The Right to Repair | Binseng Wang, Sodexo

May 5, 2021

The Right to Repair with Binseng Wang Episode

Wed, 3/24 9:30AM • 31:15

Chyrill Sandrini, Binseng Wang

Chyrill Sandrini  00:15
Hello, everyone, welcome to HTM Insider. We’re excited today to bring you Binseng Wang, as our guest today on the podcast, Binseng, I know that you’re well known in the industry, you don’t necessarily need an introduction. But for some of our listeners who might not know you, can you introduce yourself and your experience in the clinical engineering world.

Binseng Wang  00:26
Thank you for having me today, Chyrill. Again, my name is Binseng Wang, I am currently the Vice President of program management at Sodexo HTM. Don’t let the title fool you. I’m nothing but a, I said to Chyrill before big knucklehead nerd if you will. And for those who does not know me well enough, I’m actually a Brazilian Chinese still trying to speak English fluently, especially with a southern accent.

Chyrill Sandrini  00:26
Very good Binseng. Well as you know, we’re here to discuss the right to repair issue that’s, you know, really affecting the HTM clinical engineering world right now. So I would like to ask you What does right to repair mean to you?

Binseng Wang  01:37
Okay, well, my understanding is that this is a collective effort of individuals and companies who want to perform repairs, and other maintenance services, or products that they either own themselves or owned by others and need information and sometimes material resources to perform this kind of services from the manufacturers. Let me give you a couple of examples here. One is auto repair shops that are performing simple things like oil change engine repairs, on cars and trucks produced by the major automobile makers. Another example closer to what we do in-house or independent service organizations that we pay for medical equipment, use it in clinics and hospitals for patient care.

Chyrill Sandrini  02:33
Yeah, and I like the example you just gave on the vehicles. Because it’s true. We trust a lot of independent service organizations to change our oil, our brakes, and our families are in those cars. So it’s just as vital to that right to repair that we’re trusting maybe an outside person. So who’s qualified that maybe we ought to start trusting more of our in-house owners have medical equipment to do their own repairs as well? That’s a great point. Did you ever see in the industry? Where did it start? Where did the division start with the manufacturers of medical equipment? To today we’re writing legislation Where did that controversy come in?

Binseng Wang  03:25
Oh, this is really quite an old issue. I was aware of this kind of challenge way back when I started in this field in the early 1980s. And However, my understanding is that the movement called right to repair today really started to be better organized in the early part of 2010. decade. And the first legislation in this right-to-repair movement was actually to the best of my understanding pass in the Massachusetts Commonwealth, or back in 2012. And it was called, at that time automotive right to repair act.

Chyrill Sandrini  03:51
And did you see when it started in the medical industry? Do you think it became more prevalent because of COVID and the pandemic? Or did you see any type of movement before the pandemic?

Binseng Wang  03:57
Oh no this started well before the pandemic. I think this issue as I mentioned, I saw way back when and of for at least the last 30 years. There have been discussions about this. The pandemic just really accentuated. The challenges I’m going to probably discuss with you a little bit later so I’m not going to go there yet, but I think just have made the issue a whole lot clearer for everyone to see. Yeah, you know, we

Chyrill Sandrini  05:05
work with a lot of in-house programs, third-party companies like Sodexo, smaller BioMed companies across the US. And, you know, I feel it’s different for every group. But I want to know, in your opinion, how does it really affect the BioMed teams that are working in

Binseng Wang  05:26
The hospitals in terms of affecting not only so tech, so colleagues, but also our the dependent service organization, as well as in house about med clinical engineering teams of where I actually started from, I believe everyone is equally affected by this. And as I mentioned earlier, the pandemic made this issue extremely clear to everyone, because many manufacturers were either unwilling or unable to send their service team to the hospitals to perform repairs, or even scheduled maintenance during this period of time, some because there were travel restrictions, and some because they wanted to protect their own employees. So the repair and scheduled maintenance of the critical medical commentate on where it is needed for the care of the COVID patients fell on the shoulders of the old site teams doesn’t matter where it is in-house employed by the hospital, or employed by the dependent service organizations. And some manufacturers were cognizant of the tenuous situation, they actually open up and gave us some information, and sold us some parts to do this. But others were still reluctant to do so alleging that you folks are not properly trained, this is unsafe for the patients, etc, etc. But the bottom line here is that we all had to pitch in to make the equipment work reliably, safely, otherwise, many more people would have perished in this pandemic,

Chyrill Sandrini  07:16
Right? Do you think that the influence of so much of the IT industry, you know, how it’s crossing over into BioMed equipment where it wasn’t like that maybe 20 years ago? Is that part of it?

