By the Techstars Healthcare Vertical Network Team

This blog is Part 1 of a 5-part tactical series drawn directly from conversations at the Techstars Healthcare Vertical Network panel presentations in NYC in June 2025 with Techstars managing directors, leaders from Permanente Medicine, Johns Hopkins, Carefirst, PwC, and dozens of Techstars healthcare alumni founders.*

If you're building in healthcare, you've probably already had the thought: “Maybe I picked the wrong industry.”

You didn’t. But it’s understandable.

Because in healthcare, you can build something that’s clinically sound, operationally needed, and financially rational and yet... still never get it adopted.

You can have alignment across users, data, incentives, and outcomes, and still get buried in procurement, legal, or silence.

Don’t get into the mindset that this is failure. This is just the terrain.

And the reason you’re reading this — the reason this series exists — is because what you're building still matters, even when the system can’t see it yet.

Why It Feels Impossible

Healthcare is structurally allergic to speed, ambiguity, and change, which happens to be the exact operating environment of every early-stage startup. The result?

1. You’re solving for people who aren’t in the room.

The actual end user (nurse, scheduler, patient) doesn’t have decision-making power. The person with the budget doesn’t feel the day-to-day pain.

2. The friction isn’t in the tech. It’s in the system.

Integration, compliance, procurement, risk management, union rules, legacy workflows — none of which show up on your roadmap, but all of which can kill a deal.

3. You’re being evaluated on your company, not just your product.

Even with a clean pilot, health systems are asking:

• Can this team support an enterprise deployment?

• Will they be around in 12 months?

• Will our clinicians revolt if we add this tool?

4. You’re competing against inertia, not other startups.

Often, you're not replacing another solution. You're replacing spreadsheets, faxes, or unspoken assumptions about “how things are done.”

Why It Still Matters That You Build

The system is on a course to change. The only question is whether it changes because of you or despite you.

Health systems are under pressure like never before:

• Margins are shrinking. Even nonprofit systems are acting like investors now.

• Workforce burnout is structural. Clinicians aren't tired, they’re drowning.

• Policy volatility is growing. Payers, regulators, and employers are rewriting the rules in real time.

• Patient expectations have shifted. Digital-first is no longer a differentiator. It’s table stakes. 

So while your buyer may be slow, their problems are compounding fast.

And when the urgency finally hits, the builders who survive this waiting period — who are still standing with a tested, safe, integrated solution — win everything.

How Smart Founders Survive the Stall

This really isn’t about brute force. It’s about strategic durability.

If you want to stay in the game long enough to matter, here’s what great founders do differently:

1. They build for the system, not against it.

Don’t try to circumvent compliance or IT. Make it easy for them to say yes. Assume every extra click, every new login, and every manual process will kill you, and then design around it.

2. They speak fluently in ROI, even if the system doesn’t.

You can't just promise time savings or operational lift. You need the math. Minutes → hours → FTEs → dollars. And then align those dollars to the priorities of your buyer (not your user).

3. They understand their buyer’s risk profile.

This is beyond just selling innovation. It’s about reducing perceived risk. If your champion can’t defend your solution to their boss in one sentence, they won’t.

4. They start small — but with a plan to scale.

The first deployment should feel invisible. But it should also be a wedge. Come in with a clearly defined pilot and a clear expansion map tied to business outcomes.

5. They never wait.

Waiting for feedback? Write it yourself. Waiting for access? Train on public workflows. Waiting for a champion? Be your own. Forward movement doesn’t always require permission. It just requires momentum.

One Final Note: The System Doesn’t Say “Thank You.” Do It Anyway.

You won’t get applause for making a form disappear.

You won’t get awards for eliminating 13 clicks in a charting workflow.

You might never get public credit for saving a nurse 9 minutes on intake every shift.

But you will make a difference. And eventually, if you’re still standing, you’ll be the one they call when the system can’t keep up.

So yes… It’s hard. It’s slow. It’s deeply unfair.

But it’s also where the most urgent problems in the U.S. are waiting to be solved.

And if you’re the kind of founder who can sit in the discomfort, build through the silence, and design for the invisible pain points, then healthcare needs you more than ever.

Keep building. Not just because it’s hard. 

But because it’s necessary.

And you’re one of the few willing to do it.

* This content is distilled from a panel discussion during the Techstars Vertical Network Kickoff event in June 2025. Healthcare panelists included:

• Techstars Managing Directors Keith Camhi, Nick Culbertson, Tim Grace, and Jennifer Davis,

• Myra Norton, Head of Innovation, Startup & Ecosystem Acceleration at Johns Hopkins Medicine,

• Brian Hasselfeld, MD, Executive Medical Director, Digital Health & Innovation at Johns Hopkins Medicine,

• Ian Goldstein, Partner, Corporate Group & Startup Practice Area Lead at Fenwick & West,

• Jessica Locke, Chief of Staff & Strategic Innovation at Permanente Medicine Mid-Atlantic States,

• Salvatore LoGrasso, Program Director of Innovation at Northwestern Medicine,

• Sidd Bhattacharya, Partner at PwC, Healthcare AI Team,

• and many Techstars alumni founders.

Read More