The process of decision-making for medical device procurement is becoming more challenging as elements of sustainability need to be considered to balance environmental impact, cost efficiency, and clinical performance. The traditional approach to procure medical devices solely based on cost minimization is no longer relevant, as the devices have become more complex thus a proper decision-making tools are essential for accurate medical device sourcing. The aim of this paper is to identify decision-making models from peer-reviewed papers extracted from major digital databases, namely, ScienceDirect, Web of Science and Scopus. The selection process consists of identification, screening, eligibility assessment, and data extraction focusing on medical devices papers or sources. In the initial screening, a total of 78 papers that related with various industries were identified on procurement decision-making. Through title and abstract screening, the number of selected papers was reduced from 78 to 46 for use in this study. From these papers, several decision-making models were identified including Multi-Criteria Decision-Making (MCDM), modern advancements of fuzzy logic, grey systems, and other hybrid approaches. This paper also explores the role of Artificial Intelligence (AI)-driven predictive analytics and strategic frameworks, such as the Lean, Agile, Resilient, Green, and Sustainable (LARGS) model in the procurement of medical devices. The analysis of literature identifies a gap between mathematically robust models and real-world operation of medical devices, particularly in Biomedical Engineering Maintenance Services (BEMS). This research highlights a lack of coherence in the current literature and emphasizes the need for simpler, integrated hybrid frameworks that combine sustainability, resilience, and digitalization to achieve practical decision-making processes. Such frameworks are important for healthcare systems especially in developing countries, particularly in Malaysia, where a system to balance advanced technological investments with practical use in clinical setup is required and due to limited resources to support long-term system resilience.
Akande, S. A., & Enyejo, J. O. (2023). Artificial intelligence in supply chain management: A systematic review of emerging trends and evidence in healthcare operations. International Journal of Scientific Research and Modern Technology, 3(12), 257-272.
Alamroshan, F., La’li, M., & Yahyaei, M. (2022). The green-agile supplier selection problem for the medical devices: a hybrid fuzzy decision-making approach. Environmental science and pollution research, 29(5), 6793-6811.
Alemsan, N., Tortorella, G., Portioli Staudacher, A., Antony, J., Trianni, A., & Hui, F. (2025). Integrating lean and resilience: a healthcare supply chain perspective. International Journal of Industrial Engineering and Operations Management, 7(4), 289-308.
Arunyanart, S., & Khumpang, P. (2025). A decision-making framework for evaluating medical equipment suppliers under uncertainty. Scientific Reports, 15(1), 9858.
Asa, A. R., Naruses, N., Nautwima, J. P., & Tsoy, D. (2023). Supplier relationship management and organizational performance: A focus on public procurement. International Journal of Management Science and Business Administration, 9(6), 19-28.
Belotti Pedroso, C., Schneller, E., Rebolledo, C., & Beaulieu, M. (2025). Translating Strategies into Tactical Actions: The Role of Sourcing Levers in Healthcare Procurement. Hospitals, 2(2), 12.
Beltran-Salomon, E., Saavedra-Leyva, R. E., Tortorella, G., Limon-Romero, J., Tlapa, D., & Baez-Lopez, Y. (2025). Critical success factors for supplier selection and performance enhancement in the medical device industry: an Industry 4.0 approach. Processes, 13(5), 1438.
Boz, E., Çizmecio?lu, S., & Çal?k, A. (2022). A novel MDCM approach for sustainable supplier selection in healthcare system in the era of logistics 4.0. Sustainability, 14(21), 13839.
Cangelosi, M., Chahar, A., & Eggington, S. (2023). Evolving use of health technology assessment in medical device Procurement—Global systematic review: an ISPOR special interest group report. Value in Health, 26(11), 1581-1589.
Di Virgilio, V., Becerra Posada, F., & Bouchard Saindon, A. (2024). Sustainable procurement of medical devices in an international context-Part 3. Assessment of local and lifelong use conditions. Global Clinical Engineering Journal, 6(2), 16-27.
Di Virgilio, V., Maldonado, M. S., Bouchard Saindon, A., & Astolfi, L. (2025). Enhancing sustainability of medical devices procurement in Low-and Middle-Income Countries. International Journal of Sustainable Engineering, 18(1), 2547595.
Di Virgilio, V., Saindon, A. B., & Posada, F. B. (2023a). Sustainable Procurement of Medical Devices in an International Context: Part 1. Background and Definitions. Global Clinical Engineering Journal, 5(3), 29-39.
