OBJECTIVES: The actual extent of health technologies utilization is fundamental criterion for health technology assessment and management. Although crucial, this information may not be accurately available due to incomplete clinical registries and other limitations. As this is a major hindrance we developed a model enabling indirect assessment of the technology utilization, by measuring techno-markers, which are specifically associated with the technology under study. METHODS: During 2004 we evaluated the model by collecting data on techno-markers for cardiac surgery in one Israeli medical center. The Techno-markers chosen were compared to surgical registries and estimate error was calculated. Estimate error less than 5% indicates non-significant differences between techno-markers and surgical registries. RESULTS: Total of 1040 cardiac surgeries was compared to utilization of 1064(2.3%) surgical-drapes and 1224(17.7%) bone-wax units. In addition, 832 cardiopulmonary bypass (CPB) surgeries were compared to utilization of 874(5%) oxygenators, 854(2.6%) cardioplegia-sets, 1029(23.7%) control-valves, and 848(1.9%) aortic-cannulas. Furthermore, utilization of 208 "off-pump" coronary artery bypass (OPCAB) were compared to 204(2%) air-water blowers, and 241(15.8%) stabilizers CONCLUSIONS: Techno-markers demonstrated an estimate error less than 5% (surgical-drapes for cardiac surgeries, oxigenators, cardioplegia-sets, and aortic-cannulas for CPB, and air-water blowers for OPCAB) require further statistical analysis for establishing a comprehensive utilization model. Significant differences between observed and expected should alert the management system. In conclusion, valuable techno-markers must be distinctive to the technology and easy to monitor, thus their selection requires good clinical understanding of the technology. When chosen appropriately, techno-markers can provide a new approach for estimating and supervising the extent of health technology utilization.