Among those in the audience were Capital Readiness Program Cohort 8, a group of cutting-edge entrepreneurs who had just arrived for a week of intensive learning – who benefited from being the only startups in a room with decision makers representing a complex matrix of payors, providers, and clinicians.
What followed was a substance-packed panel that explored the pressure points in nursing, why trust is needed to scale, how AI can help or hinder progress, and – importantly – what is needed for innovations to truly last.
Here are the takeaway from the conversation between Caroline Brown, Founder and Principal, CDB Strategy + Advisory Services, Robert Cohen, President of Digital, Robotics, and Enabling Technologies, Stryker, Craig Gravitz, Director of Project Accelerator Transition Innovation Office, ARPA-H, and Mary Varghese Presti, Corporate Vice President of Health and Life Sciences at Microsoft.
Identify the Friction Points Are in the System
If you speak to enough nurses about their experience with entrepreneurs and their ideas for transforming the healthcare system, one theme becomes clear: many would-be innovators are skipping the core part of customer discovery by cutting nurses out of the conversation, only involving them at the end of the development cycle when there’s a tool to implement. And that’s when things can fall apart: what works well in theory, may add friction in practice.
“There are some cultural things going on that put nurses in a position where it can be really difficult to advocate for solutions that make their lives better, yet they’re the number one driver of patient satisfaction and outcomes,” explained Caroline.
Companies often focus on solving problems that lack a path to scaling, ignoring the pressure points in the system that nurses and hospitals are actually facing.
“Think about the healthcare system as a customer… what are the pressures nurses are under day by day, and what do founders miss by not engaging them early on?” Asked Mary, pointing out that entrepreneurs sometimes spend a lot of time building something that nobody actually wants.
Caroline agreed, noting that trust is essential to having a successful product, and trust comes from integrating nurses into the decision-making process early on. “From a trust perspective, one of the biggest barriers is not building that trust from the front end,” she explained. “Companies have a tendency to focus on the transactional rather than the customer's needs.”
These moments of friction - where a tool disrupts workflow, adds burden, or ignores frontline realities - are exactly where trust is built or broken, and where meaningful innovation either takes root or falls flat. And entrepreneurs need nurse buy-in from the get-go if they want to be able to scale their company – because if nurses don’t trust in the product, it’s not going to move forward.
“I think about the way nurses are trained - nurses as a population follow ‘trust but verify.’ They do the work but they always check. They are that last mile and the buck stops with them - and they're checking everything,” added Mary.
Think Tank: AI Meets the Front Line
Innovation Must Scale: What Makes Innovations Real Enough to Last
Nurses don’t always have a seat at the table – even when they ought to. Despite being the primary end-users of many of the new technologies and innovations that are implemented in healthcare settings, they are often underrepresented in the C-Suite – or missing altogether.
And that matters – because aligning innovation with clinical workflows, economic realities, and the needs of the people delivering care is what gives a solution staying power.
“Nurses are the number one driver of things like customer satisfaction,” noted Caroline, pointing out that entrepreneurs would be wise to start tackling these types of problems – as they’re problems that can truly make or break a healthcare system. “There’s a couple things you can do around nursing retention and how it relates to AI - new nurses burn out after two years.”
Robert said that telehealth coaching and support via AI for first and second-year nurses could be a novel use of technology – while solving for an actual issue health systems are encountering. According to a 2025 report published by NSI Nursing Solutions, the average turnover cost for a bedside RN is around $61k, resulting in the average hospital losing between $3.9m – $5.7m per year. AI innovations that could meaningfully reduce a hospital’s turnover rate by offering first-time nurses support and guidance would likely make the jump from pilot to infrastructure.
Asking the Right Questions is Key to Successful Innovation
The healthcare space is a complex matrix of incentives, regulations, and human behavior. AI redesigns need to consider workflows, trust, and context of use - otherwise they risk simply adding friction to the system, rather than adding value.
Founders musts ask themselves early on: who pays for this? Who benefits? Who loses? Startups must think broadly about customer discovery and consider everyone who will interact with their product to fully understand the pain points it’s solving for.
And as long as nursing is treated as a workforce constraint, not a co-creator of innovation strategy, healthcare solutions will continue to miss the mark.
