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iFixit: how uncaging equipment repair could transform med tech

Earlier this year, iFixit announced a surprising decision: the company was turning its focus to medical devices. A wiki-based site known for its consumer repair guides, the iFixit site has the stated mission: ‘teach the world to fix every single thing’.

Typically, this might mean showing consumers how to change the battery on their iPhone, or fix their MacBook if it breaks. But with the coronavirus pandemic raging, in March it pivoted half its staff toward building the world’s most comprehensive medical equipment service database.

“We didn’t create our own manuals – we’re just organising the manufacturer service information that’s available,” says Kyle Wiens, cofounder and CEO of iFixit. “It’s a wiki, so if you have a manual that we don’t, you can upload it. Our goal is to be comprehensive and current with all medical equipment – we’ve set it up as a living, breathing resource.”

The result is a library of user manuals and repair information for thousands of medical devices, arranged in an easily navigable system. If you’re a biomedical technician (biomed) who needs to fix a patient monitor, or do preventative maintenance on a ventilator, you can search the database for the device in question. With 13,000 manuals on the database, more than chances are you’ll find the documentation you need.

Why repair information is so hard to find

As Wiens explains, biomeds are sorely in need of a resource of this kind. Generally, their access to repair information is piecemeal and can take a long time to organise.

“When I asked biomeds how long they were spending organising service information, they told me it was a massive amount of time,” he says.

“One biomed said in the last year he’d spent 500 hours organising pdfs. Every biomed is doing this individually – they each have a hard drive with the manuals they’ve been able to scrabble together, and every time they meet someone from a different hospital they’ll swap hard drives and share pdfs.”

It’s inefficient to say the least, and the problem is at least in part by manufacturer design. Increasingly, medical device OEMs will keep their repair information out of the public domain, all the better to lock their users into a service plan.

“Let’s say you buy a $100,000 piece of equipment, it might cost $10,000 or $20,000 a year for a service contract with the manufacturer,” says Wiens. “This whole debate is purely about money – manufacturers have found another opportunity and they’re going to do everything they can to protect it.”

A right to repair

Wiens first became aware of this issue a few years ago. With ‘right to repair’ legislation pending across the US and the EU, he had been travelling around, testifying at hearings.

This legislation, a pushback against planned obsolescence in devices, would give consumers the ability to repair their own electronics. It would put consumer electronics on a par with cars, which can be repaired by anyone since the manufacturer is legally obliged to share their knowhow.

At the hearings, Wiens heard hospital biomeds testifying about exactly the same issue. Be it for a washing machine or an infusion pump, manufacturers were deliberately withholding their device repair manuals.

If this was an annoyance pre-Covid, it became a serious problem at a time of soaring demand for medical care. Manufacturer service reps couldn’t keep pace with the growing need for repairs, and that’s if they were allowed into the hospitals at all.

“All of a sudden, the hospitals said we don’t want outside technicians coming in, we need to limit the number of outside visitors,” says Wiens. “It also got harder for the manufacturer’s technicians to travel. So the hospitals said, we need to maintain this equipment ourselves but we can’t because you haven’t provided us with the information.”

Even during the pandemic, certain manufacturers proved unwilling to change their policies.

“I’ve talked to a lot of biomeds who’ve been asking manufacturers for service information during the pandemic,” says Wiens. “Sometimes it’s as simple as a service password to get into a repair manual in the device, sometimes they need the preventative maintenance procedures that are in the service manual. But manufacturers won’t give it to them.”

How the resource came together

Wiens’ first step was to reach out to biomeds and ask them to share the manuals they had. Initially, the company prioritised ventilators, anaesthesia systems and respiratory analysers (all devices used to support Covid-19 patients), but the list of products grew and grew.

“They sent us more files than we knew what to do with – we were overwhelmed by the amount of data,” he says. “I pulled a bunch of my technicians off their regular jobs and I said we’re going to organise these files.”

After about a week, the iFixit team realised this was a truly massive undertaking, and they weren’t making enough progress by themselves. They decided to put out a call for help.

“We reached out to groups of academics and librarians, saying can you help us organise their information,” says Wiens. “They stepped up to help, and put in around 20,000 hours organising files and creating the archive that we ended up publishing.”

Overall, more than 200 librarians and archivists donated their time. The result is a treasure trove of repair information, hosted on iFixit free of charge. It can be edited over time, and moderated by the biomeds who will be using it.

“We want to see this used by medical professionals all over the world,” says Wiens. “For instance, we were given a list of all the NHS equipment, so we tried to make sure that was on there. We’re seeing some initial signs that it is being utilised, which is wonderful.”

He adds that the software that runs iFixit is geared towards precisely this – organising and curating information, and bringing its user base together.

“Our hope is that this will be the community for biomed technicians to leverage whenever they need to fix something, or if they’ve got something they want to share with other biomeds around the world,” he says. “We need to think of ourselves as a global community of people coming together and helping each other. No biomed is an island.”

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