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Health care investing demands thorough clinical diligence

Harsha Moole, MD
Finance
April 12, 2026
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Your hospital recently adopted a new piece of technology. Maybe it was an electronic health record (EHR) module. A patient monitoring upgrade. A documentation tool. A new device in the operating room (OR). Think about what happened next. Some of your colleagues embraced it. Others resisted. The nurses figured out workarounds within a week. The information technology (IT) department sent three emails about training sessions that nobody attended. Six months later, half the staff is using the new system and the other half found a way to keep doing things the old way. A year later, someone in administration is quietly evaluating whether the purchase was worth it.

If you have worked in a hospital for more than a year, you have lived through this cycle at least once. What you probably do not realize is that you just participated in the same evaluation process that venture capitalists use to decide whether to invest millions of dollars in a health care company. You just did it from the other end.

You are already evaluating health care products

Every time your hospital introduces a new technology, you unconsciously run an assessment that mirrors the core of health care venture capital diligence.

You evaluate clinical necessity. Does this product solve a problem I actually have, or is it a solution looking for a problem? You know within the first week of using a new tool whether it addresses a genuine pain point or whether someone in procurement was sold on a demo that looked better than it performs in practice.

You evaluate adoption feasibility. Will my colleagues actually use this? You watch the rollout and immediately identify who adopts and who resists, and more importantly, why. Is the resistance because the product is poorly designed, or because the training was inadequate, or because the switching cost is too high? These are the exact questions investors should be asking before they fund a health care company, and they are questions only clinicians can answer with authority.

You evaluate workflow integration. Does this fit into how I actually work, or does it add friction? You notice every extra click, every additional step, every moment where the new system forces you to break your clinical flow. The difference between a product that gets adopted and one that gets abandoned is often measured in seconds of added workflow time, and physicians are the only people who can feel that difference in real time.

You even evaluate reimbursement viability, though you may not call it that. When your hospital’s value analysis committee rejects a product because the cost cannot be justified against existing reimbursement, or when a promising device gets shelved because there is no billing code for its use, you are watching the reimbursement gate in action. You see, firsthand, how payment dynamics determine which innovations survive and which ones die regardless of clinical merit.

The gap between the hallway and the boardroom

Physicians perform this evaluation constantly, automatically, and with clinical granularity no financial analyst can match. But it almost never reaches the people making investment decisions.

When a venture firm considers funding a health care startup, they analyze market size, competitive landscape, and revenue models. What they rarely do is ask a floor physician whether the product will actually be used. They do not poll nurses about workflow integration. They do not sit in on a value analysis committee meeting.

The result is a persistent disconnect. Investors fund products that look great in pitch meetings. Hospitals buy products that look great in procurement demos. And physicians find out about the product when it shows up on their unit with a mandatory training email.

Three questions to start asking differently

You cannot change how your hospital makes purchasing decisions overnight. But you can start translating your clinical evaluations into the language of health care investing, and in doing so, you will discover that you already have skills the investment world desperately needs.

The next time your hospital adopts a new technology, ask yourself three questions.

First: Would I have funded this? Based on what you know about the clinical problem and the adoption barriers you have observed, would you have put money behind this product? If the answer is no, that gap between your assessment and the investor’s decision is exactly the clinical insight health care funds need.

Second: What would have made this better? If someone had asked you before the purchase whether this product would be adopted, what would you have told them? If your answer would have changed the decision, your clinical judgment has investment-grade value. It just was not solicited.

Third: What problem in my daily practice still does not have a good solution? The workflow bottleneck you have been living with for years. The documentation gap nobody has fixed. Those unsolved problems are where the next generation of health care companies will be built, and you are the person best positioned to identify them.

From informal evaluation to formal impact

Physician-led investment networks are emerging that formalize what physicians have always done informally, applying clinical judgment to health care products and connecting that judgment to actual investment decisions. The same evaluation you perform when your hospital rolls out a new tool is the same evaluation that should happen before a venture fund writes a check.

Clinical diligence is only the first layer

Everything I have described so far, evaluating clinical necessity, adoption feasibility, workflow integration, represents the clinical diligence layer. It is the layer physicians are naturally equipped for, and it is the one most investors skip entirely.

But clinical validation alone does not make something a good investment. A product also has to survive the regulatory gate, navigating Food and Drug Administration (FDA) pathways for devices and drugs, or hospital IT security and compliance standards for health tech. Each pathway carries vastly different timelines, costs, and probabilities of success. And it has to survive the reimbursement gate, the question of who actually pays. Is there an existing billing code? Will insurers cover it? Will health systems absorb the cost?

A product can be clinically excellent, beloved by physicians, and still fail as an investment because the regulatory pathway takes five years longer than projected or because no payer will reimburse it at a price that sustains the business. A good product and a good investment are not the same thing. Learning to hold both evaluations simultaneously, clinical merit in one hand, commercial viability in the other, is one of the most important skills in health care investing. And it starts with the clinical layer that you are already performing every day.

You have been doing venture capital diligence your entire career

The skills are not new. The application is. And the physician who recognizes that their daily clinical evaluations are actually investment insights is the physician who starts shaping what gets built, not just what gets used.

You just did not know it had a name.

Harsha Moole is an internal medicine-trained physician-scientist with more than 100 peer-reviewed publications, including work featured in the New England Journal of Medicine. After years of clinical practice and gastroenterology outcomes research, he made an unconventional transition from the bedside to the boardroom by founding PhysicianEstate, a health care-focused venture capital firm.

Over the past seven years, Dr. Moole has made 22 early-stage health care investments across digital health, medical devices, biotech, and therapeutics. He has also built a network of more than 200 physicians from institutions such as Johns Hopkins and Stanford who help source opportunities and provide clinical diligence before capital is deployed. His core thesis is that physician-scientists with firsthand clinical experience are uniquely positioned to identify health care investments that generalist investors often miss.

His research background is reflected in his publication record on Google Scholar, and he shares professional updates on LinkedIn.

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