Two years ago, I had a vision for Consolidate Health that was completely different from what we're building today.

I wanted to create a real-world evidence platform where patients could monetize their own health data. Buyers such as researchers, pharma companies, insurers would purchase data directly from patients, with patients sharing in the economic value their data created.

It was a compelling vision. Patients taking ownership. Data democratization. Aligned incentives.

We spent two years building toward it.

Then we pivoted.

The Conversation That Changed Everything

The turning point came during a conversation with an advisor who's also a VC investor. She didn't sugarcoat it.

"Your core tech is really good," she said. "But your go-to-market is off."

She pointed out that we'd reached about 1,000 patients and secured a few unpaid pilots. Respectable progress. But she asked the question I'd been avoiding: "How does this scale?"

The honest answer was: slowly. Patient acquisition is hard. Converting healthcare organizations to a new data-buying model is harder. We were grinding toward traction, but the path to meaningful scale was murky.

She challenged us to rethink everything: how we marketed, to whom, and for what problem.

What We Had to Let Go

Pivoting meant abandoning a vision I'd been attached to for years.

The patient data monetization concept wasn't wrong; I still believe patients should share in the value their data creates. But we were trying to change too many things at once: patient behavior, buyer behavior, and the underlying infrastructure. That's a recipe for slow progress and high burn.

What we'd actually built, underneath the patient-facing application, was something valuable: robust integrations with major EHR systems. Epic, Cerner, athena, eClinicalWorks, NextGen, Flatiron, Modernizing Medicine, etc. We'd solved hard technical problems around authentication, data normalization, and API inconsistencies.

The pivot meant recognizing that our integration infrastructure - not our patient application - was our real asset.

The Signal Was Immediate

The moment we started talking to healthcare companies about API access to patient-authorized clinical data, everything changed.

These weren't theoretical conversations. Companies building AI health tools, longevity applications, and clinical research platforms had an acute, immediate need for patient data. They'd tried building EHR integrations themselves and discovered how painful it was. They were actively looking for solutions.

The demand was obvious. The gap was real. And we were positioned to fill it.

Within weeks of repositioning, we had more serious conversations than we'd had in months of pushing the original vision.

What We Learned

Your core technology might be more valuable than your product.

We thought we were building a patient data marketplace. We were actually building healthcare data infrastructure. The infrastructure had clear demand; the marketplace was ahead of its time.

Listen to the market's enthusiasm, not just its objections.

When we pitched the original vision, people nodded politely and raised concerns. When we pitched API infrastructure, they leaned in and asked how quickly they could integrate. The energy difference was unmistakable.

Some visions need to wait for scale.

The patient data monetization concept isn't dead, it's deferred. Once we have significant data flowing through our infrastructure, we can revisit models where patients share in the value. But we needed a path to scale first.

Where We Are Now

Today, Consolidate Health provides API infrastructure that enables patient-directed health data access across major EHR systems. Our customers are healthcare AI companies, longevity platforms, clinical research organizations, and anyone building applications that need real-time clinical data.

We handle the EHR integration complexity. They build products their users love.

The original vision of patient empowerment is still there, embedded in how we operate. Patients authorize data sharing. They maintain control. We're just enabling that access through a model that scales.

For Other Founders

If you're in the middle of a pivot - or wondering if you should be - a few thoughts:

Be honest about what's working. We had real technology and real traction. But traction in the wrong direction doesn't compound.

Separate the vision from the vehicle. Patient data ownership is still something I believe in. The specific product we were building wasn't the only way to get there.

Pay attention to where energy comes from. When customers pull you toward something, that's signal. When you're pushing uphill on every conversation, that's also signal.

Two years of building the "wrong" thing gave us the foundation to build the right thing. I wouldn't trade that path, even if I'd choose differently knowing what I know now.

The pivot was hard. What came after has been worth it.