The defibrillator problem: what your installed base isn't telling you.

Last week we ran a live demo for 20+ European medtech distributors — no slides, just the software. One question to the system:

"Which devices are overdue for preventive maintenance at this hospital?"

The answer came back in seconds. Fourteen devices at the account. Four overdue. And one line that made the room go quiet: a defibrillator, installed in January 2019, on a six-month inspection cycle — with no inspection record at all. Out of warranty since 2022. No service contract. A resuscitation device that nobody could prove worked.

Let us be straight about something, because it matters: that defibrillator is fictional. The whole demo runs on an invented distributor with invented clients — it says so on every screen. Nobody's patient was ever near that device.

Here's the uncomfortable part. Everyone in that room recognised it anyway.

Why every installed base has one

The defibrillator problem isn't a data-entry failure. It's a structural one, and it builds up in three perfectly innocent steps.

A device gets sold and installed — recorded in the delivery note. Its service gets handled by a different team, in a different tool — or in email. And the spreadsheet that's supposed to tie it all together gets updated "when there's time," by whoever's turn it is. No single step is negligent. The sum is a device that exists physically, generates no signal, and slowly disappears from everyone's view. The longer it stays invisible, the more certain it becomes that an auditor, an insurer — or a failure — finds it before you do.

If you distribute or service medical devices and you're honest with yourself, you don't know today how many of these you have. That's not an insult. It's what spreadsheets do.

What "visible" actually means

In the demo, the same question scaled from one hospital to the whole base: 344 devices across some fifty clients. The system answered with 93 overdue for inspection, 45 with no service history at all, and the replacement candidates by name and serial number — grouped by client, in seconds. Demo data, again — but calculated live, not staged: the maintenance schedule derives from rules on each product, not from dates anyone typed.

That's the definition worth writing down. An installed base is visible when you can ask it questions and act on the answers: which devices are overdue, which were never serviced, which are past warranty with no coverage, which are end-of-life models still running in a clinic. Every one of those answers is either a risk you retire or revenue you've been leaving on the table — a contract conversation, a replacement conversation, a paid visit.

And this is production reality, not a concept: earlier this year one medtech distributor's actual spreadsheet became 227 customers, 254 products and 1,094 installed devices in our system — near-autonomously, in a single run. That story, with the receipts, is here →

The takeaway

You don't need to buy anything to act on this. Ask your own team the demo's question: which of our installed devices are overdue for safety inspection, and which have no service record at all? If the answer takes minutes, you're fine. If it takes a meeting, a spreadsheet hunt and a caveat — that's the defibrillator problem, and it is quietly holding both your compliance and your service revenue hostage.

If you'd like to see the question answered on your data instead of our demo, that's a 30-minute working session. Bring one spreadsheet →

Owner: Jan Safka · Healtek field notes, August 2026. Clips are from the live IntMeDA demo (4 Aug 2026), running on a fictional demo distributor; the 1,094-device import is a real, anonymized customer run.