by Michael Joseph Halbach

The promise of digital health is relatively simple; utilize data to separate the critical few from the trivial many, and then leverage technology advancements to bring patients, doctors, and payers closer together and in better alignment around evidence-based prevention, diagnosis, treatment and overall well-being.  This promise has brought unprecedented investment ($14B by venture capitalists in 2018) and projections (A total digital health footprint of over $500B by 2025), which in turn has drawn the best and brightest from the entrepreneurial world.  In addition, the tech giants are planting their flags and positioning themselves accordingly.  With the general public increasingly downloading apps, buying wearables, and engaging in the general internet of things before much of the value has been validated, it is puzzling that the dam has not already broke.

The core question is, “Who’s going to pay for it?”

Patients have the most to gain, and have validated demand by engaging with technologies, but they have the least expertise to vet solutions for efficacy.  Altruistically, doctors are driven by the desire to help their patients, but also feel compression based on heavy workloads and changing financial models, not to mention concerns that it will impact how they practice medicine.  It is the existing businesses that surround the patient/doctor relationship, namely insurers, service providers and manufacturers of medical goods, that offer a single access point to significant populations of patients and medical professionals. 

As digital health startups focus on business to business (B2B) sales models, looking to transform the promise of their products into sustainable revenue streams, below are some insights from the US Markets to help navigate this terrain: 

  1. Resources are overextended

Consolidation in US healthcare is real, and with it comes distraction and overhead costs that makes it very difficult for large organizations to compete in the digital innovation space.  Between platform migrations, a volatile regulatory environment, and pressures on financial models, digital innovation often falls victim to these business demands. Where there is a focus on innovation, it typically comes through partnership.

2. The service delivery model is complex

There are numerous entities that have worked their way into the US healthcare supply chain.  It is a maze of corporate giants, unknown middlemen, group purchasing organizations, and specialized partnerships.   Navigating this environment to identify your target buyers can be a challenge.   Once decision makers are identified there is a process to building trust and then understanding the existing suppliers, customers and partners that must be integrated into a cohesive solution.

3. They deal in Trust

Healthcare businesses are typically risk averse.  Between compliance in the regulatory arena and the very human cost of missteps, ensuring not only efficacy of new solutions but more importantly safeguarding patients is foundational to their mission.

Leaning on my experiences from both sides of the vendor selection process in the B2B environment, and with a focus on startups that won business, the following were the common traits shared of by those who found success:

4. A multifaceted value proposition

The B2B sales process is long and cumbersome.  That sterling first impression often loses its luster as additional stakeholders in the business begin to engage through the RFP process.  It can be very humbling how quickly the primary value proposition gives way to operational constraints and competing priorities of over-extended resources.   This means on point messaging of a multifaceted value proposition that considers the environment of their customers (doctors / patients / companies), their vendor partners, their people and processes, and of course, it must be grounded in measurable financial returns.

5. A flexible platform and rollout strategy

In this complex environment, the most attractive technologies have the ability to adapt to multiple configurations with necessary controls in place to maintain integrity of their systems.  Buyers prioritize a flexible technology platform and a repeatable implementation process that takes into consideration a client’s internal and external demands for customization.  Your technology needs to meet them where they are, bring value in their current complex ecosystem, and provide a path forward as they adapt their solutions to the new market demands.


By their nature, digital health startups are chasing a vision, thinking outside the box and challenging today by painting a picture of tomorrow.  Large healthcare businesses are chasing client demands, regulatory compliance, and dealing with high overhead cost for innovation.  The startups that I have seen succeed bridge this gap.  This is accomplished by embracing customer challenges as your own, bringing expertise to the table, offering technologies that solve for existing commitments, and leveraging process excellence toolsets that breed confidence regardless of a companies relative size in the space.

It all starts with putting a flag in the ground, mobilizing your vision into measurable outcomes and empowering your team around those measurements.  A passionate group of people, aligned behind a clear vision, that measure progress against a set of smart metrics is the most important factor in winning business as a startup.  Your vision will get you in the door, your understanding of the market and customer challenges will get you a seat during the vendor selection process but US Healthcare companies ultimately partner when they lift the hood and see a flexible, scalable platform combined with operational maturity that is demonstrated through data driven best practices.

About the author

Michael Halbach has recently relocated to Berlin with an eye on impacting the proliferation of technology into the healthcare space.  He has over 20 years of transactional processing experience in the software industry, leveraging data to develop products and create operational maturity throughout the organization.   He has spent the last 12 years in the US Healthcare market with First Script, playing leadership roles during its growth from startup to market leader.  Most recently, as part of Aetna (one of the big three insurance companies in the US), he was the acting President of the First Script division.  Key areas of focus have included process excellence, product development, management of technical and customer service teams, the development of sales strategy and client related projects. He previously worked for First Data Corp, a global leader in the financial services payments industry.  Michael has a BA from Syracuse University.