What It Actually Takes to Build (and Scale) in HealthTech

Healthcare is one of the hardest industries to build in, not because there’s a lack of opportunity, but because everything that should be simple rarely is.

At Startup Boston Week, Amber Nigam (Co-Founder & CEO, basys.ai), Ali Hyatt (Chief Customer & Growth Officer, Henry Schein One), Kristen Nuckols (Co-Founder & Chief Clinical Officer, Imago Rehab) and Yu-Jen Chang (Investment Associate, Taiwan Global Angels) didn’t just scratch the surface. It got into the messy middle - regulation, adoption, trust, and what “innovation” really looks like in healthcare.

Let’s get into it.

Watch the full SBW2025 session.

Healthcare Doesn’t Move Fast And That’s (Mostly) the Point

If you’re building in healthtech and frustrated by compliance, here’s the reality: It’s not a bug. It’s the system.

As Ali Hyatt put it, security and compliance aren’t optional, they’re existential. A single breach can take down an entire company, especially when you’re dealing with patient data.

But here’s where it gets tricky: for early-stage founders, those same safeguards can feel like a brick wall.

The takeaway?  You’re not bypassing the system, you’re learning how to navigate it strategically.

• Leverage accelerators and ecosystem resources

• Stay focused (you can’t solve compliance for every use case at once)

• Build with security in mind from day one

Because in healthcare, “move fast and break things” doesn’t fly.

AI Isn’t Replacing Clinicians (At Least Not Yet)

There’s a lot of noise about AI transforming patient care. But on the ground? It’s a lot more nuanced.

Kristen Nuckols, who spent nearly two decades as a clinician, put it bluntly: “AI today is great at generating a starting point, it’s not great at delivering personalized care.”

Why? Because healthcare decisions aren’t just data-driven—they’re deeply contextual.

Every patient is different. Every treatment plan is nuanced. Right now, AI:

• Helps draft ideas, proposals, and documentation

• Supports workflows (not replaces them)

• Still requires heavy human oversight

And when it comes to patient-facing tools? Guardrails aren’t optional, they’re critical. If sensitive topics come up, AI shouldn’t be making the call. Humans should.

The Real Innovation? Making Care More Accessible

Some of the most compelling examples weren’t futuristic, they were practical.

Things like:

• AI-powered voice scribes reducing admin burden for providers

• Imaging AI helping patients see what’s happening in their bodies

• Remote monitoring tools tracking recovery from home instead of in-clinic

Kristen shared how patients can now complete therapy sessions remotely, with data captured and tracked over time, something that simply didn’t exist before.

And that’s where the real shift is happening, not just better care, but more accessible care.

Startups Don’t Fail Because of Tech. They Fail Because of Fit.

One of the biggest mistakes founders make? Building a solution before deeply understanding the problem.

In healthcare, that mistake gets amplified. Kristen broke it down simply, “The pitch you give to a neurologist shouldn’t be the same one you give to a payer.”

The best founders:

• Start with empathy

• Co-develop with users

• Adapt messaging (and product) to the audience

Because healthcare isn’t one market, it’s a web of interconnected ones.

Scaling Changes Everything (Including Who You Need on the Team)

Going from 0 → 10 is one game.Going from 100 → 1,000 is another.

Ali Hyatt shared what that transition actually looks like:

• Early stage = scrappy generalists

• Growth stage = specialists + structure

• Scale = systems, consistency, and repeatability

At some point, things like:

• Pricing

• Go-to-market strategy

• Sales processes

…can’t be improvised anymore and neither can hiring. The best leaders don’t just hire talent, they hire people who are better than them in specific areas.

What Investors Actually Look For (Hint: It’s Not Just the Tech)

From the investor side, Yu-Jen highlighted something that often gets overlooked: the best founders aren’t just smart—they’re deeply connected to the problem.

The signals that matter most:

• A clear understanding of the problem (often personal)

• A complementary founding team

• A real market opportunity

• Honesty and trustworthiness

And one underrated trait? Empathy. Because healthcare isn’t just a business, it’s people’s lives.

Healthcare Is Complicated. Plan Accordingly.

If there was one closing reality check, it was this: healthcare is not a typical startup market. Expect:

• Long sales cycles

• Endless pilot programs

• Complex payer systems

• Slow adoption curves

And at the same time, you still need to prove repeatable revenue. That tension? It’s part of the game.

The Bottom Line

AI isn’t magically fixing healthcare overnight, but it is unlocking new ways to:

• Reduce friction for providers

• Increase access for patients

• Personalize care over time

The founders who win in this space won’t just build better tech, they’ll:

• Understand the system deeply

• Work with stakeholders (not around them)

• Balance innovation with trust

Because in healthcare, progress doesn’t come from disruption alone, it comes from integration.

If you’re building in healthtech (or thinking about it) this is your reminder: the opportunity is massive, but so is the responsibility.