Table 1

Contrasting examples of the level of congruence between the mandate of venture capital and health technology-based ventures (adapted from ref. 18)

Heart ablation catheterLabour decision support softwareHome monitoring system
Initial idea behind the technology, and clinical aimsTo develop a catheter that can identify cardiac cells causing arrhythmia and neutralise them by delivering extremely cold temperatures
  • Cryotherapy could prove safer than the existing radiofrequency-based procedure.

To turn a predictive mathematical model into software that would improve obstetricians’ decisions during labour and delivery
  • To predict labour and shoulder dystocia, reduce unnecessary Caesarean sections, and avoid birth-related injuries.

To develop a computerised system to enable clinicians to support chronically ill patients from a distance
  • To reduce unnecessary emergency visits and hospitalisations, and empower patients.

Level of congruence, and key explanatory factorsHigh
  • An international cadre of investigators conduct clinical studies, refine early versions of the catheter, and contribute to academic marketing around the world.

  • Market approval is first obtained in Europe to generate sales as well as clinical data required for market approval in the USA.

  • The procedure generates revenues for physicians, and marketing channels already exist.

  • Obstetricians are not eager to use the system, and established clinical practices seem hard to change.

  • Although market approval is obtained in the USA, the development of new marketing channels is costly.

  • Physician insurers become the key target as purchasers (offering reduced premiums to obstetricians who accept to use the system).

  • The system is developed and evaluated in collaboration with a regional hospital.

  • The co-design approach enables generating data on efficacy and responding to users’ requests, but it limits the growth of the venture.

  • There is not a ‘single’ purchaser for a system that generates ‘distributed’ benefits (to patients, home care providers, hospitals).