The record keeping can be done via data diodes. As for the updates, they can be done by trained hospital staff, doesn't even have to be medical. Remote updates

The record keeping can be done via data diodes. As for the updates, they can be done by trained hospital staff, doesn't even have to be medical. Remote updates give the manufacturer remote killing abilities. Don't think that such power concentration is a good idea. For governments you kinda need it, but outside of them there is no need.