— The Product and Business Design of a Healthcare Startup

Irving Rivera
Dec 20, 2018 · 15 min read is a marketplace that connects potential clinical trials volunteers to medical researchers with just one-click.

However, we didn’t always have such a clear vision or polish product. In fact, this all started by winning the Startup Weekend Fort Worth 2014 Competition. In this case study, I will tell you our full story about our humble beginnings, successes, and failures using the jobs-to-be-done framework.


Back in 2014, after 5+ years of active duty service with the United States Army — I decided that I was ready for a career change. The reason why I started teaching myself digital design and participating in networking events such as Startup Weekends.

One of such events was Dallas Startup Weekend: Health Edition 2014. Where our team lead by Daniel won second place with Health Record Trust a software service that removes personally identifiable information from EHR health records and deliver HIPAA-compliant data. There while working on the business model for this startup, I had a eureka moment. Mmhh these medical records look like a Soldier’s record brief — so I wonder if they could be used for a similar purpose.

With this idea in mind, I started doing some research and I was right. In the same way, I use the Soldiers’ Record Brief for placing officers into qualify positions. Researchers do use medical records to match patients to clinical trials. However, I needed to be sure about how this industry works since I did not have a background in healthcare. So it was time to run a lean startup MVP experiment to validate this idea — and that was exactly what our team did during Startup Weekend Fort Worth 2014.


The clinical trials market is very fragmented and providers only offer useless directories or newsletter services.

The clinical trials matching process still relies on the manual labor of recruiters operating under referrals and commissions plans.

Most volunteers refer other friends and family members to participate in paid clinical trials — for a viral coefficient K = 1.8 + 0.95


To test these insights we decided to build a LeadPages’ landing page asking potential clinical trials volunteers to apply.

We drove cold paid traffic to this page using Google Adwords and the term “high cholesterol paid clinical trials.” At the cost of $4.30 per click.

In order to see if the applicants qualified for this type of clinical trial. We designed a Typeform survey asking for the personal medical profile (BMI, cholesterol level, etc.) of the volunteer.


We received 132 clicks on our MVP page and out of those only 21 decided to apply.

After reviewing their answers to the surveys, only 1 in 9 matched the inclusion and exclusion criteria of the clinical trial.

Given these conditions, I concluded that the unit economics of a marketplace for clinical trials could be expressed as the following:

  • CAC: $77.40
  • Success Fee: $299
  • LTV: $744.85

Startup Weekend Pitch Deck 2014


Based on this unit economics and the interesting challenge of building an intelligent marketplace for the application and matching of clinical trials. I decided to commit myself a 100% into solving this problem. However, like any other successful startup in history, I needed to find my why.



Core Values

Market Size


Unmet Needs

Newsletter solutions are not timely or relevant to the volunteers’ needs. They just spam subscribers based on broad categories such as locations and illnesses.

ODI #1

  • Building an instant email notification system for matched (no published) clinical trials

Directories don’t solve the matching and discovery problem of finding the right clinical trial for a specific condition. Additionally, the application process is a handoff to offline channels without a repeatable or scalable workflow.

ODI #2

  • Building a matching algorithm that can qualify the volunteers online. Reversing the workflow by having the clinical researchers apply to the volunteers’ medical profile

Widgets don’t keep the information provided in the database making their users input the same data each time. They are just a glorified search filter for directories.

ODI #3

  • Building a platform with a relational database that works in the background applying and matching the volunteers’ medical profile to the right clinical trials for their specific condition

Apps are not putting the success of their users first. They depend on big pharma contracts and unsolicited referrals.

ODI #4

  • Building a cross-device free marketplace that puts the success of their users first. By offering a single step application process for both volunteers and researchers

Problem Statement

Currently, the search, application, and matching process for clinical trials is very tedious and ineffective — for both volunteers and researchers. Due to the complexity of having to operate in a very fragmented market. That still relies on the manual labor of recruiters — and where over 50% of all clinical trials are failing to enroll more than one candidate per study.

The reason why pharmaceutical companies are paying thousands of dollars, for single patient enrollment into a clinical trial — that it could take up to 300 days to randomized.


Volunteers’ Persona

Messaging helps you connect with the right medical trial for your specific condition with just one-click.

Researchers’ Persona

Positioning is a risk-free marketplace for clinical trials that can help you get more volunteers for your studies with zero contracts or setup fees.

Design Principles

Style Tile

Webapp Workflow

AARRR Funnel


In our quest of solving our users’ problems and unmet needs in the most effective and intuitive way. We borrowed from the most popular mental models and design patterns to ideate and prototype our artifacts in congruency to our design principles.

