Fantasy Board Draft

Publish Date: June 2nd 2025

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Few failures in health tech have been as spectacular—or foreboding—as the collapse of the now infamous blood-testing start­up Thera­nos. Many have asked the question of how they could get it so wrong. At first glance the compa­ny had every­thing it needed to succeed — a charis­mat­ic Stanford drop-out founder, propri­etary technol­o­gy and a star studded board filled with some of the world’s most experi­enced leaders.

So how did a compa­ny once worth 10 billion dollars at its peak end up as a caution­ary tale for all start ups?

The answer may just lie at the top.

Thera­nos wasn’t sunk by a lack of vision—or even hype. It was undone, in part, by a board­room that looked impres­sive on paper but had no business guiding a health tech compa­ny. Two of its members were in their nineties. None had a background in life sciences. As NYU Stern School of Business profes­sor Aswath Damodaran put it, the board “might have made sense for a defense contrac­tor, but not a health­care compa­ny.”

And here’s the uncom­fort­able part: this wasn’t a one-off. We’ve seen versions of this board again and again—well-meaning founders surround­ing themselves with prestige instead of purpose. It’s not malice. It’s a blind spot. Many still see the board as a formal­i­ty, or a credi­bil­i­ty enhancer rather than what it really is: one of the most strate­gic tools a compa­ny has.

A board can anchor a company—or accel­er­ate its failure. In health tech, where the terrain is unique­ly complex and the stakes unusu­al­ly high, getting this right is non-negotiable.

So here’s a thought: what if founders approached board-build­ing the same way fanta­sy sports players draft their teams? Delib­er­ate­ly. Position by position. Not just the biggest names, but the best fit.

To build a board that actual­ly helps you win, you need to know which roles matter—and what skills they demand.

This is especial­ly true in Europe, where health tech startups can’t stay local for long. Every new country means a new set of rules: differ­ent regula­tors, procure­ment systems, reimburse­ment process­es. Every move across a border is a new game entire­ly. And you need people on your board who’ve played it before.

In our experi­ence, the best boards tend to share a common lineup. Five roles that consis­tent­ly show up in winning health tech compa­nies are:

• The Insid­er
• The Execu­tive Clini­cian
• The MBA
• The Regula­to­ry Expert
• The Patient Advocate

So, what exact­ly does a well-round­ed board look like in practice?

Let’s break down the five profiles that matter most—who they are, why they’re essen­tial, and how they help turn complex­i­ty into compet­i­tive edge.

Under­stand­ing insti­tu­tion­al purchas­ing decisions repre­sents a criti­cal success factor for health tech compa­nies. The Insid­er provides essen­tial exper­tise in this domain.

Founders in the field typical­ly emerge from clini­cal or techni­cal backgrounds. While this exper­tise enables product devel­op­ment, it rarely encom­pass­es suffi­cient under­stand­ing of purchas­ing mecha­nisms within health­care systems.

The transi­tion from success­ful clini­cal studies or pilots to an actual purchase presents signif­i­cant oppor­tu­ni­ties for go-to-market accel­er­a­tion. Secur­ing clini­cal enthu­si­asm is an impor­tant achieve­ment, but the real challenge comes next—navigating procure­ment process­es efficient­ly. The Insid­er helps optimise this journey through:

• Align­ment between clini­cal valida­tion and purchas­ing author­i­ties
• Design of pilots leading to commer­cial contracts
• Tacti­cal timing with annual budget alloca­tion
• Revenue scenar­ios based on indus­try procure­ment timelines

With the right guidance, time to secur­ing the first check can be signif­i­cant­ly reduced by avoid­ing repeat­ed itera­tions that waste time and resources. The Insid­er provides essen­tial direc­tion through this criti­cal transi­tion. Search for candi­dates who have had:

• Direct respon­si­bil­i­ty for procure­ment budgets with technol­o­gy purchase author­i­ty
• Experi­ence with technol­o­gy evalu­a­tion commit­tees
• Knowl­edge of frame­work agree­ments and purchas­ing organ­i­sa­tions

Search beyond gener­al health­care experi­ence to find individ­u­als with specif­ic purchas­ing author­i­ty in relevant insti­tu­tions.

Where do you find them?

