Why HealthTech Pilots Stall—And How to Break the Cycle

Jan de Vries · 2026-11-03

Across Europe, HealthTech companies are building tools that could ease the burden on clinicians, improve patient outcomes, and stretch every dollar of public funding. Yet many of these solutions get stuck in the pilot phase, never achieving the widespread adoption that would make a real difference. This isn't a new challenge. Companies working with large public healthcare organizations—like the UK's NHS or Ireland's HSE—know the drill. These institutions operate at enormous scale, juggling patient safety, public accountability, and tight budgets. So it's no surprise that rolling out new technology often meets with caution. But when so many promising companies can't graduate from pilot to full deployment, you have to wonder: are these processes designed to welcome innovation, or to keep healthcare stuck in its ways? ### The Pilot Trap Pilots are a crucial first step. They let clinicians test a technology in the real world, see how patients respond, and iron out kinks before scaling up. The problem is that pilots often become the final step, not just the first. Why? Because the tough questions—who pays for the technology? Who's responsible for implementation? How will it integrate with existing systems? Who provides training and support?—are often left unanswered until it's too late. By then, momentum fades and adoption stalls. And let's not forget the human factor. The clinicians who champion a pilot are usually the early adopters, the ones excited about new tech. But their colleagues might not share that enthusiasm. A solution that works brilliantly in one department can face an uphill battle getting buy-in from stakeholders elsewhere. ### Procurement: The Familiarity Bias Procurement is another hurdle. Public healthcare organizations have a duty to spend taxpayer money wisely. They need suppliers who are financially stable and products that meet stringent clinical, technical, and regulatory standards. That's completely understandable. But for a young, unproven HealthTech company, this creates a catch-22: you need a contract to build your track record, but you need a track record to win a contract. Procurement requirements are often tailored to suppliers with years of experience securing public-sector deals, leaving startups out in the cold. On top of that, procurement decisions can lean heavily on price. A technology with a high upfront cost might struggle to get approved, even if it saves money down the line. The result? An unintended preference for established suppliers—even when a smaller company has a better solution. > "The irony is that by playing it safe, procurement may end up costing more in the long run—both in dollars and in missed opportunities to improve care." ### When Caution Becomes Culture Healthcare providers must ensure that what they offer the public is backed by strong evidence and accountability. That's non-negotiable. But when caution becomes the default culture, it can actually create new risks. Delaying the adoption of useful technology can harm patients, burn out clinicians, and waste public funds. So how do we break the cycle? It starts with acknowledging that pilots should be a bridge, not a destination. That means planning for scale from day one—identifying budget owners, implementation leads, and integration strategies early on. It also means rethinking procurement to give startups a fair shot, perhaps through streamlined processes for innovative solutions. Most importantly, it requires a cultural shift. Healthcare leaders must balance caution with curiosity, recognizing that innovation isn't a luxury—it's a necessity for sustainable, high-quality care.