Website Homepage

Website Blog

Company Profiles

Clinical Trial Applications

Forms Interactions

One-click API

Transactional Emails

Android Wireframes

iOS Wireframes


Visitors’ Clickthru

Researchers’ Clickthru

Volunteers’ Clickthru

Native Apps Clickthru

ClinicalSolutions Health Wildcatters Pitch Day 2016


Most of the user research and validation for this project was done in-person or via phone call. However, most of the really valuable insights came from the impromptu feedback of users via email and in-app messaging.

User Testing

Following industry best practices we conducted our usability testing with the support of remote tools such as Hotjar. In order to leverage the authenticity of having customers use their own devices, in their own environment, and in their own terms without our external influence. Helping us understand how would they use our webapp on their own without us coaching, influencing, or pitching our value proposition before they interacted with the product. Resulting in:

  • Average time to completion 5–20 minutes
  • Better progressives disclosures and skipping options
  • Smarted selection of mandatory and optional input fields

Email Architecture

Having tested our app and validated the user-flows interactions we were now ready to fully map out our transactional emails architecture. Based on the entire webapp workflow and pirates metrics requirements.

Native App Wireflow

With the goal of having a delightful user experience while being platform agnostic. We designed a user flow that will fulfill our promise of service — of connecting clinical trials applicants to medical researchers with just one-click.

Content Strategy

Like any other startup, one of the most important parts of a successful business is our customer acquisition strategy. With this in mind, we developed a content strategy and information architecture for our inbound traffic to our blog. Taking into account the most popular search terms and queries intent.

Health Wildcatters Application Pitch 2016

At this point with a fully developed MVP and validated idea. I decided to apply to multiple startups accelerators especially those with a vertical dedicated to healthcare such as Health Wildcatters — in which we were admitted.


Implementing a good marketing and sales plan is especially important for all young startups even more so when building a marketplace — since you have to solve the same problem twice. Particularly intriguing and challenging in B2B sales because you always get asked the same two questions:

  • How many users do you have and how are you getting them?
  • For whom have you done this in the past and what were their results?

The Supply (Researchers) | Outbound

In order to implement a successful sales strategy, I learned and borrowed from the best practitioners across all industries. Implementing the same mental model recruiters are using in the HR business of enterprise sales.


Now the best part about working in a very competitive landscape against companies that don’t put the success of their users first — is that they are basically building a directory. Listing all your potential customers.


After identifying the correct email addresses of your future clients the first step is to allow them to self-qualified themselves. And with the right CRM tool, you can quickly identify who is interested in your offer by the way they react to your emails. Additionally, at this point don’t forget to pixeled them for your future ABM strategy.

Account-based Marketing


Now that you have their attention is time to personalize your message directly to them by delivering value. Show them the gap between their current recruitment efforts and your proprietary solution. This is one of the highest conversion strategies pioneer by the experts at HubSpot Labs with their Website Grader.


Time to start closing your prospects if the previous step did not get you the phone call. This one will. Show them was is in it for them — the ROI. Virtually give them the product for free so if they really want it. All they need to do is to ask for the real-life version.


This should be the last step of their buyers’ journey if they don’t close here move on to the next one. Here you want to tell them the blue-skies story — the grow or die dilemma. At no fault of their own but for the mistake of not taking action today in an ever-evolving market. Reference Zuora’s greatest sales deck.

The Demand (Volunteers) | Inbound

Our value proposition for volunteers is pretty easy to understand — that is if you are looking to participate in a clinical trial. So our job here is to get in front of these users as their first and best choice.

Content Marketing

The purpose of this funnel is to get in front of users that based on their interests and behaviors in social media. They specifically demonstrate their potential diagnosis of the illnesses we are recruiting for.

Paid Media

Based on the same principles of self-selection — here we only target users that match our recruitment efforts and clinical trials listings.

Measure & Analyze

Needless to say that if you don’t track it. It doesn’t happen! However, more than doing things right sometimes is even more important to do the right things. A reason for us to establish the right KPIs from the get-go such as:

  • Burn Rate (Costs)
  • Number of Matches (Revenues)
  • Number of Clinical Trials (Product)
  • Number of Registered Volunteers (Users)

Phase I Researchers Acquisition

After over a hundred touch points with potential customers, most objections and concerns started to sound alike. Landing in the areas of how works, track record, and pricing. So given these conditions, it was pretty easy to design a sales script that anticipates the customers’ questions even before they asked them.

Phase II Volunteers Acquisition

Given that our customer acquisition plan for volunteers is based on a converged media plan is extremely important to track the performance and effectiveness of our efforts across all channels. One of the best ways to do so is with a proper UTM linking structure such as:


Additionally, never forget to make sure you are using the conversion tracking pixels offer by most paid media providers.


After implementing, measuring, and analyzing the overall user experience of the entire product and the performance of all of our customer acquisition campaigns. I discovered that even though our execution was being very effective at the input level. The outputs and unit economics of this business on its current form are unprofitable.

