How to Run and Pay for Your First Hospital Pilot

Run your first pilot as a commercial step, not a giveaway. If you can, sell the device, even close to cost, so the pilot shows up as revenue. Pick physicians you have real confidence in, start in a controlled setting, and fund more than one site, because any single site can stall.

Should I give the device away for free?

I would rather you didn't. If you sell it, even at cost, you at least generate some revenue activity, and those devices go on your revenue line. What you pay on the other side, for the study and the people running it, is a different question. But booked sales show commercial activity, and that is always a nice thing to show the market.

For studies, I have usually had my customers buy the device. When there is a reimbursement code for it, the hospital is not losing money. Giving devices away made sense in my career when a product was pre-market and there was no reimbursement for it yet.

What should the pilot budget cover?

More than the devices. The principal investigator for the study gets paid. If they write a paper, they get paid to write it. If you want a respected physician on the podium talking about your results, there is value in paying for that podium presence too. I also see real value in an economic study done alongside the clinical outcomes, because it gives the hospital a cost story as well as a clinical one.

And plan for more than one site. When a founder walks me through a raise, I remind them: don't forget to fund three or four pilots. If you fund only one and it stalls, you have nothing to show.

How do I choose the first sites and physicians?

Go to high-volume physicians who can get cases done quickly with high quality. When I helped set up studies at high-volume centers, that was the question our clinical team always asked: who are your highest-volume doctors who can get volume done quickly with high quality? You want things to go well, so put a new device in the hands of people you have a high level of confidence in. This is your baby.

Then start simple. Let the team use the device a couple of times in a controlled environment, on routine procedures, before it is needed in a harder case. The last thing you want is to use something for the first time under duress.

What if the pilot stalls?

First, find the roadblock. Every hospital system and every review board process is different, and it can take months or even a year. Ask what makes this a priority for the clinician. Is the hospital making money from it? Will it give the physician a podium? People move on what is high priority and high impact for them, so think about it from their side.

If the site has gone quiet, push for an answer. At that point an angry answer is better than no answer, because at least you can respond to it. A short series of well-written follow-ups that ends with a polite breakup message often gets people to reply.

And keep a backup list. If your one interested physician goes quiet and you have nobody else to call, you are stuck. Have other possible pilot sites lined up before you need them.

Where to start

Write a one-page pilot plan with three parts. First, the sites and physicians, ranked, with backups. Second, the budget, including investigator, paper and podium costs for three or four sites. Third, the commercial terms, with the device sold wherever a reimbursement code allows it.