How to move from a pilot project to a successful commercial project
The healthcare sector is flooded with innovation, but most pilots never scale. Interest is there, but converting a digital health pilot into a paying customer is a different story.
At this year’s HLTH event, industry leaders warned of “pilot fatigue” — the growing number of ventures stuck in endless trials that fail to mature into commercial partnerships. In fact, while 80% of healthcare leaders believe AI will transform care, only about 30% of pilots ever progress to full production.
Time and again, promising innovations stall at the pilot stage because the path to enterprise-wide deployment (and payment) is unclear. In 2025, over 80% of healthcare leaders believe AI will transform care, yet only ~30% of pilots ever progress to full production use.
Pilot success doesn’t guarantee scale. In this article, we explored why, and how to bridge this gap.
Why Promising Pilots Fail to Scale
A pilot can prove clinical value yet still falter commercially:
- No Clear Path to Payment: Many pilots run on one-off deals or pilot budgets. If there’s no reimbursement code, billing plan, or budget line for the product after the pilot, adoption stalls.
- User Success vs. Buyer Requirements: A pilot may suit end users (clinicians, patients) but still fail to meet the criteria that buyers or budget-holders need. Patient and clinician benefits don’t always translate into business impact for the hospital or payer.
- Evidence and Outcomes Gaps. Pilot studies often involve small samples and short durations. Health systems and payers, however, demand robust evidence of clinical efficacy, economic value, and operational feasibility before broad adoption.
- Pilot, and Now What? It’s easy to fall into the trap that securing a successful pilot is the finish line. It’s not. Your pilot is your starting point, and without a post-pilot game plan place (identifying budget sources, procurement steps, and scaling milestones), it will be almost impossible to get to your paid invoice.
Aligning User Success with Buyer Needs
Reconciling frontline enthusiasm with executive approval is key.
To ensure a pilot’s success criteria satisfy both users and buyers:
Identify Alpha Pilot Sites
Define one or two alpha pilot sites where target users can test and help refine the product before wider release. These early users should work collaboratively with your development team to anticipate and resolve challenges. Make sure there is additional value for them (discounted pricing, early-adopter recognition, etc.), as these sites are hard to come by.
Build Value for Both Users and Buyers
Develop a value story that speaks to both end users and economic buyers (hospital administrators, payers). Explicitly tying pilot outcomes to metrics that matter to purchasers helps ensure successful scaling and conversion into paying customers.
Internal Champion
Identify a respected insider who will advocate for the solution. This champion should have the influence to navigate institutional decision-making. Startups and product teams report that a strong champion who can “lay out a clear plan to secure stakeholder buy-in” and circulate pilot success data is often the linchpin in moving from test to enterprise deal. Equip champions with clear evidence (metrics, case for change) they can easily share.
Engage Stakeholders Early
Don’t limit pilot planning to the end-user department. Plan backwards from the invoice, and involve IT, legal, compliance, and finance teams — the stakeholders who will scrutinize the solution before any large purchase. Address their concerns early (data privacy, cybersecurity, integration with existing systems, contracting terms).
Measure What Matters to Buyers
During the pilot, track outcomes that demonstrate business value, not just user satisfaction. Alongside clinical metrics, capture data on workflow efficiency, cost impact, revenue capture, patient retention, or other key performance indicators. This creates a business case to justify scaling. Essentially, translate clinical success into economic and operational terms. If users love the tool but the CFO sees no financial rationale, scaling will languish.
Invest in Operational Support During Pilots
Treat even a small pilot like an implementation project. Allocate sufficient staff or vendor support to ensure smooth integration. If nurses are testing a new device, have training sessions and IT on-call support available. Research shows that even small pilots can be “big lifts” for frontline teams. Providing training, budget, and staff support helps embed the innovation into everyday workflows. This not only improves pilot success but also prepares the organization for what a scaled deployment will entail — and reveals the true resources needed for scale.