Binseng Wang  07:30
Well, it’s not that it was crossed or sent into Biomed. It’s the issue here is slightly different. It’s like today, you have in your pocket a cell phone that is more powerful than the computer that sent our astronauts to the moon, for example, a few decades ago. Okay, so everything, we talked about cars before, right, your car now has 2030 microprocessors embedded in your car. So it’s not surprising that almost all medical equipment has some type of hardware-software embedded in them. And so the challenge to repair equipment is becoming more and more serious, because of the fact that most of that software is transparent, invisible to the service personnel. And they generate a bunch of very valuable information. For example, if your car red light turns on, on your dashboard, you know, there’s something wrong, but you don’t know what is wrong. So you need to take that either to a dealer, Well, fortunately, because of the right to repair movement, you can take to a neighborhood or car shop or one of those car parts company, they will put a reader on your car has low oil pressure, therefore you are missing oil for me your for your brakes or something like that. And they can quickly tell you not only the problem, pinpoint the problem, and also fix the problem for you. So you don’t have to drive 2030 miles to find a dealer for your service. The car and we have the same problem right now in the medical equipment area because more and more equipment is incorporating hardware and software.

Chyrill Sandrini  09:37
Yeah, I agree and it holds a lot of patient information right and patient care. So that being said, this right to repair act, how has it affected patient care in your eyes?

Binseng Wang  09:52
Well, as I said right now, medical equipment is a critical essential tool for healthcare providers, there is almost no diagnostic and therapeutic service that can be provided to a patient with some type of instrument, even a simple thermometer to see whether you have a fever to start thinking about maybe you were infected by COVID, something that is a piece of equipment, right? That’s technology. And to go on and go take a sample from your nasal parts to the laboratory to see whether you did you will be infected by COVID or not. And then, later on, to infuse liquids into you with medication. Hopefully not going to happen to use sharp by all means. If someone can really serious you may need a ventilator even though all those things are medical equipment, they have information technology involved, and the need to keep those things safe and effective. All those things need some type of calibration, verification of function, and maybe replacement of wearable parts. So all this is really critical for the entire healthcare industry, and ultimately, to be honest to the patients out there. And I include myself, I’m all those patients because I’m older, I can’t get sick, and I need help.

Chyrill Sandrini  11:35
Yeah, no, exactly. And I think patients in general out there don’t understand how much technology is. In all that medical equipment that traps them, right when they go into the doctor’s office, an urgent care center, a surgery center, or hospital, that it’s all critical now. Critical equipment, that they’re all computers, right? They’re all computers.

Binseng Wang  12:06
Yeah, well, the concern here is not so much tracking. It’s not like that there are personal privacy information that is being stored that are at risk of being lost, or being stolen or no, no, we are not talking about that kind of information, we are talking about reading functional information. For example, you are using an infusion pump to provide liquid to a patient, you want to make sure that the volume of fluid is proper, the speed, the velocity of the fluid, and the speed delivers proper, the same thing goes for a ventilator, the ventilator to delivering air oxygen to the patient, that information is critical. Because if the action concentration is not appropriate, then the patient is now receiving proper care and could suffer serious consequences. So if that kind of information we cannot access and therefore decipher What’s wrong, maybe it’s just because an oxygen sensor cell needs to be replaced. Or we need that information very urgently, in order to repair that piece of the ventilator, for example, and take care of the patient, we cannot wait a week or even a few days for a manufacturer representative to show up and then fix that. So even during the normal time, this is very challenging. Imagine during the pandemic, some of them weren’t even able to travel. So how you’re going to take care of the patient if your ventilator is down and you are waiting for the manufacturer representative to show up.

Chyrill Sandrini  13:56
So do you think the manufacturer representatives and the manufacturers are just about money?

Binseng Wang  14:01
No. Let’s make something very clear. Right. Now, before we go to not all manufacturers are against the right to repair. Actually, the majority of manufacturers are in favor and have released information parts, etc to us is just a small number of manufacturers. Unfortunately, this small number tends to be very large companies that have a lot of products in the hospitals and they are reluctant to release the information and make quite a bit of allegations that unfortunately have not been proven. There. There is no real evidence out there of serious risk to patients or caregivers. And so these are the ones who are really holding up Key progress or better care for the patients? So it is not everyone on here. Let’s be very clear and paradoxical. Sorry, the paradox all the I want to raise another point here, this same manufacturer, the ones who are reluctant to share information, they operate in other countries, which is very common, right. For example, in the European Union, there is a law that requires them to share this service information since 2018. So, so why do Europeans deserve to have that information where the Americans don’t have the right to that information? That is really astounding to me because I cannot imagine that life of the Europeans is more valuable than double half of Americans.

