Building Collaboratively in Medtech: How Founders Use Partnerships to Scale
Strategic partnerships often determine how quickly a medtech company scales. The right collaborators can accelerate innovation, strengthen credibility, expand market access, and solve challenges that are difficult to overcome alone.
Scale through shared innovation: In the right markets, opening your platform can attract more innovators, generate stronger clinical evidence, and create a larger ecosystem around your technology.
Build the category before competing in it: Emerging markets require collective effort. Align physicians, societies, industry groups, and even competitors around a shared vision before competing for market share.
Choose partners with alignment: Partnerships only create value when incentives remain aligned over time. Build relationships with organizations that stay close to your customers and can support your long-term commercial strategy.
Make your board part of the process: Boards create the most value when they're invited to solve problems, not approve predetermined answers. Exploring problems together builds alignment and makes better use of their experience.
Embrace co-opetition: In underserved markets, collaborating with adjacent companies can grow category awareness, amplify your collective voice, and reduce customer acquisition costs.
Open the Moat: Collaboration as a Business Model
Mary Lou Jepsen is the founder of Openwater, which is building optical and ultrasound-based imaging and therapeutic platforms. Jepsen’s path is one of the most counterintuitive in medtech. She open-sourced the company’s foundational technology.
The reaction from early investors was, predictably, a screaming match. "I had to hold the phone about two feet away while they screamed at me," Jepsen says.
Her conviction held. Openwater’s platform is licensed under the GNU Affero General Public License (AGPL) and the Creative Commons 4.0 Share-Alike license. Anyone can use the patents for any purpose, with one exception: they can’t sue Openwater or its customers for doing so.
"Open source is not a synonym for charity," she says. "It actually gets us a lot more revenue. We become profitable faster."
The model relies on parallel innovation. Instead of one company trying to develop every possible therapy on its own, multiple research groups and commercial teams can build on the same underlying platform at the same time. Openwater keeps the system ISO 13485-certified, which helps teams stay FDA- and IRB-ready, and then sells certification and support services to groups building on its platform.
The unit economics are revealing. At $10K per device and 2,000 units, Openwater is a $20M company. But if manufacturing scale brings the device cost down to $2,000 and distribution expands to 100,000 units, hardware revenue alone reaches $200 million. Layer in certification, support, services, and the broader platform value created by many teams building on the same base, and Jepsen sees a path toward “a billion-dollar company.”
The open model accelerates that path by expanding the number of people validating, iterating, and deploying the technology across indications.
There’s also a clinical flywheel. By sharing safety data across implementations, the field reduces redundant trials and builds bigger datasets. Jepsen estimates a third of the cost of regulatory approval is just collecting safety data. Pool that, and everyone moves faster.
The lesson: not every moat has to be built from secrecy. In a horizontal infrastructure, opening the underlying tech may compound faster than locking every piece of it down.
Treat Physician Societies and Competitors as a Coalition
Kelly Huang is the CEO of Elucid, which uses AI to analyze coronary CT angiograms. Elucid earned a Category I CPT code from CMS one year after market entry, an unusually fast pace in a space where reimbursement timelines often stretch several years.
Elucid’s pace didn’t happen by accident; it was the result of careful coalition building.
"In medtech reimbursement, no one succeeds alone," he says. Elucid works closely with the Society of Cardiovascular Computed Tomography, the American College of Radiology, AdvaMed, and MDMA. The goal is to bring CMS and commercial payers a unified case — one supported by aligned clinical evidence, economic data, and physician demand.
Huang also takes a practical view of competitors in emerging markets. Elucid, HeartFlow, and Cleerly are all helping establish the broader category around advanced cardiac CT analysis and reimbursement. “When you’re going into a market where you’re trying to develop a new technology, these competitors are really like great neighbors,” he says. "Together, you’re keeping the parks clean and the streets safe."
