A lot of hospital and lab equipment has worked like this for a long time. Often done with “credits” on a mag card, smart card, usb, or something downloaded. I definitely recall seeing floppy disks in use for it way back…

This is because, in some cases, the machine is actually rented or leased and the maintenance and supply costs are charged based on usage rather than as capex. Maintaining these machines is not cheap, especially calibration and testing.