Chyrill Sandrini  15:59
I agree. I agree. I wasn’t aware of that been saying and, you know, that’s a good point. It’s a good precedent that hopefully, our legislators see and that we’re able to make some changes here in us soon. So if you were to say there was one myth about the right to repair, what would be that myth that you could debunk?

Binseng Wang  16:20
The myth? Actually, I really don’t pretend to be the one to debunk here because actually has been researching intensively by the Food and Drug Administration, the FDA, put the recommended date of the Congress of the United States, the FDA was asked by the Congress to investigate this allegation made by some manufacturers and as I mentioned, and FDA did a very extensive study, and published a report. The report was provided to Congress because it was asked by the Congress and concluded, let me read a sentence. So I don’t misquote here. It said that the currently available objective evidence is not sufficient to conclude whether there is a widespread public health concern related to servicing of medical devices, including by third party services that will justify imposing additional different burdensome regulatory requirements at this time. So it’s not something that I have been able to prove, or other individuals associations or colleagues of ours did No, this is the government itself, did extensive studies from their own data, and data available in public from other sources like equity Institute, drug commission, etc. and concrete today is no objective evidence.

Chyrill Sandrini  17:57
Right. I read that report. And I feel the same way I share your point of view on what was in that FDA report. So speaking about the legislation, the FDA, have you seen any political barriers from your point of view, that are something that might not cause a wind to the right to repair and in the legislation?

Binseng Wang  18:22
First, I don’t think this is really a political issue. Okay. Or in the sense that being a partisan issue, or it is an issue that would be a part of our population would be against because their liberties or their rights are being infringed or something like that. The reason for me to say this is very simple, because we have several states right now, to have such a bill introduced into the state assemblies, and some bills were actually sponsored by Democrats, whereas in another state the same role, very similar bill had been introduced by Republicans. So this proves that this is not a partisan issue. Okay. This is, an issue that involves, on one hand, the manufacturers, the few manufacturers that are against reducing such information and material, and the people, on the other hand, that work in hospitals, either employed by the hospitals, or by the third party to try to provide good services to the patients. And unfortunately, like any political decision, this is a political decision, in the sense, it’s a political process to introduce a bill and get it approved, enacted and all that the process is subject to lobby by both sides by all stake stakeholders in this case. So in this case, unfortunately, the reality is that the stakeholders Those who are better organized, have more money to lobby, the decision-makers are the ones likely to win the argument, despite the merit sometimes not being there. And we have seen this in some other cases, as you are well aware of the hospitals, in-house service teams, as well as depressive organizations, tend to be small to medium-sized companies that don’t have the lobbying capabilities to fight against such pressure from the manufacturers. That’s where I think I’m seeing the most barriers.

Chyrill Sandrini  20:43
Yeah, we had Kevin O’Reilly from US PIRG on yesterday. And he gave us some advice on where the BMETs can go to maybe Join the movement. That being said, he suggested writing your senator, your congressman, he has a letter that you can you know, sign? What are your thoughts on how the BMET community held one HTM individual in a hospital in the middle of some state that can help with this movement? Do you think that that matters from them to help for them to help or?

Binseng Wang  21:22
Well? Absolutely, absolutely. I have read too many letters. But I don’t think that people read the letters. And I am an industrial, illustrious unknown person to them. Right? So I don’t think that’s enough, okay. It’s necessary, but not enough. I really like to ask every one of our colleagues or their professional colleagues, to approach a legislator, someone from the legislators, staff, or friends of theirs, or relative ideas. Imagine you may have someone whose uncle happened to be a state, house husband, Amber, or senator, whatever is the case, reach out and talk to them. Because very often they don’t understand the issue. That well, because after all, the medical field is a field that is highly specialized, they probably listen to their doctors, but not necessarily other people. And so they are aware of the issues. for them. It’s easy for the manufacturers to bring up the typical Fudd furred means the fear, uncertainty, and doubt, right, when they say, well, this could hurt someone, then the legislators are well, I don’t think I want to push this because this is not probably something good for me to do. Another venue. Another opportunity that I would like to call the attention of my colleagues is to reach out to their hospital leadership, and through their hospital leadership to go to the local chapter or state organization of the American Hospital Association, American Medical Association, got those groups have strong lobbies, they have the opposite, understand the issues, because they are the ones who need the tools that we help them. Keep in good, safe, and reliable conditions. Right. So they can go and talk to the legislator because if they are in favor of the right to repair legislation, we have a much higher chance of getting this passed. Yeah, I

Chyrill Sandrini  23:44
agree. And it’s coming up soon, right. It’s the middle of April.