The shared effort matters because payers and policymakers are not just evaluating a company. They are evaluating whether a category deserves to exist. One company can make a strong argument, but several credible companies moving in the same direction can help CMS see that a field is emerging — not just a single product. Once the category exists, the companies can compete on execution.
The same principle applies to KOLs. Huang emphasizes the importance of engaging a focused group of credible clinicians who use the product and understand its value. Their experience helps establish early trust with societies and payers, because reimbursement decisions carry more weight when the case is made by physicians, not just companies.
The lesson: in early markets, category creation is rarely a solo effort.. Build the coalition first — with societies, clinicians, trade groups, and even the companies you may eventually compete against.
Pick Distribution Partners Carefully, Then Move on if it’s Not Working
Kirk Huntsman is the CEO of Vivos, which is developing alternative therapies for sleep apnea. Huntsman knows how powerful distribution partnerships can be for accelerating growth.
"Anytime you want to take your company to the next level, sometimes you’ve got to belly up and play with the big boys," Huntsman says. "But be careful who you align with."
He learned that firsthand after Vivos signed a distribution agreement with a large strategic. Shortly after the deal closed, leadership changed, priorities shifted, and months of alignment effectively disappeared.
Vivos’ next step was to partner with sleep testing centers — even acquiring some — where patients first learn they have sleep apnea and start weighing their options. The strategy is to establish a presence at the diagnosis stage so that patients immediately consider Vivos as an alternative to CPAP. Ultimately, the combination of strategic alliances and acquisitions has helped pave a path for the company to become “the go-to technology” in the category, says Huntsman.
The lesson: a big-name distribution partner is just a bet on someone else’s continued attention. Build alignment closer to where the patient first encounters the problem, even if that means smaller, more numerous partnerships.
Sit on the Same Side of the Table as Your Board
Ahmed Elmouelhi is the CEO of TRiCares, which is developing transcatheter tricuspid valve replacement technology. TRiCares is venture-backed, and Elmouelhi has a clear philosophy on how founders should work with their boards:
"You have to be on the same side of the table as your board," he says. "You can’t be trying to sell them on something."
His default mode is to bring the board the problem and work through possible paths together. If he goes in with a fixed conclusion he wants the board to ratify, the conversation will get adversarial more often than not.
He borrows a framing from a mentor: let people play in the sandbox with you. "Nobody wants to see the final product. They’re going to say, ‘It’s not exactly the way I want it.’ What everybody really wants to do is be in the sandbox."
The corollary is that the question you ask matters as much as what you ask about. Elmouelhi distinguishes between fake and real engagement. A fake question presents three options where two are obviously bad. A real question asks, "Here are three paths I see, possibly a fourth I haven’t thought of, what do you think?"
That posture only works if it’s authentic. If you’re using "what do you think" as a sales technique, your board will smell it.
The lesson: your board is one of the most expensive resources you have access to. Treat them like genuine collaborators.
In Emerging Categories, Default to ‘Co-opetition’
Claire Dixon is the CEO of Neuraura, a women’s health startup focused on PCOS, is a perfect case for what she calls “co-opetition.” The category is so underserved that the few players in it are best treated as allies.
"We’ve taken a very clear approach in terms of being much more embracing of partners and thinking about partnerships as a huge part of our commercial strategy," Dixon says.
For Neuraura, that has meant building relationships with online pharmacies, pharmaceutical companies, wellness platforms, skincare brands, and other innovators already serving women affected by PCOS. These groups have direct access to the same population and a shared incentive to close the awareness and care gap.
Dixon says some of Neuraura’s most impactful relationships have been with peer companies serving the same community through adjacent clinical or wellness solutions. “We all support each other. We all increase our voice and reach,” she says. “And that will bring down our cost to customer acquisition.”
The lesson: in an underserved or fragmented category, awareness creation is often shared work. If you’re one of the few companies talking about the problem, amplifying others in the space can help grow the category faster.