated and collaborative approach. Because in the end, this isn’t about service models or market dynamics. It’s about something much simpler and much more important: When a patient needs care, will the equipment be ready?
Dave Francoeur is the COO of iMed Biomedical Inc. and has more than 30 years of industry experience.