Di Virgilio, V., Saindon, A. B., & Posada, F. B. (2023b). Sustainable Procurement of Medical Devices in an International Context : Part 2 Needs Assessment. Editor’s Corner, 18.
Diaconu, K., Chen, Y.-F., Cummins, C., Jimenez Moyao, G., Manaseki-Holland, S., & Lilford, R. (2017). Methods for medical device and equipment procurement and prioritization within low-and middle-income countries: findings of a systematic literature review. Globalization and health, 13(1), 59.
Firth, I., Hitch, J., Henderson, N., & Cookson, G. (2023). Moving towards a more environmentally sustainable pharmaceutical industry: recommendations for industry and the transition to green HTA. Expert Review of Pharmacoeconomics & Outcomes Research, 23(6), 591-595.
ForouzeshNejad, A. A. (2023). Leagile and sustainable supplier selection problem in the Industry 4.0 era: a case study of the medical devices using hybrid multi-criteria decision making tool. Environmental science and pollution research, 30(5), 13418-13437.
Gjini, I., & Fetahi, B. (2025). Applications of Artificial Intelligence in Healthcare Management: A Systematic Review of Operational Efficiency and Challenges: AI in Healthcare Management. Open Access Macedonian Journal of Medical Sciences, 13(4), 199-202.
Göncü, K. K., & Çetin, O. (2022). A decision model for supplier selection criteria in healthcare enterprises with dematel ANP method. Sustainability, 14(21), 13912.
Hayati, E. N., Jauhari, W. A., Damayanti, R. W., Rosyidi, C. N., & Fauadi, M. H. F. B. M. (2025). A Framework for Sustainable Supplier Selection Integrating Grey Forecasting and F-MCDM Methods: A Case Study. Jurnal Optimasi Sistem Industri, 24(1), 63-83.
Hede, S., Nunes, M. J. L., Ferreira, P. F. V., & Rocha, L. A. (2013). Incorporating sustainability in decision-making for medical device development. Technology in Society, 35(4), 276-293.
Hinrichs-Krapels, S., Ditewig, B., Boulding, H., Chalkidou, A., Erskine, J., & Shokraneh, F. (2022). Purchasing high-cost medical devices and equipment in hospitals: a systematic review. BMJ open, 12(9), e057516.
Ho, W., Xu, X., & Dey, P. K. (2010). Multi-criteria decision making approaches for supplier evaluation and selection: A literature review. European Journal of operational research, 202(1), 16-24.
Ivanov, D., Dolgui, A., & Sokolov, B. (2019). The impact of digital technology and Industry 4.0 on the ripple effect and supply chain risk analytics. International journal of production research, 57(3), 829-846.
Johnson, L. L., & Ebakivie, O. (2026). Triple A: How Analytics, AI, and Algorithms Are Improving Inventory Management in Healthcare. Logistics, 10(5), 103.
Kaya, G. K. (2021). Rational decision-making in purchasing medical devices. Proceedings of the International Conference on Industrial Engineering and Operations Management,
MacNeill, A. J., McGain, F., & Sherman, J. D. (2021). Planetary health care: a framework for sustainable health systems. The Lancet Planetary Health, 5(2), e66-e68.
Meehan, J., & Bryde, D. (2011). Sustainable procurement practice. Business strategy and the environment, 20(2), 94-106.
Montesinos, L., Checa Rifá, P., Rifá Fabregat, M., Maldonado-Romo, J., Capacci, S., Maccaro, A., & Piaggio, D. (2024). Sustainability across the medical device lifecycle: a scoping review. Sustainability, 16(4), 1433.
Nazari-Shirkouhi, S., & Samadi, S. (2025). Enhancing healthcare supply chains: A comprehensive evaluation of lean, agile, resilient and green paradigms. Engineering Applications of Artificial Intelligence, 145, 110204.
Oliveira, V., Sobral, J., & Ribeiro, M. M. (2019). Development of a tool for selection and acquisition of medical devices based on the analytic hierarchy process. 2019 IEEE 6th Portuguese Meeting on Bioengineering (ENBENG),
Pamucar, D., Torkayesh, A. E., & Biswas, S. (2023). Supplier selection in healthcare supply chain management during the COVID-19 pandemic: a novel fuzzy rough decision-making approach. Annals of Operations Research, 328(1), 977-1019.
