Hospital technology decision makers now confront a growing pipeline of information technology (IT) and major medical equipment that challenges traditional capital allocation processes. In a highly fragmented industry that is driven by coverage and reimbursement policies set by the Centers for Medicare and Medicaid Services (CMS) and private insurers, the cumulative impact of hospitals' technology investment decisions shapes health care for decades.We propose a framework for the development of a national collaboration for the planning and assessment of emerging technologies, designed to improve the quality and efficiency of hospital decisions. Broader application of technology assessment would restrain inappropriate technology adoption and use.