Binseng Wang  23:49
Yes. Many states, many states have such a concentration discussion right now.

Chyrill Sandrini  23:55
Yeah. I think sometimes we always feel that we’re so busy. And we’re so small, and our voice can’t be heard. But I think you’re a shining example of as long as you keep, you know, telling the story. Right? As sometimes somebody is going to listen, and I think that’s important right now is that 80 HTM staff across the US feels empowered to tell their story, right? Because they’re the ones on the front line. And we’ve seen it, you know, ventilators and hospitals that can’t be on patients, beds in hospitals that can’t be on patience because they’re broken, and you’re waiting on the manufacturer to come in and repair them. So we’ve seen it if you could write the legislation, right, what would it say?

Binseng Wang  24:46
Well, first of all, I would like to thank you for calling me an idealist Don Quixote may be tilting the windmill but I met sometimes I’m a dreamer. And I really like to see where the not necessarily individually, but if I can get my colleagues to collaborate, we can do something good for the collective of basically everyone out there. And certainly, I don’t think I’m capable of writing such legislation or anything like that. But I would like to suggest everyone talk to their friends and people who can influence such legislation to think about three basic points. Just very simple things. First, is to provide the service information, instructions, how to perform the services without revealing any trade secrets. And at the cost of production or this, this is nothing really new because of the or other medical devices, or that the FDA has actually such requirements. For example, for lasers, there is specifically recall, for manufacturers to provide that information here in the United States is an FDA regulation. And second, if the ikoma has some type of software to provide a passcode or, or access key or something like that, to access the error codes, messages are generated by machine this like, equivalent to the car red light that I mentioned that you can go to a Pep Boys and have someone or plug in a device and read off say, Hey, this is the problem that you have, that’s why you need to do we need that kind of access. This is not a trade secret, this is nothing really special, that manufacturer will lose their patents or anything like that. Finally, for the manufacturer to sell us, the proprietary replacement parts, service tools, calibration test equipment that is specialized for that particular device. Again, they are obviously entitled to charge a reasonable price for those parts and test tools are but we need access to that. And we don’t want to make them lose their rights, if trade secrets or nothing like that, or even the money that they invested in doing those things. So we are perfectly willing to pay for those things at a reasonable price, obviously. And ultimately, this is going to help everyone, even the manufacturers, if you ask them to think for a minute, they will also realize this sooner or later some of them, the people and other companies are going to be patients as well. And they need help, just like anybody else needs medical care. Right.

Chyrill Sandrini  28:14
Yep. Great point fencing. I mean, I know a lot of the people that I have come across everyone is always very conscious about the equipment that could possibly be used on myself or my family. Right. And I think if maybe manufacturers looked at that, that that way, maybe this is going to be on my mom, my grandma might be on this ventilator, I would want it to work perfectly, right?

Binseng Wang  28:42

Chyrill Sandrini  28:43
You don’t want to hear that. We can’t, we can’t we don’t have any more ventilators. We need to wait for a representative from the OEM to come out to repair it. I think they would be stopping the ground, so to speak, and looking for someone to repair that machine to save their loved one’s life. Right.

Binseng Wang  29:04

Chyrill Sandrini  29:05
Yep. So we’re coming to the end here have Binseng I really appreciate you joining us today. But I have a question for you. So we’re doing every segment A Wow, a word of wisdom. Now, you can use a few words. But I’d like you to tell us what is your word or words of wisdom that you can leave with our listeners and our viewers today?

Binseng Wang  29:31
Yeah, well, in my don Quixote this role. I’ll say, Hey, friends, colleagues, let’s take up the challenge by thinking this way. Let’s challenge the current status with audacity challenge with audacity is what I would recommend anyone to think about. We must think outside of the box, we cannot just say oh Katies has been the way it is been for years and we just conformed to it. We need to challenge the status quo. So challenge with audacity is what I would recommend.

Chyrill Sandrini  30:11
That’s perfect. That is you, you know, and I and I do have to say, and we were just talking earlier before we started, that I did read your book. There your latest book, it was very intriguing. I didn’t do so well on the test. But now I get it. I understand it a lot better. It’s a great read. It’s a short read, but it’s one that I’ve had to read twice to grasp. We really appreciate you joining us today. And are you attending the expo?

Binseng Wang  30:43
No, unfortunately, right now, I’m not allowed to travel unless for essential business needs. But I also hopefully be participating in future events or if they are going to do that show, in part visually alternately be attending the virtual portion.

Very good. Well, thank you, Binseng it’s been a joy talking to you today.

Binseng Wang  31:11
Oh, it’s my pleasure. Thank you so much for having me today.

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