Parker, G., & Miller, F. A. (2025). Environmental sustainability in health technology assessment: an analysis of the activities of Canada’s Drug Agency and the England’s NICE. International Journal of Technology Assessment in Health Care, 41(1), e53.
Paul, P. O., Ogugua, J. O., & Eyo-Udo, N. L. (2024). Procurement in healthcare: Ensuring efficiency and compliance in medical supplies and equipment management. Journal of Healthcare Procurement and Supply Chain Management, 6(1), 19-34.
Rahmani, K., Karimi, S., Rezayatmand, R., & Raeisi, A. R. (2021). Value-based procurement for medical devices: a scoping review. Medical Journal of the Islamic Republic of Iran, 35, 134.
Rathi, R., Kaswan, M. S., Antony, J., Cross, J., Garza-Reyes, J. A., & Furterer, S. L. (2023). Success factors for the adoption of green lean six sigma in healthcare facility: an ISM-MICMAC study. International Journal of Lean Six Sigma, 14(4), 864-897.
Rostami, O., Tavakoli, M., Tajally, A., & GhanavatiNejad, M. (2023). A goal programming-based fuzzy best–worst method for the viable supplier selection problem: a case study. Soft computing, 27(6), 2827-2852.
Salimian, S., Mousavi, S. M., & Antucheviciene, J. (2022). An interval-valued intuitionistic fuzzy model based on extended VIKOR and MARCOS for sustainable supplier selection in organ transplantation networks for healthcare devices. Sustainability, 14(7), 3795.
Samuel, A. D., Augustine, K., Jehoiarib, U., & Alice, A. D. (2024). The role of artificial intelligence and machine learning in optimizing US healthcare supply chain management. WORLD, 24(2), 1996-2002.
Sherman, J. D., Thiel, C., MacNeill, A., Eckelman, M. J., Dubrow, R., Hopf, H., Lagasse, R., Bialowitz, J., Costello, A., & Forbes, M. (2020). The green print: advancement of environmental sustainability in healthcare. Resources, Conservation and Recycling, 161, 104882.
Sheykhizadeh, M., Ghasemi, R., Vandchali, H. R., Sepehri, A., & Torabi, S. A. (2024). A hybrid decision-making framework for a supplier selection problem based on lean, agile, resilience, and green criteria: a case study of a pharmaceutical industry: M. Sheykhzadeh et al. Environment, development and sustainability, 26(12), 30969-30996.
Sloane, E. B. (2004). Using a decision support system tool for healthcare technology assessments. IEEE Engineering in Medicine and Biology Magazine, 23(3), 42-55.
Stevi?, Ž., Pamu?ar, D., Puška, A., & Chatterjee, P. (2020). Sustainable supplier selection in healthcare industries using a new MCDM method: Measurement of alternatives and ranking according to COmpromise solution (MARCOS). Computers & industrial engineering, 140, 106231.
Tadi?, D., Stefanovi?, M., & Aleksi?, A. (2014). The evaluation and ranking of medical device suppliers by using fuzzy topsis methodology. Journal of Intelligent & Fuzzy Systems, 27(4), 2091-2101.
Thille, A. W., Lyazidi, A., Richard, J.-C. M., Galia, F., & Brochard, L. (2009). A bench study of intensive-care-unit ventilators: new versus old and turbine-based versus compressed gas-based ventilators. Intensive care medicine, 35(8), 1368-1376.
Thiyagarajan, S., Cudney, E. A., Chimmani, P., D’silva, L. H., & Laux, C. M. (2026). Leveraging AI to Build Agile and Resilient Healthcare Supply Chains for Sustainable Performance: A Systematic Scoping Review and Future Directions. Sustainability, 18(3), 1434.
Torkki, P., Rotinen, L., Taponen, S., Tella, S., Grönman, K., Deviatkin, I., Pitkänen, L. J., Venesoja, A., Koljonen, K., & Repo, E. (2024). Increasing the role of sustainability in public procurement of personal protective equipment. Journal of Cleaner Production, 455, 142335.
Salim, S. A., Salim, S. H., Miskon, S., Dahlan, H. M., & Bahari, M. (2026). Decision-Making Methods for Sustainable Supplier Selection in Medical Device Procurement: A Systematic Literature Review. International Journal of Academic Research in Business and Social Sciences, 16(6), 1168–1178.
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