Buying guide
When to repair, when to refurbish, when to replace — and how to build a defensible multi-year capital plan from CMMS data.
By EzMedSource editorial team · April 24, 2026
Most hospitals replace equipment on one of two signals: it breaks beyond repair, or the depreciation schedule ran out. Neither is a good signal.
This guide is for biomed and capital planners who want a defensible, repeatable replacement-planning process that produces a 3–5 year capital plan and can withstand a finance committee's scrutiny.
A device is a replacement candidate when two or more of these are true:
1. Service cost ratio above threshold. Annualized service and repair cost exceeds 30% of new-unit cost. Above 50%, replacement is almost always correct.
2. End of OEM support. Parts or software no longer available from the OEM, or ISO coverage is thinning. The device does not have to be broken — support attrition alone can be decisive.
3. Technology obsolescence. The clinical standard has moved. Older ultrasound without harmonic imaging, older defibrillators without waveform analysis, older ventilators without modern modes. Clinical risk rises even if the device works.
4. Failure-rate trend. Mean-time-between-failures has crossed into out-of-band territory for that device type relative to your fleet median.
Single signals rarely justify capital spend. Two or more make the case.
Most CMMS systems contain everything you need:
A useful aggregated view per device:
Sort devices by service-cost ratio descending. The top decile is your replacement shortlist. The second decile is your watch list.
With more candidates than budget, score each:
Sum the scores. Replace from the top down until budget is exhausted. Document the method — finance will respect the framework even when they push back on an individual line.
Consider these before adding an item to the capital budget:
The plan should live on a single page per device category:
This is the document you bring to finance. It is also the document that gives clinical leadership confidence in the process.
Beloved but obsolete. Clinicians resist replacing devices they love. Pilot the replacement device with the clinical champions first, and give them veto early.
Replaced into a shortage. Current events (post-pandemic ventilators, periodic anesthesia shortages) can disrupt procurement. Build in optionality — two qualified models, two qualified vendors.
Recall-forced replacement. A Class I recall on a device you had slated for replacement in 3 years accelerates the plan. Document the forcing event separately; finance will want the paper trail.
End-of-life software. Increasingly common — the device works but the OEM stops patching. Treat as a support-status signal; plan replacement within 18 months of end-of-patch.
Run this process annually. Between cycles, update the CMMS aggregation monthly. Capital planning improves when it is a living process, not an October scramble.
The plan is a tool. The tool is only as good as the data behind it and the rigor in applying it. When both are present, capital planning stops being a defensive exercise and becomes a strategic one.