Technology, and its contribution to the activities of healthcare organisations, is changing ever faster. Like-for-like replacement of a worn out item of hospital equipment may not even be possible as the last model is unlikely to be the same as the current one or meet the latest clinical need. Updated diagnostic or therapeutic technology can provide improved and more efficient patient care. Demand for common devices such as basic patient monitors is changing in developed economies as the number of hospital beds reduces and the amount of sophisticated monitoring increases. Telemetry and central monitoring are developing hand in hand with hospital at home facilities and a demand for robust, network-linked devices in primary care. This has practical implications when setting up new services, as the equipment eventually needed may vary significantly from that envisaged in the early planning stages of, say, a new hospital. When acquiring new or replacement equipment, therefore, it is wise to consider different approaches to service provision and the possibility of adopting new technologies or approaches. Maintaining flexibility is also a good investment in the longer term.