Focus scout­ing efforts on former procure­ment officers and admin­is­tra­tors from major health­care insti­tu­tions. Ideal candi­dates under­stand both formal and infor­mal aspects of health­care purchas­ing within specif­ic markets.

Clini­cal leaders can provide essen­tial perspec­tives on health­care deliv­ery reali­ties and estab­lish credi­bil­i­ty with key stakeholders.Health tech must address clini­cal needs while integrat­ing effec­tive­ly into estab­lished care pathways. The Execu­tive Clini­cian contributes with:

• Insights on clini­cal workflow integra­tion require­ments
• Early identi­fi­ca­tion of imple­men­ta­tion challenges
• Credi­bil­i­ty with clini­cal users and insti­tu­tion­al decision-makers
• Guidance on outcomes measure­ment and value demon­stra­tion

Their perspec­tive ensures innova­tions trans­late effec­tive­ly into clini­cal value within the constraints of health­care deliv­ery models. The ideal Execu­tive Clini­cian combines clini­cal exper­tise with opera­tional leader­ship experi­ence:

• Senior clini­cal leader­ship role (medical direc­tor, chief nursing officer) in relevant special­ty
• Experi­ence imple­ment­ing innova­tion in clini­cal environ­ments
• Under­stand­ing of value measure­ment frame­works and outcomes evalu­a­tion

Focus on candi­dates who bridge clini­cal exper­tise with organ­i­sa­tion­al leader­ship, rather than solely acade­m­ic or research-orient­ed clini­cians.

Where do you find them?

Target senior clini­cians who have held leader­ship positions within European health­care insti­tu­tions. Depart­ment heads, medical direc­tors, and clini­cal trans­for­ma­tion leaders from univer­si­ty hospi­tals and major medical centres repre­sent promis­ing candi­dates.

The most valuable board members in this catego­ry have direct experi­ence imple­ment­ing similar technolo­gies and under­stand the clini­cal and organ­i­sa­tion­al dimen­sions of health­care innova­tion.

Commer­cial guidance from the MBA helps trans­late technol­o­gy into sustain­able business models. CXOs face diffi­cult commer­cial challenges, from diverse reimburse­ment mecha­nisms to complex stake­hold­er ecosys­tems. The MBA provides:

• Assess­ment of business model assump­tions
• Guidance on go-to-market sequenc­ing across segments and geogra­phies
• Resource alloca­tion for maximum market impact
• Finan­cial planning aligned with health­care funding reali­ties

Their exper­tise helps ensure commer­cial strat­e­gy aligns with the specif­ic charac­ter­is­tics of your target markets. Seek candi­dates with proven business experi­ence in health­care, such as:

• Experi­ence scaling health­care business­es across European markets
• Under­stand­ing of reimburse­ment and payment mecha­nisms
• Famil­iar­i­ty with health­care invest­ment landscapes and funding require­ments

Focus on practi­cal commer­cial experi­ence rather than purely theoret­i­cal business knowl­edge.

Where do you find them?

Ideal candi­dates include execu­tives who have success­ful­ly scaled health­care ventures, health­care-focused investors, or manage­ment consul­tants special­is­ing in health­care commer­cial­i­sa­tion.

Navigat­ing the nebulous regula­to­ry landscape requires highly special­ized exper­tise, often outsourced to profes­sion­al service providers. This becomes especial­ly challeng­ing for innov­a­tive products, where regula­to­ry frame­works are sometimes vague or still evolv­ing. The Regula­to­ry Expert helps:

• Deter­mine classi­fi­ca­tion pathways
• Design devel­op­ment process­es that incor­po­rate regula­to­ry require­ments
• Approval approach­es for speed and thorough­ness
• Antic­i­pate regula­to­ry devel­op­ments impact­ing future require­ments

Effec­tive regula­to­ry strat­e­gy prevents both unnec­es­sary compli­ance burden and market access delays. Your Regula­to­ry Expert should possess:

• Compre­hen­sive under­stand­ing of MDR, IVDR, and relevant pharma­ceu­ti­cal regula­tions
• Experi­ence with software as medical device (SaMD) classi­fi­ca­tions
• Famil­iar­i­ty with health technol­o­gy assess­ment process­es

Where do you find them?

