In light of today's tight hospital financial picture caused by Medicare's prospective payment system and local constraints, capital expenditures must be made with great care and forethought. The process for purchase decision making should assess the need for the device; specifically identify what is required; carefully evaluate the product via technical, clinical, and user studies; collate the results for committee decision making; and plan for the introduction and support of the product through its lifetime. A case study of the acquisition of a neonatal monitoring system is presented.