Medical Technology Investment Decision-Making at U.S. Hospitals: A Comparative Case Study of Four Organizations

Investments in expensive medical technologies, ranging from computed tomography (CT) scanners to proton beam accelerators, consume a major share of hospitals’ capital budgets. The demand by physicians, patients and other stakeholders for medical technologies often exceeds a hospital’s financial resources. When allocating their tight budgets, hospitals also need to account for multiple organizational objectives. The objective of this paper is to analyze current practices in medical technology investment decision-making at U.S. hospitals. Through semi-structured interviews of administrators at four hospital organizations, we obtained information on their medical technology investment decision approach. Findings from our interviews confirm that a systematic decision process that considers all organizational objectives, analyzes and integrates comprehensive data, and is objective and consistent is rarely applied. We propose that hospital organizations develop and implement such systematic processes and do so by building upon decision analysis principles and approaches, such as the Simple Multi-Attribute Rating Technique (SMART)