Researchers’ Customer Development

The most important discovery of talking and dealing with our clients that we found was that even when we created a very intuitive interface for ease of use and self-serving capabilities. Research sites owners prefer the white glove treatment of having us create their company profiles and list their trials for them — which is not a big deal. However, this triggers the need for us to develop a super admin dashboard where we can serve, track, and report the matching of each volunteer for all paying customers.

Interactive Invision Prototype

Volunteers’ Customer Development

What we learned here was super interesting and informative. At the beginning of this project, we defined our target volunteer’ persona as a patient with a terminal disease. However, during the execution of our customer acquisition campaigns, we discovered that our most effective customer avatar are patients with chronic conditions such as Arthritis, Type-2 Diabetes, Major Depressive Disorder, etc. Because these kind of users are highly motivated and eager to improve their quality of life. Unlike terminally ill patients who only tend to follow the predispose standard of care.

Product-Market Fit

So did we find product/market fit? I do believe so myself. Even though our units economics are as harsh as Uber’s and other share economy startups like the food prep and delivery services. Because we did connect clinical research site owners with chronic disease patients with just one-click.

Post Health Wildcatters Deck 2017

Now after having conducted our customer development process and adjusted our business model to better serve our target personas — this is our current investors’ pitch deck.


So before I bored you, with all the corporate documentation, we use here at I want to talk about how I managed this project. Being in charge of such a massive endeavor was not as hard as it seems. However, it did take a lot of work since I was responsible for every moving piece of the project. In order to better explain this let’s break down some aspects of this project in agile terms — because this webapp had three major epics with the following user stories:

Admin’s Module

  • Software Intelligence
  • Users Management
  • Listings Management
  • Transactional Controls

Research’s Module

  • Registration
  • Trials Listing
  • Selections and Payment

Volunteer’s Module

  • Registration
  • Medical Profile CRUDs
  • Match Making

Since the tech development of the project was outsourced to a remote IT company I managed each sprint with something I like to call the Kanban Document. Where I used to review the prior day’s work using a two-columns approach full with detailed instructions and marked screenshots.

Regulatory Concerns

Being that we are a healthcare startup regulatory concerns are kind of a big deal for us. The reason why we made the security and privacy of our users our number one priority. Technology wise we keep everything encrypted and we require double opt-in and double confirmation for all user actions. Additionally, we operate under very strict terms of service and privacy policies. Moreover, is that our target market is the clinical trials recruitment industry I made sure to collaborate that our practices are within the bounds of the law and ethical procedures established by the U.S. Department of Health & Human Services and the Institutional Review Boards.

Due Diligence

In case you haven’t figured it out yet. Let me tell you that I am a huge nerd. So consequently, I love excel and spreadsheets — here I track everything to the micro-penny. Keeping everything inside their unique folders and named with the following nomenclature.

Company Name — Document Name — YYYYMMDD

Additionally, let me give special thanks to my BAIL team (Banking, Accounting, Insurance, Legal) and the teams at Stripe Atlas and Zenefits for their amazing support and care.

Investors’ Updates

Much as been said about how to keep investors in the loop to avoid misunderstandings or surprises. First when possible always share your news in person. For monthly updates, I use the following format of having two main sections inputs and outputs. In the inputs section I list and describe the actions and artifacts I produced during the past month — I call it doing my job. For the outputs, I show and share the company’s KPIs — the effects of my inputs and actions… because remember no plan survives contact with the enemy.


The most rewarding part of this project was meeting the great people that work in the healthcare industry from different backgrounds and levels of experience. Interviewing potential clients and users was super informative and full of surprises. For all the good ones and the bad ones — from when my assumptions nailed the product design and for the times that I came short. But all these learning experiences was what made possible the product that you see here today at

Lessons Learned

The following is just a few points from a list of things I know now that I wished I knew then — before I started this company:

  • Buyers go for the less risky solution, not the less expensive one
  • Customers are interested in randomized applicants, not just leads
  • Tailored questionnaires are still an important part of the recruitment process
  • The paid clinical trials market is an entirely different market from the therapeutic one
  • Your biggest competition are customers not taking action — is not your competitors

Future Features

One more thing…

More than accelerating the development of the lifesaving drugs we all need. I firmly believe that whoever can build a portable medical identity with networks effects for patients regardless of their EMR provider can become a billion dollar company. And I am sure that’s API feature can become the one — by giving you personalized health and fitness recommendations.

Design Portfolio

Irving Rivera’s Design Porfolio

Irving Rivera

Written by

Interaction Designer currently @TCS but previously @HWildCatters @designationio @USArmy @uprm | #CX #HCI #IA #IxD #UCD #UI #UX

Design Portfolio

Irving Rivera’s Design Porfolio