Pivot or persevere?

And we’re back! This week I arrived in sunny (but freezing!) Nashville, Tennessee! It feels like only yesterday I was on Jumeirah Beach in Dubai, so it feels somewhat surreal to be back into the winter weather and navigating a snow storm! I’m here for ViVe, a digital health conference that claims to be the only conference “where digital health execs go to do business”. I’m curious to see how it stacks up against Arab Health, and to get my first real look at how things actually operate in the infamous U.S. healthcare system.

As I pass the halfway point on my ICURe journey, I want to reflect on my original business plan and discuss an important lesson…knowing when to pivot. Like most entrepreneurs starting out, I assumed my ‘Plan A’ was going to be a success, but as I dig further into market exploration and start to actually talk to customers, I’m starting to appreciate something I was told by Chris Prett, an ICURe mentor, in the early days of my ICURe journey: “Start with Plan A and then pivot to a plan that works”. My first few days at the ViVe conference have made me question my original business plan, so I’m going to share a few reflections on the conference and also the factors that are swaying me towards my first pivot.

The Pivot Mindset: Navigating Change and Strategy

To get started, I’m going to steal a quote from one of my favourite books, The Lean Startup by Eric Ries:

“Pivot or persevere: When you hit upon something that is not working, you have two basic choices: change direction or keep going”

This decision point is one every entrepreneur faces and it’s important to remember that a pivot is never a complete abandonment of your original plan. A pivot changes one element at a time and is often needed due to external factors (e.g. social trends, technology trends, health trends, infrastructure trends). ICURe has pushed me to question my assumptions, test the market, and gather real-world feedback on my innovation. I’ve had both validating and challenging feedback and I’ve found that the hardest part isn’t recognising when something isn’t working; it’s having the clarity to pivot when necessary. Holding onto an idea too tightly can be just as risky as abandoning it too soon. So, as I reflect on my original business plan, the question isn’t just if I should pivot, but how to do it strategically.

If you’ve been reading along, you’ll know I usually write quite generally about the world of business itself. However, this time I’m diving deeper into my own company, sharing insights from the healthcare market and the rationale behind expanding into other sectors

I’m currently focused on building a company in healthcare, but I’m also fully aware of the challenges in selling AI-driven software-based medical devices. The regulatory landscape is lagging far behind AI innovation, with constant changes and general unpredictability. In addition, the sales cycle in hospitals is notoriously slow and difficult to navigate. They say the grass is always greener, but in reality, both private and public healthcare systems around the world come with their own distinct, but equally challenging, procurement and sales hurdles. Decisions are layered with bureaucracy, deals move slowly and getting buy-in from both users (in my case doctors) and customers (hospital providers) is time consuming and difficult. I’m focusing on the negatives a bit heavily here, but having spent my career to date focused on healthcare research, it’s been an eye-opener to understand how complex the world of business in healthcare actually is. I’m excited to face these challenges head-on, however I’m also keen to understand if there are other markets outside of healthcare that my technology could be of use. Expanding into other markets could provide a way to accelerate growth and build momentum before fully tackling the healthcare sector’s challenges

In Nashville, I’ve found that the focus on AI in healthcare is mostly limited to using AI to streamline administrative tasks, optimise/automate billing, and enhance operational efficiency with limited examples of companies tackling complex clinical decision-making or using AI as a software based medical device. While there’s interest in predictive analytics, and some great companies working in this space (see Masimo and Darena Solutions), the appetite for AI-driven patient care solutions is much more cautious, with most companies opting for the ‘low hanging fruit’ (for example, unregulated AI solutions that streamline administration). This isn’t necessarily a bad thing – I’m a strong advocate for treading carefully when it comes to using AI to influence clinical decisions and patient care. However, it does make me start to question: is there an easier market for me to break into first? Is there a market that will allow me to improve my tech readiness, demonstrate impact and ultimately put me in a stronger position for selling to hospitals and achieving medical device certification? Could there be a way to sharpen our product in a lower-risk environment before tackling the complexities of clinical use? This line of thinking is exactly what has led me to the decision point I mentioned earlier, is it time to change direction or keep going?

For those that have been following from the start, you might recall that early on in my ICURe journey I was asked to pick a wildcard market to explore. At the time, it felt a bit random, I even thought it would be a distraction, but now I’m starting to see the point: ICURe was training me to think beyond my first assumptions, to challenge my own plans and mindset. By thinking of a wildcard market and opening myself up to spotting other possibilities, the idea of pivoting away from my original plan didn’t feel as scary.

One of my wildcard markets was the insurance sector. Not the most exciting, I know, but after hearing mostly negative things about the US insurance market, discovering they might be a customer for my product wasn’t something I was expecting. While I’m new to this field, meeting insurers in Nashville has allowed me to learn that insurance companies are adopting predictive analytics much faster than hospitals, driven by a need to improve care standards, efficiency, and patient throughput. While our solution has always been clinician focused, I’m learning that with a few adjustments, our tool could also serve as an advanced data analytics platform, providing insurance companies with a performance indicator for hospitals. In other words, by slightly adapting (pivoting) my tool, I could have a strong offering in the insurance market as well as the healthcare market.

This realisation, brought me back to thinking about our mission. Our technology is designed to help clinicians make decisions and positively impact patient care, this is at the heart of what we do. Would this pivot conflict with that mission? Well, not necessarily. It could serve as a beachhead market, helping us generate revenue, get to market faster, and ultimately achieve our mission, just slightly later. In fact, it could provide the runway we need to refine our technology, build credibility, and position ourselves for broader healthcare adoption in the future. In the end, the goal is still the same, but the path there might look a little different than I originally expected. I’m still in the early days of considering whether this pivot into insurance is right for my product, maybe by the time I get to Las Vegas (next week for HIMSS), I’ll have changed my mind again! But that’s how it should be when you are on an exploration journey. Always be open to new markets, new ideas and new strategies that will help you achieve your mission.

Pivoting Tips

As an early-stage entrepreneur, you’re bound to face moments when a pivot is necessary. Even if you’re not currently considering one, it’s always helpful to keep these principles in mind for when the time comes:

Recognise the Signs Early: Pay attention to feedback. This can be difficult but whether it’s from customers, partners, or the market. If something isn’t working, don’t ignore it. Acknowledge when you need to pivot early to avoid wasting time and resources.

Pivot, Don’t Abandon: A pivot isn’t about starting from scratch. It’s about adjusting one element of your business to better align with market needs. Stay grounded in your mission but be flexible in how you achieve it.

Be Data-Driven: Use data and real-world feedback to inform your pivot. Whether it’s customer feedback or market trends, make sure your decisions are based on insights that help you better meet the needs of your audience.

Leverage Your Network: Don’t try to pivot in isolation. Lean on mentors, industry peers, and advisors who can offer fresh perspectives and guide you through the process.

Embrace the Unknown: While this one might sound a bit cheesy, pivoting can be uncomfortable, but it’s also an exciting opportunity to lean into a new field and grow your . Don’t shy away from it embrace the uncertainty and use it as a chance to evolve and improve your business.

I have one more day in Nashville to go so I’m going to use this time to speak to more insurance companies and find out what pivoting my business plan to focus on this market would involve. I’m also excited to be heading out to the famous Honky Tonk Road tonight to see Chris Janson at the ViVe industry night party! More updates on how that goes in the next one!

Thanks for reading and I’ll see you in the next one!