Start With the Problem

Healthcare is filled with well intentioned solutions. Yet the people working inside healthcare also know how often a solution creates another task, another login, another workflow, another form, or another responsibility without addressing the reason the problem existed in the first place.

That is why our philosophy at 1st Acuvenas begins somewhere simpler: start with the problem. And sometimes that means starting with the person.

Human centered design offers an important lesson here. Harvard Medical School describes the approach as beginning with people and asking what they feel, say, need, value, and what obstacles stand in their way. One example described a patient initially viewed as “noncompliant” because she repeatedly missed appointments. Listening revealed something very different: attending the appointments threatened her ability to keep her job as her family’s breadwinner. The underlying problem was not indifference to her health. It was the way care collided with her life.

A systematic review examining design thinking across healthcare found 24 studies covering numerous health conditions and system processes. Twelve reported success and 11 reported mixed success. Importantly, the four studies directly comparing design thinking interventions with traditional approaches reported better satisfaction, usability, and effectiveness, although the authors also emphasized significant methodological limitations in the evidence base.

So this should not become another fashionable slogan. It is a discipline: listen, observe, define, test, learn, then build.

Technology should follow the problem, not lead it, and that principle becomes even more important as healthcare organizations gain access to increasingly powerful technology.

The World Medical Association’s 2025 guidance on medical technology development stated the principle clearly: start with real clinical problems rather than technology hype, understand stakeholders and workflows, and validate the problem before choosing a technological solution.

Harvard’s Global Health Institute recently described a similar approach in global health research. Instead of beginning with a dataset or new tool, researchers profiled by the institute begin with the people most affected, identify the gaps they experience, and then work backward toward the research or technology that might actually help.

That resonates deeply with what we are trying to build, because the objective is not technology, not another company, not another application. The objective is a better outcome.

Sometimes technology will help produce it. Sometimes better communication will. Sometimes the answer is a redesigned workflow, clearer accountability, a partnership, or simply a human being picking up the phone at exactly the right moment.

This philosophy extends far beyond case management. A physician practice may have a patient communication problem. A hospital may have a transition problem. A home based organization may have a documentation problem. A community organization may understand a need but lack the infrastructure to respond to it. An executive may see a recurring operational failure without knowing which discipline is needed to fix it. A public organization may have resources that are difficult for people to navigate. An entrepreneur may have built something technically impressive that does not fit the way healthcare actually operates.

These may look like entirely different challenges, but the same discipline can apply to all of them: understand what is happening, listen to the people experiencing it, separate the symptom from the cause, identify what has already been tried, determine what expertise is actually required, then decide what should be built.

That is also how we think about our own ventures. We do not believe every problem deserves another company, or another platform. Some problems need better execution. Some need better information. Some need a different relationship or specialized expertise. Some deserve infrastructure that does not yet exist. Our responsibility is to know the difference.

That means being willing to say we do not know yet, then doing the work necessary to understand.

I believe there is something powerful about building that way. It keeps ambition connected to reality, innovation connected to people, and technology connected to purpose. And it keeps the people closest to the problem inside the conversation instead of treating them as an afterthought.

At 1st Acuvenas, that is the standard we want to keep returning to as the enterprise grows: build close to the problem, think beyond the problem.

Because before we ask what we can build, we should understand what is truly worth solving.