As of now, maintenance strategy looks similar to strategy taken by the medical fraternity in themes, concepts and procedures.

If things go suddenly wrong we just fix the problem as quickly as possible. A person is healthy to the point when the person becomes unhealthy.

That might work fine for simple diseases like harmless flu, infections, wounds and fractures. And it is rather necessary to do so during such infrequent periods of crisis.

But that does not work for more serious diseases or chronic ones.

For such serious and chronic ones either we go for preventive measures like general cleanliness, hygiene, food and restoring normal living conditions or predictive measures through regular check ups that detects problems like high or low blood pressures, diabetes and cancer.

Once detected, we treat the symptoms post haste resorting to either prolonged doses of medication or surgery or both, like in the case of cancer. But unfortunately, the chance of survival or prolonging life of a patient is rather low.

However, it is time we rethink our strategy of maintaining health of a human being or any machine or system.

We may do so by orienting our strategy to understand the dynamics of a disease. By doing so, our approach changes radically. For example. let us take Type 2 diabetes, which is becoming a global epidemic. Acute or chronic stress initiates or triggers the disease (Initiator). Poor or inadequate nutrition or wrong choice of food accelerates the process  (Accelerator) whereas taking regular physical exercise retards or slows down the process (Retarder). Worthwhile to mention that the Initiator(s), Accelerator (s) and Retarder (s) get together to produce changes that trigger of unhealthy or undesirable behavior or failure patterns. Such interactions, which I call ‘imperfections‘ between initiator (s), accelerator (s) and retarder (s) change the gene expression which gives rise to a disease, which often has to be treated over the entire lifecycle of a patient or system with a low probability of success.

The present strategy to fight diabetes is to modulate insulin levels through oral medication or injections to keep blood sugar to an acceptable level. It often proves to be a frustrating process for patients to maintain their blood sugar levels in this manner. But more importantly, the present strategy is not geared to reverse Type 2 diabetes or eliminate the disease.

The difference between the two approaches lies in the fact — “respond to the symptom” (high blood sugar) vs “respond to the “imperfection” — the interaction between Initiators, Accelerators and Retarders”. The response to symptom is done through constant monitoring and action based on the condition of the system, without attempting to take care of the inherent imperfections. On the other hand, the response to imperfections involve appropriate and adequate actions around the I, A, R s and monitoring their presence and levels of severity.

So a successful strategy to reverse diabetes would be to eliminate or avoid the initiator (or keep it as low as possible); weaken or eliminate the Accelerator and strengthen or improve the Retarder. A custom made successful strategy might be formulated by careful observation and analysis of the dynamics of the patient.

As a passing note, by following this simple strategy of addressing the “system imperfections“, I could successfully reverse my Type 2 Diabetes, which even doctors considered impossible. Moreover, the consequences of diabetes were also reversed.

Fixing diseases as and when they surface or appear is similar to Breakdown Maintenance strategy, which most industries adopt. Clearly, other than cases where the consequences of a failure is really low, adoption of this strategy is not beneficial in terms of maintenance effort, safety, availability and costs.

As a parallel in engineering, tackling a diseases through preventive measures is like Preventive Maintenance and Total Productive Maintenance — a highly evolved form of Preventive Maintenance. Though such a strategy can prove to be very useful to maintain basic operating conditions, the limitation, as in the case of human beings, is that it does not usually ensure successful ‘mission reliability’  (high chance of survival or prolonging healthy life to the maximum) as demonstrated by Waddington Effect. (You may refer to my posts on Waddington Effect here 1 and here 2)

Similarly, predictive strategy along with its follow up actions in medical science, is similar to Predictive Maintenance, Condition Based Maintenance and Reliability Centered Maintenance in engineering discipline. Though we can successfully avoid or eliminate the consequences of failures; improvement in reliability (extending MTBF — Mean Time Between Failures) or performance is limited to the degree of existing “imperfections” in the system (gene expression of the system), which the above strategies hardly address.

For the purpose of illustration of IAR method, you may like to visit my post on — Application of IAR technique

To summarize, a successful maintenance strategy that aims at zero breakdown and zero safety and performance failures and useful extension of MTBF of any system may be as follows:

1. Observe the dynamics of the machine or system. This might be done by observing  energy flows or materials movement and its dynamics or vibration patterns or analysis of failure patterns or conducting design audits, etc. Such methods can be employed individually or in combination, which depends on the context.
2. Understand the failures or abnormal behavior  or performance patterns from equipment history or Review of existing equipment maintenance plan
3. Identify the Initiators, Accelerators and Retarders (IARs)
4. Formulate a customized comprehensive strategy  and detailed maintenance and improvement plan around the identified IARs keeping in mind the action principles of elimination, weakening and strengthening the IARs appropriately. This ensures Reliability of Equipment Usage over the lifecycle of an equipment at the lowest possible costs and efforts. The advantage lies in the fact that once done, REU gives ongoing benefits to a manufacturing plant over years.
5. Keep upgrading the maintenance plan, sensors and analysis algorithms based on new evidences and information. This leads to custom built Artificial Intelligence for any system that proves invaluable in the long run.
6. Improve the system in small steps that give measureable benefits.By Dibyendu De