Fe-Fi-Fo-Fum : A fairy tale about digital health start-ups

I spent a good chunk of last week at the GIANT health event in London. I saw some terrific presentations, drank some awful coffee and – because the venue is normally a nightclub – marvelled at the sight of a panel of experts discussing “applied artificial intelligence in healthcare” beneath a giant glitter ball.

But above all I met some inspiring people; healthcare professionals, investors, lawyers, designers and entrepreneurs. Lots and lots of entrepreneurs, many of them with businesses at the very earliest stages of development.

Lots of my conversations with these entrepreneurs revolved around ‘Lean Startup’ concepts and I realised that people fell into two broad camps. Some saw Lean Startup as a set of principles to apply within their business in support of their existing passion, experience and skills. Even without an insight into their business plans or innovation I’d say these people have a better than average chance of success. Others I felt have less chance of success, they seemed to think that Lean Startup is The Answer and if you follow it you will succeed.

I worried about their chance of success for two key reasons:

  • They seemed to have limited awareness of what it takes to set up and grow a business.
  • They seemed confused by one key aspect of Lean Startup – validated learning and the minimum viable product. To them the “fail” part of “fail early, fail fast” was almost the objective itself, taking the view that “if I fail often enough and quickly enough, eventually I will succeed.”

I think you should aim to win but expect to fail and plan to learn from any failures along the way. To help you on that journey I offer two suggestions.

Number one: Get some simple commercial advice.

I don’t mean hire a lawyer or an accountant, although you will certainly need those in time. I also don’t mean the mentors that digital health accelerators or support communities can connect you with. They are incredibly valuable and if you can get one you should but they are typically health care professionals or healthcare experts from within big corporates and unless they have set up and run their own business they can’t tell you what it’s really like and help you decide if it’s the right path for you.

What I do mean is talk to someone who has run or is running a business. Ask them all those questions you didn’t want to ask in front of an audience at GIANT (for example, after a presentation on fund-raising, one medical student and budding entrepreneur I talked to asked me to explain the basic concept of a limited company and shareholders). Get them to help you think about your innovation and how it might evolve as a business. And, most importantly, ask them what it’s like to run a business and try to work out if that’s really you.

Number two: Use the Fe-Fi-Fo-Fum approach.

I’ve come up with this mnemonic to help people apply aspects of Lean Startup effectively:

  • FE means Fail Early: This is the part that everyone does seem to have grasped – speed is key.
  • FI means Fail Intelligently: In Lean Startup this is part of a ‘build-measure-learn’ feedback loop. Think about the measure and learn bits just as much as you do about the build and then you will be learning from any failures and getting closer to success.
  • FO means Fail Originally: Don’t make mistakes that others have already made for you. Look at your innovative new concept, do some research and try to find out if someone else has already tried to do something similar. They probably have and there are probably lessons in their success or failure that you can learn for free. How much do you think Facebook learned from Myspace? Or Google from Yahoo? And don’t forget the commercial advice piece above. You want any failure to teach you something about your customers and how they engage with your product. Don’t fail for a simple commercial reason that could have been avoided.

There is no FUM – that would be too contrived and this isn’t really a fairy tale.

Good luck.



Rob Brougham


© Rob Brougham. Rob is a digital veteran, having spent the bulk of his career in the telecoms industry. He set up his first company, a conference call firm, in 2003 and successfully sold it in 2006. He first developed a passion for digital health when he led BT’s telehealth business, providing clinically led remote support services to patients with chronic long term conditions such as COPD and diabetes. He now runs his own consultancy, TCLT Solutions Ltd, supporting digital health and other technology enabled firms create and deploy effective commercial strategies and is co-founder of a start-up that is at about to launch its MVP, www.bloophealth.com. You can contact Rob at rob@tclt.co.uk

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  • Dafydd Loughran

    Great write up Rob and good to meet last week, hopefully i’m in that first category!!