Building the Market Before the Product

Build the Category Before You Build the Product — Then Remove Friction 

For years before founding Inmedix, Andrew worked on something most startups ignore: shaping the field itself. He knew that if rheumatologists didn’t already believe autonomic dysfunction mattered, no diagnostic would gain traction. So he started by giving the specialty a name — immuno-autonomics — and then spent years embedding it into the clinical conversation. “I co-chaired the Immuno-autonomic Study Group, an annual meeting of the American College of Rheumatology (ACR) with Professor and GSK SVP, Paul Peter Tak, MD, PhD, for five years,” he says. “The goal was to pound the message that this mattered.”

He published editorials, collaborated with leading rheumatologists, and built a scientific advisory board capable of championing the idea independently. Being a practicing physician gave him credibility others couldn’t match. As the “consult of last resort,” Andrew understood the frustration of failing most of the time with autoimmune patients — and he knew autonomic imbalance was a missing part of the puzzle. “If you understand the pain and you feel the solution,” he says, “it makes all the difference.”

But category creation alone isn’t enough. Andrew matched belief-building with a commercial strategy designed to remove friction. CloudHRV doesn’t rely on new CPT codes or long reimbursement battles. Instead, it uses an existing HRV procedure code that physicians bill themselves — and get paid for, while Inmedix earns a per-click fee. That alignment makes adoption far easier. “It’s easier to try something if you’re getting paid for the work you do,” Andrew says. Add in the fact that the test fits naturally into clinic workflow — performed during the waiting time before a doctor enters the room. This is how Inmedix approached solving two of the biggest barriers to diagnostic adoption.

The combination of a primed market and a low-friction commercial model created something rare in medtech: demand ahead of launch. When Inmedix commissioned an independent CoreEvitas study surveying 231 rheumatologists, 96% said they wanted to use the diagnostic as soon as it became available. That interest wasn’t the result of marketing. It was the result of a decade spent preparing the field to understand the problem — and designing the business model to make saying yes easy.

For founders, the lesson is clear: build belief first, remove friction second. When clinicians already understand the “why” and the economics align with their workflow, adoption becomes a pull, not a push.

Let Clinical Data Do the Heavy Lifting

Clinical evidence wasn’t a box to check at Inmedix — it was the strategy. Coming from clinical practice, Andrew knew physicians wouldn’t adopt a new diagnostic because of clever messaging. They would adopt it because the data stood up to scrutiny. “Doctors like me don’t care what a pharma company tells us in their marketing material,” he says. “We want to see the peer-review study.”

That mindset pushed Andrew to generate data far earlier than most startups would consider. He completed clinical studies even before raising significant outside capital — an unusual move, but one that let him speak with authority about what CloudHRV actually did. “It’s very unusual to have clinical trials before you raise money,” he says, “but it meant we knew we were solving a real problem.”

Those early studies became the foundation for an 18-study clinical plan funded through an upcoming Series A. Each dataset serves a different stakeholder — patients, rheumatologists, FDA reviewers, and payers — but together they define autonomic measurement as a legitimate part of clinical care. Just as importantly, they create something most companies can’t replicate on demand: time.

“No matter how much money you have,” Andrew says, “you can’t do a double-blind study in less than one year.” Clinical research runs on biology’s clock, not a venture timeline. By the time a competitor notices the category, Inmedix often has years of published data in hand. “From a strategic exit point of view,” he notes, “it’s a lot easier to acquire than to compete with us.”

Andrew’s advice echoes that experience: be brutally honest with your data. “Be rigorous with yourself. Don’t fool yourself,” he says. “Scientific rigor isn’t just a moat — it opens up opportunities.” Evidence becomes the throughline: it shows up in investor conversations, in journal articles, in payer discussions, and eventually in physician adoption.

Leverage Pre-Sub Meetings as a Competitive Advantage

Part of that rigor extended to how Andrew navigated the FDA. CloudHRV followed a 510(k) pathway using existing HRV devices as predicates, but the clarity behind that choice came from five separate pre-submission meetings — far more than most early-stage teams pursue.

“Whenever I see a pitch, I always ask, ‘Have you had a pre-sub with the FDA?’” Andrew says. “If you haven’t, it’s automatically a ‘no’. Take advantage of it. It’s free.” Each conversation helped the team refine assumptions, validate the regulatory path, and avoid surprises. His rule was simple: propose your plan, listen carefully, and don’t argue. “If you’re respectful and you’ve done your homework, the FDA wants you to succeed,” he says.

That same pragmatism shaped Inmedix’s IP strategy. Rather than filing patents that would expose proprietary algorithms, the company protects its core methods as trade secrets while relying on an exclusive worldwide license for the underlying technology. Combined with clinical data, it creates a layered form of defensibility — one more advantage competitors can’t easily unwind.