As budget constraints persist, capital equipment planning is under serious pressure. In this roundtable, five healthcare technology management (HTM) experts examine why equipment age is a an unreliable metric for replacement considerations, how value should be defined, and where data gaps are still holding back better capital decisions.

Participants include Marc Schlessinger, principal consultant and investigator at Staritas (an ECRI Institute offshoot); Carol Davis-Smith, president of Carol Davis-Smith & Associates, LLC; Scott Skinner, director, clinical capital intelligence, Sodexo Healthcare; Lani Bartkowiak, HTM program manager, ProHealth Care; and Sara Salari, director of clinical engineering, University of Florida Health. Responses have been edited for brevity.

HCB News: Which factors should guide replacement decisions instead of equipment age alone?

Sara Salari: Instead of relying on age, replacement decisions should focus on what matters:
• Safety: Does the device pose any risk to patients or staff?
• Durability: Is it still structurally sound and able to handle daily use?
• Reliability: Is it breaking down more often or affecting care delivery?
• Parts and service availability: Can it still be maintained and supported?
• Efficiency: Will a new device improve workflow or outcomes?
• Usability and “flashiness”: Is the new device helpful, or a complex gadget that may fail more often?

Lani Bartkowiak: As they say, age is just a number. It does not provide a full picture of the equipment’s health, technological capabilities, risks, or its ability to meet an organization’s needs. It also does not reflect a biomed department’s ability to service and support the equipment.

Carol Davis-Smith: The chronological age of equipment is often overused. By that, I mean the time between when the equipment was purchased (or installed) and today’s date. This measure does not necessarily account for when the equipment was manufactured.

I routinely recommend consideration of three types of end of life: technical, clinical, and financial. Technical end of life is whether the original equipment manufacturer (OEM) still provides parts and service for the equipment. Clinical end of life relates to whether the equipment meets current standards of practice and/or local clinical needs. Financial end of life is whether the asset is fully depreciated.

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