Quick Start
What the H-BMC is, how the pieces fit, and the first five things to do.
What the H-BMC Is
The H-BMC is a structured way to build and test the business model behind a healthcare innovation. A business model is built from interconnected, evidence-rated hypotheses and explicit decisions about how a business creates, delivers, and captures value. On the canvas itself, related hypotheses are synthesized into Cairns, the few well-supported needs and facts solid enough to build on, and choices are recorded as Decisions, informed by that evidence. The canvas, eighteen blocks across eight rows, is articulated through Cairns and Decisions; the hypotheses stand behind them, and every row answers one question an investor will ask.
You will collect a mountain of information. Investors will hear eight sentences. The H-BMC is the path between:
The Five Things to Do First
Start with the unmet need, not your technology
The #1 cause of start-up failure is no market need. Define the job stakeholders are trying to accomplish, without embedding your solution, and build the need from discovery evidence. A good problem beats a good solution: the need is durable, the solution will change.
Separate individuals from institutions
People always make the decisions, but some decide for themselves (patients, clinicians, champions, detractors) and some decide on behalf of institutions (committees, payors, regulators). They are judged by different criteria. The canvas asks most customer-facing questions twice for exactly this reason. Hospitals do not buy things; people do.
Write everything as a hypothesis, then earn the right to believe it
Every claim on the canvas starts as a belief. Interviews and documents raise or refute it. Related, well-supported hypotheses stack into Cairns: the small number of needs and facts strong enough to build on.
Make your choices explicit
Price, channel, partners, and make-versus-buy are not discovered, they are decided. Record each decision with the evidence that informed it and what it commits you to believing, so a choice never masquerades as a finding.
Define a Target Market, then search for the entry wedge
Decide where you will build your first sustainable business, then search for the Beachhead: the narrow entry wedge that positions you to win the Target Market. This matters more in healthcare than elsewhere. In most industries an initial market is a cheap experiment you can abandon; in healthcare, the regulatory approvals, reimbursement pathways, and user and buyer relationships you build in the beachhead are the assets that must transfer forward. Choose the beachhead for what it enables, not just what it earns: a beachhead you win that leads nowhere is a bridge to nowhere.
The Canvas at a Glance
4c. Advisory Bodies
Each row answers one investor question; the eight answers are the storylines of your pitch. Blocks are marked by how their content is produced: discovered from evidence, decided by the team, or calculated from the rows above.