How to SURVIVE a Healthcare AI Startup?

We’re experiencing a remarkable moment in healthcare. Never before have we seen the industry adopt new technologies at this pace. AI is intersecting with medicine in ways that were unthinkable just months ago. The rate of change is unprecedented, and Healthcare apps are launching faster than ever.

Over the past few months, I’ve had the chance to talk with many people at this intersection. This includes founders with bold visions, clinicians experimenting with AI, and others simply trying to make sense of the chaos. I’ve also met people quietly working on side projects, often in the margins of their day jobs, exploring ideas with heart and curiosity. Honestly, some of the most inspiring stories are theirs. You don’t need a full-time startup to start building. Sometimes, all it takes is a question you can’t stop thinking about.

All these interactions made one thing very clear to me:

If you’ve ever had an idea, a “what if,” or a nagging itch to solve something, there’s no better time to build. However, as exciting as it sounds, building a company is not the same as building a demo. It’s a LOT more than code or funding or pitch decks. It gets messy. It gets personal.

So, I put together a handy framework, a survival kit of sorts, to help my kindred spirits. It is a compendium of lessons I’ve learned the hard way, lessons others shared with me, and advice I have received from other founders. It’s the framework I’ve leaned on throughout the life of our startup, now 16 years in, and yes, still very much a startup. The truth is, no matter how long you’ve been building, the rules of survival never stop applying.

I call it: SURVIVE

TL;DR

S - Story (Start With Why)

Every great startup begins with a story.

Your story is more than your background. It’s the reason you're building what you're building. It’s your lens. Your "WHY".

That’s why the first step in this journey is to Start With Why, a principle made famous by Simon Sinek. In fact, if you haven’t seen his “Start With Why” TED talk, stop reading and watch it right now (seriously!). It’s one of the simplest and most powerful frameworks for purpose-driven innovation.

In today’s world, where technology is becoming increasingly commoditized with vibe coding, your story is what sets you apart. Not your stack. Not your speed. Not your slides.

Especially in healthcare, your why often comes from lived experience, something you saw, felt, or couldn’t ignore. But it doesn’t always have to be your personal story. It could be a story you witnessed, one that stuck with you and made you ask, “Why isn’t this better?”

When your work is rooted in a story, you’re not just building a product. You’re building from belief. That’s where you gather real momentum.

U - Uncover the Real Need

Uncovering a real need means going beyond your initial story and immersing yourself in the problem space. In startup lingo, this is the pursuit of Product-Market Fit (PMF), an elusive state where your offering perfectly aligns with what people desperately need.

There are many definitions floating around, but one of my favorites is the guide for finding product market fit by Lenny Rachitsky, who simplifies it into a progression.

Step 1? “Get one company to love your product.”

(Not your own team. Not your friends. A real user who will give you honest, unfiltered feedback.)

This doesn’t happen in isolation. You need to talk, listen, and challenge your assumptions. As I’ve learned repeatedly:

PMF does NOT come from features; it comes from feedback.

If you want real actionable tips on PMF, Guillermo Flor is one of the best people to follow on LinkedIn.

Startups that skip this step end up building in a vacuum. Don't fall into that trap.

R  - Revenue is Proof

Let’s be honest: if no one’s paying for it, it’s not a business. It’s a hobby.

Continuing with Lenny Rachitsky’s PMF framework,

Step 2 is this: “Get one company to pay (a meaningful amount) for your product.”

It sounds simple, but it’s a milestone most ideas never reach. That first payment changes everything. It’s no longer just a project. It’s proof.

This is where I like to share my favorite line of all time.

“Show me the money!” – Jerry Maguire

Yes, it’s a fun line, but it’s also a reality check. Revenue validates value. Period.

Don’t push the pricing strategy until after acquiring your first customer. Start thinking about the offers early. Alex Hormozi $100M Offers is a great resource. He breaks down how to craft compelling offers that customers feel “stupid saying no.” That’s your benchmark.

Pricing isn’t just about numbers. It’s about confidence, positioning, and being clear on what your product is truly worth.

V - Vocalize with Intention

Founders must learn to talk about what they’re building - confidently, consistently, and intentionally. It’s uncomfortable at first. You’ll worry about annoying people. You’ll think you’re “selling.”

Spoiler: You are!

You are selling your idea. Your vision. Your belief.

You’ll also need to face the bitter truth that once you become a founder, your relationships will change. People will see you differently. People may no longer see you as “the specialist” or “the former [title]”. Now, you’re the person pushing a product. And that’s okay. If you believe in what you're building, speak about it with clarity and conviction.

This is something Russell Brunson highlights in Expert Secrets. Your voice gains power when it’s anchored in belief, simplicity, and repetition. The more clearly and authentically you speak about your product and purpose, the more people will resonate with it.

But vocalizing doesn’t mean overtalking, especially when you’re in a conversation with a potential customer. If they’re nodding, leaning in, and connecting, don’t keep talking. Know when to shut up.

That’s when you stop pitching. Stop selling and start closing the deal.

ABC – Always Be Closing.

I - Ignore the Noise

Welcome to the age of FOMO: the Fear of Missing Out.

Every headline screams urgency. Every LinkedIn post makes it seem like someone else just landed a huge partnership, raised a round, or launched a revolutionary AI feature. It’s easy to feel like you’re falling behind, and even easier to get distracted.

This pressure is especially intense in AI for healthcare, where the pace of innovation is both exciting and overwhelming. New models, tools, and platforms are emerging daily. All of a sudden, everyone seems to be an “AI-first” company.

FOMO is not a strategy.

