Experienced technicians take decades of troubleshooting knowledge with them when they retire. Here’s how HTM departments can start capturing it.

By Dmytro (Dima) Okhrimchuk

Every healthcare technology management (HTM) department has a version of this party. Sheet cake in the break room, a card signed by three shifts, a few war stories about the ventilator recall of whatever year. Someone gives a speech about 30 years of service. And then the most experienced diagnostic mind in the building hands in a badge and drives home.

The field has gotten good at measuring what leaves in that moment: one full-time equivalent, now a vacancy that will take months to fill. What nobody measures is the other thing that walked out—three decades of accumulated diagnostic reasoning that exists nowhere except in that person’s head. Not in the CMMS. Not in a manual. Not anywhere.

The technician shortage is usually framed as a recruiting and training problem. It is both. But it is also a third thing that gets almost no attention: a knowledge-capture problem. The good news is, unlike the pipeline—which will take a decade to fix—the capture problem can be addressed starting with the next work order.

The Retirement Wave Is Already Here

The demographics have been public for years. AAMI’s HTM demographic survey found that 47% of HTM staff are 50 or older; among managers, nearly six in 10. The organizations surveyed averaged 8.5% vacancy, with a third reporting that positions take two to four months to fill and another 30% reporting longer than four months.

The pipeline is moving in the wrong direction. According to AAMI’s vice president of HTM, at least 30 BMET programs have closed in the past five years, leaving 23 states without a single BMET-specific academic pathway. The Bureau of Labor Statistics projects strong growth for medical equipment repairers, translating to thousands of openings a year, while formal programs graduate only a few hundred people annually. AAMI’s newest State of HTM survey confirms the age curve has not bent: Only about 18% of the field is 34 or younger.

The field’s responses—apprenticeships, military-transition recruiting, program advocacy—are necessary and working at the margins. But they all address the headcount side of the retirement wave. AAMI’s own framing points at the deeper issue: a widening “training gap between the country’s most senior and soon-to-be-retiring BMETs and the next generation of HTM professionals.”

Here is the uncomfortable question inside that sentence. When the senior half of that gap retires, where does what they know actually go?

What’s Missing from the Work Order

Consider what a 30-year technician actually knows. Which infusion pump model throws a phantom occlusion alarm when the door latch wears in a particular way. Which telemetry dead zones are really a wireless problem and not a device problem. The sequence of three checks that resolves an intermittent imaging artifact 90% of the time, learned across 200 service calls nobody else remembers.

Now look for that knowledge in your records. The work orders exist, thousands of them with this technician’s name on them. But open them, and read what they say: “Repaired and tested OK.” “Replaced part, verified operation.” “Good to go.”

The record confirms that work happened. It almost never captures how the problem was actually solved. It doesn’t detail what was checked first, what ruled out the obvious causes, what pointed to the real one. That is not the technician’s failing. Work-order documentation was designed to prove completion for compliance and history, and it is typically written after the fact, from memory, at the end of a day of competing demands. The diagnostic reasoning—the part that took 30 years to build—was never asked for, so it was never written down.

The result is that most HTM departments own an index of outcomes and mistake it for a library of knowledge. The index says what was fixed. The library—how—retires one badge at a time.

The Cost of Starting Over

As a result, new technicians re-derive solved problems. Every intermittent failure is investigated from scratch, including the ones a departed colleague solved a dozen times. Time-to-competence stretches at the moment departments can least afford it.

Mentorship remains one of the field’s best ways to transfer knowledge, but it depends on having experienced technicians with time to teach. In departments already dealing with vacancies, that time is often in short supply.

Organizations may also become more dependent on manufacturers or third-party service providers for problems they once resolved in-house.

What Leaders Can Do

None of what leaders can do to address this requires new headcount. It requires making knowledge capture part of the department’s normal workflow. 

Audit what your records would teach. Pull 20 closed repair work orders for your most problematic asset type. Read them as if you were a technician hired next month. Could you learn how those problems were actually diagnosed? If the honest answer is no, you’ve identified a gap.

Capture knowledge before scheduled retirements. Retirement dates aren’t surprises. In the final months, sit the departing technician down with the department’s 10 trickiest recurring assets, and record what fails, what it looks like, what to check in what order, and what the false leads are. Spend two hours per asset. It will be the highest-leverage documentation the department produces that year.

Capture the troubleshooting process while it’s still fresh. Most documentation happens after the repair is complete, so work orders capture the outcome but not the path to it. Asking technicians what they tried and what pointed them to the fix at close-out, allowing them to dictate notes during the repair, or otherwise capturing the diagnostic process as they work can preserve knowledge that would otherwise be lost.

Make the veteran’s reasoning reusable. Pair traditional mentorship with recorded case walkthroughs of repairs. One explanation, captured once, teaches every future hire, including the ones who arrive after the explainer has retired.

Knowledge Doesn’t Have to Retire

The pipeline problem deserves the attention it’s getting. Apprenticeships, recruiting, and advocacy all play an important role. But new hires bring potential, not decades of experience. If that experience isn’t captured before veteran technicians retire, departments lose it and the next generation has to build it again.

Most HTM leaders know when their most experienced technicians will retire. The opportunity is to make sure their knowledge doesn’t retire with them. That starts by capturing how problems are diagnosed—not just that they were fixed.

About the author: Dmytro (Dima) Okhrimchuk, founder and CEO of Leera AI, a voice-first AI assistant built for healthcare technology management teams

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