Kevin McDonnell’s Post

You don’t scale a HealthTech product. You localise it hundreds of times. I’ve lost count of how many times I’ve heard: “Once we get this working in [insert Trust name], we’ll scale across the region.” Here’s what actually happens: You get it working in one Trust. You go next door, and the whole thing unravels. Different data. Different workflows. Different stakeholders Different funding quirks Different operating policies Same product. Completely different install. What looks like ‘scale’ on a slide deck... often is duct tape in real life. Because healthcare isn’t a single market. It’s a hundreds micro-markets stitched together. And each of those micro-markets will make your product: Integrate differently Justify ROI differently Be evaluated by a different stakeholders Be owned by someone with a different job title Be used in a slightly different way to meet local workflows. If you’re good, it still works. If you’re great, you’ve made it feel like it works the same. But under the hood? It can often become a mess of adaptations: Custom pathways for another’s triage model Manual workarounds no one dares document Hard-coded rules for one Trust’s discharge process A version of your product that no longer matches your pitch deck IMO success isn’t scale. It’s survivability. It's adaptability. Because you don’t really deploy once and scale. You localise again, and again, and again… until someone else calls it scale. I once had a a 'standard' product that could be customised in over 500 ways to meet the nuances of each deployment. However these adaptations are your competitive advantage. Because the only “scalable” HealthTech products are the ones flexible enough to be localised hundreds of times... without breaking.