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Environmental sustainability of the “right to repair” medical devices

A medical right-to-repair (RTR) movement can improve the sustainability and environmental impact of the medical field. However, the effective implementation of the medical RTR remains a challenge. Health systems increasingly rely on linear supply chains based on single-use medical products. This intrinsically unsustainable paradigm of manufacturing and using medical devices is contributing to rising healthcare costs and global environmental degradation. The effects endanger public health by contaminating air, soil and water, depleting resources and causing catastrophic climate change. In this regard, sustainable development urges changes in the way the health system meets its needs. Medical RTR would allow medical devices to circulate through engineering cycles of reuse, repair, reuse, and recycling. Thus, medical RTR would enable the healthcare system to transition to a more circular economy and promote the goal of increasingly complex care in an environmentally friendly future. The circular economy is an integral part of the sustainability agenda and has the potential to contribute to several Sustainable Development Goals (SDGs). Thus, an effective implementation of the medical RTR has a strong impact on the achievement of affordable and sustainable standards for the health system.

“Right to repair” for a circular economy in health care:

The concept of “circular economy” encompasses the reuse, recycling and repair of materials and products instead of single-use use through circular production and consumption patterns.

During the Covid-19 pandemic, medical device companies responded by providing biomedical engineers with technical information and resources to meet the needs of frontline healthcare providers. In the United States, Oregon Senator Ron Wyden introduced the RTR Act last year, requiring manufacturers to provide the technical knowledge and tools that hospitals need to repair medical devices.

Since then, the medical RTR movement has made significant strides. On July 9, 2021, US President Biden signed a comprehensive executive order calling on the Federal Trade Commission (FTC) to enact RTR regulations and rules that prevent manufacturers from imposing restrictions on the repair of their products.

In this regard, medical RTR enables the implementation of a circular health care model that ensures medical devices are maintained for a longer life in peak use. It provides a way to maximize equipment productivity, minimize waste, and achieve sustainable standards. The medical RTR can flow medical devices through technological cycles of repair, reconditioning, and reuse. As a result, RTR legislation is expected to enable the US healthcare sector to become more sustainable, environmentally friendly, and affordable.

Significance of the “right to repair” in the medical field:

In the wake of the Covid-19 pandemic, supply chain systems have proven to be susceptible to disruptions from production bottlenecks, interrupted transport systems and price increases. Alongside Covid-19, climate change remains the most important threat to the global ecosystem, including the health system. It is therefore vital that we act with appropriate concern.

In 2003, large hospitals in the US made up less than 1% of all commercial buildings, but used up to 4.3% of all commercial energy in the US. In terms of global warming, US hospitals produced the equivalent of about 215 million tons of carbon dioxide in 2007 (Commercial Building Energy Consumption Survey-CBECS).

Medical RTR appears to be a critical strategy to develop a green health sector, in addition to addressing shortages in medical equipment. Reconditioning and repairs have been shown to be effective in reducing waste and improving environmental performance. In fact, reprocessing companies in the United States, Canada, and Europe reduced the amount of solid hospital waste by nearly 7,100 tons in 2018 (MacNeill et al., 2020).

Challenges to the medical right to repair:

Despite the importance of repairability to environmental sustainability, there are challenges in repairing medical devices. Security and adaptability are the most important challenges that need to be considered in the further development of the RTR laws.

First, patient safety is a top priority when implementing medical RTR. Regulations and standards are critical to ensuring high quality repairs so medical devices can function as planned. In contrast, inaccurate repairs can have serious and life-threatening consequences.

Second, the safety aspect must be considered throughout the repair process. To this end, the patient’s privacy must be protected and security must be maintained against hacking and other cybercrime.

Third, the medical RTR must be adaptable to ongoing innovations in the healthcare system and to the needs of the healthcare system. Medical RTR should respect intellectual property rights to continue innovation in medical technology. OEMs can identify shortcomings and inefficiencies and innovate in response to clinical needs, and regulation should not hamper these evolving specifications. However, in contexts where urgent repairs can be lifesaving, such as the Covid-19 pandemic, medical RTR can help balance the need to maintain innovation with the need for reparability and openness in patient care.

Roadmap to a Circular Healthcare Economy:

In order for the medical RTR to be effective, incorrect design practices for programmed obsolescence must disappear in order to achieve permanently effective and sustainable development.

An action plan must include clear incentives for manufacturers to provide spare parts, tools, and the technical knowledge needed to enable hospitals to repair their equipment. In addition, products should be designed to last a long time and to be repaired multiple times before needing to be recycled. Therefore, design for longevity is a key feature of the circular economy.

In addition, rules and regulations related to the medical RTR must ensure that medical devices are subject to high quality repairs and safety regulations. To that end, it requires collaboration between manufacturers and hospitals to ensure that biomedical technicians adhere to the same standards that manufacturers have adopted.

To sum up:

A circular health economy based on medical RTR increases efficiency and offers an alternative to the unsustainable environmental impact of current practices. An active role of the health system in ecological change will most likely require a high level of concerted action by various people and institutions.

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