20 Hurdles For Healthcare Tech Startups In Scaling Solutions

Forbes

4 days ago

A healthcare startup may launch with a bold and innovative idea, but turning that idea into a scalable solution that works across hospitals and complex health systems is rarely straightforward. From integrating with legacy infrastructure to navigating strict compliance requirements and diverse stakeholder priorities, even the most agile teams can struggle to scale effectively.
Left unaddressed, these challenges can stall adoption, drain internal resources and limit a product's long-term impact. Below, members of Forbes Technology Council highlight some of the most common hurdles healthcare startups must be ready for and share their expertise on breaking into and succeeding in this challenging sector.
1. Finding Client Champions
To scale solutions within a health system or payer organization, you need to engage a team of internal champions who can understand, justify and prioritize your platform. Organizations evaluate dozens if not hundreds of companies each year. Champions help articulate your value, often leveraging their professional credibility to advocate for it. Finding and 'winning' them is essential to scaling. - Graham Gardner, Kyruus Health
2. Navigating Integration Requirements Across Hospital Systems
One of the biggest hurdles is navigating the complexities of integration requirements across different hospital systems. Healthcare startups frequently underestimate the time and resources needed for integrations. Success requires building flexible APIs from day one and having dedicated integration specialists who understand healthcare IT infrastructure, not just general software development. - Ted Kail, Cority
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3. Gaining Traction In A Risk-Averse Environment
Most healthcare organizations are risk-averse and don't want to be early adopters. They look for proven, well-established companies and products, making it difficult for healthcare startups to get traction, even when they have clearly better solutions. Partnering and delivering real value to that first set of clients is critical in scaling early on. - John Bou, Modio Health
4. Integrating With Insurance Systems
Health insurance companies amplify the interoperability challenge by adding another layer of complex, often siloed, data and systems that healthcare tech startups must integrate with. This makes the negotiation and implementation of business associate and HIPAA agreements more complicated, given the data types, security requirements and shared liabilities that arise from integrating with both providers and payers. - Ajai Paul, Affirm Inc.
5. Understanding The Complex Stakeholder Ecosystem
Healthcare startups often make the mistake of viewing the U.S. healthcare system with a 'singular' point of view. It is an integrated ecosystem where each stakeholder is affected by the others, which means multiple interests must be aligned when adopting new technologies. - Raghav Ramabadran, Intelligine Technologies
6. Building Custom Integrations For Each Customer
Healthcare startups' challenges include integrating with electronic health record systems, which is not a 'plug and play' process. Each hospital or system has its own highly customized version of an EHR, with unique workflows, data fields and security protocols. This lack of standardization means startups must build a new integration for nearly every customer. - Chris Ciabarra, Athena Security Inc.
7. Developing Strong Governance From The Outset
Healthcare startups often wait to build full product depth until after landing their first client, but healthcare's high-risk, structured environment demands strong governance from day one. Change control, release management and a deep understanding of current operations, especially when replacing legacy systems, are essential before customizing. Building depth late risks delays and failure! - Trisha Swift, Mula Integrative Health & Wellness
8. Maintaining HIPAA Compliance With Digital Content
One challenge healthcare startups face when scaling tech is managing digital content while staying HIPAA-compliant. Hospitals need more than stock photos and shared drives—they expect secure, role-based access to branded visuals that convey authenticity and protect patient privacy. Without a digital asset management strategy, startups risk falling short on compliance, credibility and growth. - Andrew Fingerman, PhotoShelter
9. Ensuring Consistent Performance And Compliance Across Disparate Systems
Healthcare startups often struggle to scale because hospital environments vary widely in terms of infrastructure, workflows and data systems. Without a unified data architecture, real-time metrics, and built-in security and governance, it's hard to ensure consistent performance—or meet privacy requirements like HIPAA and business associate agreements governing protected health information. - Dave Albano, Diliko