Chasing the next shiny thing doesn’t make your product better. It pulls you away from your users, your vision, and the real-world problem you set out to solve. As a founder, your power comes from focus, not feature-chasing.

One of the best breakdowns of this mindset comes from a YouTube talk on FOMO around AI in Healthcare by Merv Adrian . It’s a fascinating watch, especially if you’re feeling the urge to pivot just because someone else launched something.

So take a breath. Stay grounded. Let your product grow from insight, not insecurity.

V - Venture out to the Blue Oceans

Startups are about exploration. You rarely hit the mark on your first try.

If you’ve uncovered a real need and found product-market fit - congratulations!! That’s a major milestone. But even with PMF, you might still find yourself in crowded waters. Other companies may be solving the same problem. You’re still explaining how you’re different. You’re still fighting to stand out.

That’s what is called a Red Ocean, a space full of competition, noise, and lookalike solutions. AI for healthcare is an exceptionally crowded ocean. Many apps are emerging, often chasing similar outcomes with overlapping features and promises.

So what comes after PMF?

This is where you begin looking for your Blue Ocean, the space where your solution stops competing on features and starts standing on its own. A Blue Ocean strategy is about shifting the frame entirely.

It’s not just being better or cost-effective, it’s being different in a way that matters.

You carve out that space by specializing. By narrowing your focus. By building from your story, your insight, and the very thing that made you believe this problem needed solving in the first place.

To get there:

– Keep venturing

– Revisit your positioning

– Solve deeper for fewer people

– Let your own experience shape the product’s edge

In healthcare, your differentiation often doesn’t come from the technology; it comes from the workflow, the context, and the story behind the problem.

So yes, finding product-market fit is survival. But finding your Blue Ocean is how you thrive.

Venture until you find it.

If you haven’t read Blue Ocean Strategy, add it to your list.

E - Embrace the Emotional Journey

Last, but definitely not least (actually the most important), let’s talk about the emotional journey.

This is going to be hard. Really hard. There will be late nights, uncertain months, and decisions that leave you second-guessing everything. But that’s the price of building something meaningful.

If you consider Work-Life Balance (WLB) a fixed ratio, startup life may not be for you. However, if you can align your work with your life, build boundaries, and understand your emotional capacity, you’ll have a better shot at making it.

Because here’s the truth:

Burnout is real.

Isolation is real.

Guilt of missing time with your kids is real. But so is the deep, motivating desire to build a more secure, purpose-driven future, for them and for yourself.

You have to weigh both. You have to choose with intention, not out of fear or FOMO. Sometimes, it’s okay to go slower. To delay. To rest. Sometimes, the most courageous thing you can do is not push harder, but protect what matters most.

This is not a linear path; it’s a deeply personal one. But trust me, if you stay grounded, surround yourself with the right people, and build from a place of purpose, it is absolutely worth it.

A Ben Horowitz quote from The Hard Thing About Hard Things summarizes what you are signing up for:

"The hard thing isn’t setting a big, hairy, audacious goal. The hard thing is laying people off when you miss the big goal. The hard thing isn’t hiring great people. The hard thing is when those “great people” develop a sense of entitlement and start demanding unreasonable things. The hard thing isn’t setting up an organizational chart. The hard thing is getting people to communicate within the organization that you just designed. The hard thing isn’t dreaming big. The hard thing is waking up in the middle of the night in a cold sweat when the dream turns into a nightmare." - Ben Horowitz

If You’re Building in Healthcare, Let’s Talk

This isn’t a playbook. It’s a field guide, a living framework I continue to share, refine, and learn from every day.

In full honesty, I’m still figuring it out.

Even after 16 years, our team at Darena Solutions | MeldRx still thinks like a startup. We experiment. We adapt. And most importantly, we stay open, learning from our own experiences and from others who are walking the same path.

AI in healthcare is one of the most exciting opportunities of our time, and we’ve come to believe that: no single company will build “the one solution” that solves everything. Real impact will come from interoperability and collaboration, from combining the strengths of many.

The breakthroughs we need won’t come from chasing hype. They’ll come from solving real problems in unique ways, and doing it alongside others who care deeply about the same outcomes. That’s why we’ve chosen to venture beyond the noise and focus on building in our own Blue Ocean, one grounded in real clinical need, integration, and shared success.

We’re developing a clinical decision support "platform" that seamlessly aggregates solutions from multiple providers (startups and beyond) into a single, unified experience. Think of it as an AI + Evidence-Based melded ecosystem for care teams, where innovations can plug into a shared framework, work together, and drive better decisions across the care continuum, not just at the point of care. It's based on a framework we have developed. We call it CDS STAT.

We’ve launched the MeldRx Accelerator Program to help founders like you (and ourselves) "map" the journey from demo to deployment for an AI solution, into the hands of clinicians and researchers who can truly use it, and get there - Fast. Really fast.

If you’re building something meaningful, especially in clinical decision support, triage, or clinical enablement, we’d love to talk. Contact us if you're interested. We’d love to hear what you’re working on and to share what we’re building, too.

Your Turn. What’s in Your Survival Kit?

So, tell me:

• What’s in your survival kit?

• What lessons would you add?

• Where have you stumbled, and how did you keep going?

If you’re building something, or even just thinking about it, this is your moment to "vocalize". Drop a comment. Share your story. Share your questions. Or better yet, create your own version of this guide and pass it along to someone else to help them on their journey.

Because no one survives alone, and no one builds the same way twice.

Whether you're years in or just getting started, your perspective could be exactly what someone else needs to hear.

Let’s build something meaningful, together.

Note: Parts of this article were co-written with the assistance of AI tools; reviewed, refined, and made better by years of human experience, lessons, trials, and errors.