For health­care technol­o­gy in Europe, regula­to­ry experts should under­stand both pan-European frame­works and nation­al imple­men­ta­tion nuances. For digital health solutions in partic­u­lar, guidance on software quali­fi­ca­tion and classi­fi­ca­tion is essen­tial.
Target regula­to­ry affairs direc­tors from estab­lished medical technol­o­gy compa­nies, consul­tants special­is­ing in health­care technol­o­gy regula­tions, or profes­sion­als with experi­ence at notified bodies. Indus­try associ­a­tions and regula­to­ry consul­tan­cies can provide connec­tions to suitable candi­dates.

Health­care technol­o­gy ultimate­ly succeeds through deliv­er­ing meaning­ful improve­ments for patients. The Patient Advocate ensures this perspec­tive remains central to decision making. As commer­cial and techni­cal consid­er­a­tions dominate board discus­sions, the patient perspec­tive is often neglect­ed. The Patient Advocate ensures:

• Focus on genuine patient needs and outcomes
• Identi­fi­ca­tion of adoption barri­ers from the patient perspec­tive
• Connec­tion to patient commu­ni­ties and advoca­cy networks
• Integra­tion of patient-report­ed outcomes into value demon­stra­tion

Seek candi­dates with:

• Experi­ence repre­sent­ing patient inter­ests
• Opinion leader­ship or influ­ence in patient advoca­cy organ­i­sa­tions
• Insight into patient technol­o­gy adoption barri­ers and enablers

Look to patient advoca­cy organizations—and surpris­ing­ly, platforms like Facebook can be effec­tive places to find these profiles.

Where do you find them?

Look for leaders from patient advoca­cy organ­i­sa­tions, health­care profes­sion­als focused on patient experi­ence, or individ­u­als bridg­ing clini­cal and patient advoca­cy roles. Patient repre­sen­ta­tives who have partic­i­pat­ed in health technol­o­gy assess­ment process­es, clini­cal guide­line devel­op­ment, or health­care policy initia­tives bring partic­u­lar­ly valuable perspec­tives.

Consid­er individ­u­als who have served on ethics commit­tees or patient adviso­ry boards for health­care organ­i­sa­tions, as they under­stand both patient needs and insti­tu­tion­al constraints.

Up Next: Board Structure

This article has outlined the essen­tial exper­tise profiles a success­ful board requires. In the next install­ment of this series, we will examine optimal board compo­si­tion, gover­nance struc­tures, and remuner­a­tion frame­works that ensure your draft­ed members become a winning team.

While identi­fy­ing and recruit­ing the right board members requires signif­i­cant invest­ment of time and resources, the return on this investment—measured in time to market and business model robustness—exceeds that of many other activ­i­ties. The most success­ful health tech compa­nies recog­nize that board construc­tion repre­sents a funda­men­tal strate­gic decision rather than a compli­ance require­ment.

In the meantime, begin evalu­at­ing your current or planned board compo­si­tion against these five essen­tial profiles. Identi­fy the most criti­cal gaps based on your specif­ic business challenges and stage of devel­op­ment, and start build­ing lists of poten­tial candi­dates who might fill these roles.

Healthcare Debuggged’s Board Registry

Finding the right board members—or finding the right board opportunities—shouldn’t be left to chance. That’s why we’ve creat­ed the Health­care Debugged Board Registry, a selec­tive network connect­ing health tech compa­nies with quali­fied board candi­dates who possess the specif­ic exper­tise profiles outlined in this article.

For Poten­tial Board Members: Do you have experi­ence in health­care procure­ment, clini­cal leader­ship, health­care commer­cial­i­sa­tion, regula­to­ry affairs, or patient advoca­cy? Your exper­tise could be instru­men­tal in helping the next break­through health­care innova­tion succeed in the European market. Contact us to be consid­ered for curat­ed board oppor­tu­ni­ties matched to your specif­ic exper­tise.

For Health tech CXOs: The right board can dramat­i­cal­ly accel­er­ate your path to market success. Rather than spend­ing months search­ing for candi­dates through fragment­ed networks, access our pre-vetted pool of quali­fied board candi­dates with the specif­ic exper­tise your compa­ny needs. Tell us about your compa­ny and board require­ments, and we’ll help you build the strate­gic asset your venture deserves.

Don’t be a stranger, write us!