10. Working Within Complex Pricing And Claims Rules
One of the challenges is the integration of new tech into strict hospital billing and compliance processes. Hospitals have complex pricing and claims rules, and startups must work within these rules. They can't disrupt revenue or patient data safety. Doing this right builds trust and helps a solution scale faster. - Abhishek Sinha, Accenture
11. Processing Both Structured And Unstructured Health Data
Integrating structured data (EHRs; lab results) and unstructured data (clinical notes; imaging; video) can be a major challenge. Healthcare startups must ensure their tech can process both, all while adapting to varying data and privacy standards across systems, which further complicates scaling and interoperability. Fortunately, generative AI is making this easier to do. - David Talby, John Snow Labs
12. Balancing Accuracy And Transparency With Scalability
The healthcare and life sciences sector faces rigorous accuracy and transparency requirements that cannot be sacrificed and must be built into products from the start. Balancing this with scalability—which is really code for 'solving problems you don't have yet'—is a constant challenge—especially for startups, which often place a key focus on agility and speed. - Martin Snyder, Certara
13. Maintaining A Consistent, Accurate Record Of Core Assets
One key challenge healthcare startups face when scaling tech solutions across systems is the inability to maintain a consistent and accurate record of core assets—such as patients, providers and devices—due to the absence of a robust master data management strategy. This causes data fragmentation, which in turn hinders decision-making, innovation and seamless integration across platforms. - Somnath Banerjee
14. Keeping Up With A Range Of Regional Norms And Laws
Key challenges include a wide range of compliance requirements, regulations, cultural norms, and data privacy and region-specific laws—making a one-size-fits-all solution impractical, even within a single organization. Startups often rely on business rules engines that lack user friendliness. Agentic AI offers a more adaptable and intuitive alternative. - Koushik Sundar, Citibank
15. Working Within Legacy Hospital Systems
One major challenge healthcare startups face when scaling tech solutions is integration with legacy hospital systems. Many hospitals rely on outdated EHRs or siloed IT infrastructure, making interoperability difficult. Startups must ensure compliance, data security and seamless integration to gain trust and adoption at scale. - Srikanth Bellamkonda
16. Clearly Demonstrating ROI And Pathways To Reimbursement
Healthcare startups often struggle to clearly demonstrate a return on investment and secure reimbursement pathways. Without established billing codes or tangible cost-savings data, hospitals hesitate to allocate budget. Startups must invest heavily in economic validation, health economics and outcomes research, ensuring payers and finance teams see sustainable revenue models before adoption. - Manav Kapoor, Amazon
17. Creating An Internal COE
Establishing an internal center of excellence with deep industry experience in scaling healthcare systems is vital, but costly. A key challenge lies in selecting vendors that align with the company's DNA. Bridging the gap between emerging tech and the unique demands of healthcare requires thoughtful planning and a nuanced understanding of both innovation and patient-centric outcomes. - Hari Sonnenahalli, NTT Data Business Solutions
18. Overcoming Resistance To New Tech
I've regularly observed the challenges clinical sites face when adopting new technologies. There is often reluctance or resistance to change; staffing shortages further exacerbate these issues. A more effective approach may be to 'mirror' site-level data. This would allow AI-driven platforms to build a harmonized system that enables forward progress without disrupting existing workflows. - Rachel Tam, Bristol Myers Squibb
19. Accounting For Integration Issues When Building Solutions
The biggest hurdle to overcome when scaling tech solutions across hospitals or healthcare systems is not technical; rather, it is integration—into provider workflows, clinical practice guidelines, financial models and revenue cycle management programs. Unless the issues around integration are considered and covered when building the solution, scaling will not occur. The landscape is littered with misaligned HealthTech startups. - Mark Francis, Electronic Caregiver
20. Completing Vendor Risk Documentation
Post-ransomware, hospitals demand extensive vendor risk audits with hundreds of security controls, SOC 2/HITRUST docs, and custom BAAs. Completing these lengthy questionnaires stretches sales cycles to 18 to 24 months, burning cash and pulling engineers from product work to compliance, blocking scale. - Mohit Menghnani, Twilio