From Manuals to Maintenance: Fine-Tuning MedGemma for Multi-Modal Imaging System Support in Low-Resource Settings

Imaging device downtime is a major barrier to healthcare delivery in low- and middle-income countries (LMICs), often driven by limited access to specialized biomedical engineering support. We present a multi-modality medical equipment maintenance question-answering (QA) framework and demonstrate the fine-tuning of a medical foundation model for specialized technical troubleshooting tasks. Guided by a multi-country survey across nine LMICs, we curated technical manuals from MRI and ultrasound systems to generate the INGENZI_DatasetV1, containing 10,294 high-quality, filtered QA-context pairs. Using QLoRA-based parameter-efficient fine-tuning, we adapted the MedGemma-4b-it model to interpret system error logs and generate step-by-step equipment repair instructions. Compared to the baseline model, the fine-tuned system achieved substantial improvements across metrics, including F1 score (0.22 to 0.38), ROUGE-2 (0.18 to 0.41), and BERTScore F1 (0.86 to 0.91). These metric gains demonstrate that the model generates significantly more precise and procedurally accurate technical responses to new troubleshooting queries. This work establishes a reliable foundation for AI-assisted diagnostic and maintenance tools in resource-constrained settings.

Empowering Medical Equipment Sustainability in Low-Resource Settings: An AI-Powered Diagnostic and Support Platform for Biomedical Technicians

In low- and middle-income countries (LMICs), a significant proportion of medical diagnostic equipment remains underutilized or non-functional due to a lack of timely maintenance, limited access to technical expertise, and minimal support from manufacturers, particularly for devices acquired through third-party vendors or donations. This challenge contributes to increased equipment downtime, delayed diagnoses, and compromised patient care. This research explores the development and validation of an AI-powered support platform designed to assist biomedical technicians in diagnosing and repairing medical devices in real-time. The system integrates a large language model (LLM) with a user-friendly web interface, enabling imaging technologists/radiographers and biomedical technicians to input error codes or device symptoms and receive accurate, step-by-step troubleshooting guidance. The platform also includes a global peer-to-peer discussion forum to support knowledge exchange and provide additional context for rare or undocumented issues. A proof of concept was developed using the Philips HDI 5000 ultrasound machine, achieving 100% precision in error code interpretation and 80% accuracy in suggesting corrective actions. This study demonstrates the feasibility and potential of AI-driven systems to support medical device maintenance, with the aim of reducing equipment downtime to improve healthcare delivery in resource-constrained environments.