Funding Permissionless MedTech Innovation Globally

Funding Permissionless MedTech Innovation Globally

Unlocking global capital for untapped markets through credentialed trust

Aneesh Sathe and Rahul Garg

Executive Summary

We intend to create and test blockchain protocols that improve the way investors and MedTech startups communicate for due diligence. Introducing a double-blind review and standard evaluation protocols, we aim to make investment processes more efficient, transparent, and democratized, especially where MedTech infrastructure is underdeveloped. We also seek to create a generalizable universal design applicable to other complex technologies.

Problem Statement

Despite the growing MedTech industry, inefficiencies in investor-startup interactions are fraught with challenges, including lengthy due diligence, knowledge asymmetry, and a lack of standardized evaluation metrics. These challenges derail investments and hinder much needed innovation especially in the underserved markets.

At a higher level, the collective action of venture capital firms and their respective capital markets are emergent gatekeepers for global MedTech innovation.


We propose to create a portfolio of protocols that not only accelerate investor-startup interactions but also bring greater clarity and trust in the investment evaluation process. Democratizing the investment opportunities would help sidestep financial gatekeepers making way for permissionless innovation in MedTech.

Our solution is a double-blind peer review mechanism, allowing investors to obtain unbiased evaluations of startups. Experts, including seasoned MedTech professionals, doctors, legal advisors, regulatory experts, and investment bankers, will assess the technological viability, market potential, and legal compliance of startups anonymously. This platform will serve both investors and founders, ensuring informed decision-making, reducing investment timelines, and increasing the credibility of startups seeking funding.

At the technology level we expect to use (but need to research) blockchain and zero-knowledge proof approaches to create high-trust reports (through on-chain attestation) while maintaining anonymity. Tokenization with legal wrapping would enable easy issuing of equity to individuals. The community of MedTech experts would participate in an on-chain platform enabling communication, credential verification, work tracking, and payments.


We aim to create an abstraction boundary around the data-room evaluation process, which is the current default to evaluate startups. By creating an on-chain protocol for expert evaluation we would create a high-value public good dropping barriers to both raising funds and investment participation. Akin to the postal service, the protocol would deliver a complex but high-trust output on a global scale.

1. What is the existing target protocol you are hoping to improve or enhance?

  • The existing target protocol aimed for improvement is the communication and evaluation process between investors and MedTech startups. This includes the mechanisms for due diligence and startup evaluation in the MedTech sector. This will also reduce the barriers to entry for individual investors to participate in startup funding.

2. What is the core idea or insight about potential improvement you want to pursue?

  • Investors rely heavily on domain experts when making investment decisions. However, most of the time access to experts is limited leading to investors passing on good investments and startups unable to raise. If the due diligence process were unbundled, the resulting service would enable stronger investments and open the doors to a new population of investors.

3. What is your discovery methodology for investigating the current state of the target protocol?

  • Our research process involves the interrogation of current inefficiencies in investor-startup engagement. This could include expert interviews, analysis of the current investment processes, and examination of challenges faced by startups in securing funding.

4. In what form will you prototype your improvement idea?

  • We would reach out to our network and create a mini version of the due diligence service and offer it as a test to both startups and VCs.

5. How will you field-test your improvement idea?

We will likely run pilot programs of an alpha version of a blockchain protocol with MedTech startups and investors to assess the efficacy and impact of the protocols on investment cycles.

6. Who will be able to judge the quality of your output?

7. How will you publish and evangelize your improvement idea?

We would create a design specification to enable permissionless development of blockchain applications to deliver the various services required to support the due diligence process.

8. What is the success vision for your idea?

  • The success vision would be the creation of an on-chain foundation to enable investment in MedTech startups using the due diligence protocol to validate technology and investment opportunity.
  • In the bigger picture, we hope that our work would enable the creation of similar platforms to tap on expertise beyond MedTech.

First up, I wanted to shout out product risks as a little framework. There’s four conventionally (value, usability, feasibility, viability) and a fifth (ethicality):

  • Value risk (whether customers will buy it or users will choose to use it)
  • Usability risk (whether users can figure out how to use it)
  • Feasibility risk (whether our engineers can build what we need with the time, skills and technology we have)
  • Business viability risk (whether this solution also works for the various aspects of our business)
  • Ethicality risk (whether this solution is or could be considered to breach some ethical constraint)

These are all probably applicable for evaluating and communicating MedTech proposals and opportunities/risks. There’s a bunch of useful fictions and models associated with each that could probably be leveraged or refactored for your purposes.

Second, Boydian strategic theory (see Coram’s Boyd biography and Osinga’s Science, Strategy and War) has this notion of “people, ideas and technology; in that order”. Interestingly, whilst reading Mukherjee’s The Gene there was an epigraph/quote from Sydney Brenner which posited the opposite: something like “Progress in science depends on new techniques, new discoveries and new ideas, probably in that order.”. The juxtaposition…

  • Boyd’s people > ideas > technology vs.
  • Brenner’s techniques > discoveries > ideas (people being last, I guess)

…struck me as being particularly relevant to how operators vs academics may perceive the MedTech space, and thus how miscommunication can emerge.

An additional wrinkle to the academic vs. operator frame is another Boydian quip: I recall Boyd hearing of pilot safety rates during training and bemoaning the lack of fatalities (probably ironically, rather than literally)—pilots weren’t dying so the boundaries were not being sufficiently probed. Contrast that with the risk appetite in clinical areas like genetics (e.g. the recurring generational moratoriums on certain subsets of research). A potential, completely opposite stance to risk for MedTech innovators vs capital allocators could be at the root of miscommunications?

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Thanks a ton for your feedback Matt.

Absolutely agreed on the risks, I’m especially concerned about the usability and feasibility risks in our proposal. Specifically bringing a global community onto an on-chain platform with the specific intent of peer review.

I am very much biased toward’s Brenner’s view: in the world of medicine/biotech ideas and innovations simply cannot be explored unless some underlying platform/technique is developed. Take the example of the thermocycler. Most of modern genomics would be impossible without that “little” technique.

About the capital allocators vs medtech innovators’ approach to risk: The whole reason for this PIGgy is that I wish the allocators had as much technical depth to have such a stance. It’s not just that there are miscommunications, there are fundamental gaps in knowledge which makes investing more like approximate betting. This leads to weird situations like Theranos, while thousands of startups gasp for funds.