For early-stage MedTech startups, key milestones for investors are not just regulatory successes. They are fundamental proofs of concept—showing the device works in a model and demonstrating how it would function in a clinical setting. This builds an investor's vision of the product's future.

Truly transformative healthcare companies often solve "boring" but fundamental problems. Instead of tackling surface-level symptoms (e.g., appointment booking), the best founders dig deep to fix the complex, underlying infrastructure issues of the healthcare system, creating a durable competitive moat.

Many medtech companies design large trials where a tiny, clinically meaningless response can be statistically significant. Dr. Holman advises entrepreneurs to instead run rigorous trials that prove genuine clinical value, arguing that credible data is the ultimate moat, even if it carries a higher risk of failure.

Instead of chasing fleeting trends, true innovation improves the core, unchanging elements of an industry. In healthcare, this means enhancing the fundamental patient-provider relationship and experience, which are constants.

Successful MedTech innovation starts by identifying a pressing, real-world clinical problem and then developing a solution. This 'problem-first' approach is more effective than creating a technology and searching for an application, a common pitfall for founders with academic backgrounds.

While the primary goal of making the Cobra OS smaller was to improve safety, an unexpected benefit emerged. The device's smaller profile made it suitable for patients with smaller anatomies, such as women, opening a major new clinical application in postpartum hemorrhage.

In high-stakes fields like medtech, the "fail fast" startup mantra is irresponsible. The goal should be to "learn fast" instead—maximizing learning cycles internally through research and simulation to de-risk products before they have real-world consequences for patient safety.

Frontline Medical chose to develop the Cobra OS not because it was their most revolutionary concept, but because it was manufacturable with limited resources. They prioritized the idea that 'checked all the boxes' for feasibility, market success, and patient impact, ensuring they could bring a product to market.

The game-changing insight wasn't a new idea, but an observation of how installers were already "hacking" the process. They were forcing an exterior-designed product to be installed from the inside for safety. Pella simply designed a system that formalized and optimized this behavior.