Companies often focus commercial efforts on major urban and academic hospitals. However, the actual disease burden and patient populations are often concentrated in rural areas, representing significant untapped demand for medical technology.

Contrary to conventional wisdom, large medical practices are predicted to outpace major hospital systems in AI adoption. Practices' more modern, cloud-based infrastructure allows them to deploy AI tools more quickly than hospitals, which are often hindered by legacy technology, complex governance, and slower ROI realization on new tech.

Urgency is forcing a major shift in hospital procurement. CIOs are no longer willing to wait years for incumbents like Epic to develop AI tools. They are actively partnering with startups to deploy commercially ready solutions now, prioritizing speed and immediate operational impact over vendor loyalty.

US biotechs increasingly use sites like Australia to accelerate development, as Create Medicines did by moving from concept to clinic in under 12 months. What was once viewed with suspicion is now a key strategy to generate data faster and more cheaply, competing with the speed of China's ecosystem.

Innovative medical devices get a temporary 'tracking' CPT code. To secure permanent reimbursement, companies must demonstrate widespread physician adoption, but achieving that adoption is nearly impossible without the insurance coverage they are trying to obtain.

While fee-for-service models incentivize in-clinic treatments, value-based care shifts the focus to outcomes and overall cost. Under these new models, home dialysis—which offers better patient outcomes and lower societal costs—becomes more profitable for providers, creating a powerful financial incentive to drive adoption.

Augurex's CEO identified a major opportunity by noting that biomarker use in rheumatology was 10-15 years behind oncology. This "technology lag" between medical specialties signals a significant unmet need and a prime area for innovation, allowing proven concepts from one field to revolutionize another.

Gaining FDA approval is not the finish line. Many innovative devices fail because they lack a clear reimbursement strategy. Founders must build the economic case for payers and providers in concert with their clinical and regulatory strategy from day one.

Disruptive MedTech ideas attract investment, but they are high-risk. Founders should de-risk these big bets by developing market access and commercial strategies simultaneously with product development, not after FDA approval.