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From Pilot to Paid: Turning Proof into Revenue in U.S. Hospitals Executive Summary — The Pilot-to-Paid Mandate Regulatory clearance is only the first battle .Winning reimbursement, budget approval, and multi-site adoption is the war . For MedTech and digital health teams, pilots often feel like traction. In reality, they’re a fork in the road: one path becomes repeatable revenue; the other becomes a Traction Mirage  — activity without conversion. Across MedTech, most pilots n

You proved clinical value. Now it’s time to turn pilots into revenue.   Pathova’s Free GTM Diagnostic is a short, high‑signal engagement that pressure‑tests your commercialization plan against how hospitals actually  buy: multi‑stakeholder value analysis, budget windows, reimbursement realities, and (often) GPO contracting. Value Analysis Committees (VACs) are multidisciplinary by design—typically spanning physicians, nursing, supply chain, finance, risk/regulatory, and IT/se

Confidentiality Notice All company names, individual identities, and specific details in this case study have been anonymized or fictionalized to protect client confidentiality. This composite narrative reflects real challenges commonly faced by MedTech startups advancing from pilots to paid contracts. The goal: deliver practical, actionable lessons for MedTech founders and teams. TL;DR Outcomes 2 system‑level contracts signed — first paid agreements 31% pilot‑to‑contract con

Regulatory clearance and strong clinical data are necessary—but not sufficient. Hospitals buy through multidisciplinary committees that weigh clinical value and  operational, safety, and budget impact, often via a formal value‑analysis process. Evidence consistently shows that device purchasing is a team sport that balances technical, financial, safety, and clinical requirements—user trials and hospital‑based HTA included. If your go‑to‑market assumes “good study → fast adopt

Pilots are meant to de‑risk adoption. Too often they defer it.  Inside hospitals, new products face an evaluative process that weighs clinical outcomes, safety, workflow, and cost. That complexity—spread across clinicians, supply chain/value analysis, finance, and IT—explains why otherwise successful pilots can stall in “committee land.” Research underscores the multidisciplinary reality and the need for strong, decision‑grade evidence to move from trial to purchase.   BMJ Op

Every early commercial hire in MedTech knows this feeling: overwhelmed and pulled in every direction, expected to close deals while simultaneously building the commercialization systems you desperately need. You’re running back-to-back demos, chasing pilots that weren’t designed for success, wrestling with procurement, finance, and reimbursement questions. Every time you try to step back and build structure, another urgent issue demands your attention. Founders feel it too. I

The Hidden Graveyard of MedTech Innovation Regulatory clearance. Clinical validation. A few promising pilots. It feels like momentum — until it isn’t. Nearly 70% of MedTech and digital health pilots never convert to paid contracts.  They stall in a limbo we call Pilot Purgatory : proof without revenue, interest without adoption, champions without contracts. For founders, Pilot Purgatory isn’t just frustrating. It’s existential. Every delayed conversion drains capital, credibi

This isn’t just a self-assessment; it’s the first step in our GTM Diagnostic, a tool designed to provide clarity and actionable insights. Use it to demonstrate to customers and investors that you’re building a dependable, measurable process, not just a prototype.

Regulatory Clearance ≠ Market Readiness For most MedTech innovators, FDA approval or strong clinical validation feels like the finish line. In reality, it’s just the starting gun. You’ve proven your science works, but that doesn’t mean your business will scale. This is the gap too many companies miss. It’s why so many MedTech startups stall after a few impressive pilots. The Hidden Gap Between Proof and Revenue Regulatory approval means you can sell. It doesn’t mean customers

Regulatory approval is a milestone worth celebrating. Pilots showing strong clinical value are significant achievements. Yet, for most MedTech founders, these victories lead to a sobering reality: stalled traction, investor pressure, and a pipeline of pilots that never convert.