The goal of hospital-based technology assessment is the development of a model for decision making and clinical resource management that functions as an integral part of hospital operations. This article describes technology assessment and its application to health care provision in hospital settings. The authors provide a list of essential questions that ought to be asked as part of any evaluation of a proposed technology. Because technology assessment should be incorporated into the strategic management of a hospital, an operational model is offered for combining technology assessment with capital planning. Although it is argued that a functional operating technology assessment program is vital to cost-effective and quality health care, it is not a guarantee.