4PM Ventures

The Future of Healthcare Innovation — A 4PM Ventures Perspective

Part 5 — Why Platforms Will Win
Healthcare Has Outgrown the Hero Product
In our previous articles, we explored why healthcare innovations so rarely become successful companies.

Part 1 — Healthcare Innovation Is Broken https://www.facebook.com/share/p/17ZYD5NgYF/
Part 2 — The Healthcare Startup Failure Problem Is Not A Startup Problem
https://www.facebook.com/share/p/1HPzty7urN/

Part 3 — The Missing Technology Entrepreneur https://www.facebook.com/share/p/1BHV5uVt6t/

In Part 4 - Healthcare Has Outgrown the Hero Founder, https://www.facebook.com/share/p/1EGJGu9LS4/
we continued this discussion by asking a new question:

What happens when healthcare becomes too complex for the traditional "Hero Founder" model?

Our answer was simple: Healthcare does not need only more Venture Capital. Healthcare needs Venture Builders capable of institutionalizing technology entrepreneurship.

Today, we'd like to take one step further. We believe healthcare has also outgrown the Hero Product.

And the reason lies in one of the most important economic shifts of our time:

the rise of the Platform Economy.

We Are Entering the Era of the Platform Economy
For decades, value was created by companies that produced and sold products or services.

Today, an increasing share of value is created by companies that organize interactions among multiple independent participants.

This is what we call the Platform Economy.

A Platform Economy is an economic system in which value is created not primarily through ownership of assets, but through orchestrating interactions, data, and transactions among independent participants.

In a Platform Economy:

every new participant increases the value of the system;
value is co-created by the participants themselves;
data becomes a strategic asset;
multiple business models can coexist within one ecosystem.

It is no coincidence that platform businesses dominate many industries today.

Marketplaces have transformed retail.
Uber transformed transportation.
Airbnb transformed hospitality.
Amazon evolved from an online bookstore into a global platform ecosystem.

Today:

• 7 of the world's 12 most valuable companies are platform businesses;

• more than 60% of technology unicorns are built on platform models.

Healthcare, in our view, is becoming the next major market to embrace the Platform Economy.

Because healthcare itself is fragmented by nature.

Patients.
Physicians.
Hospitals.
Insurers.
Pharmaceutical companies.
Medical device manufacturers.
Regulators.
Researchers.

No single product can effectively connect all these participants. Platforms can.

But Is Everything Called a Platform Actually a Platform?
Today, almost every company claims to be a platform.

Yet the word "platform" is often used to describe very different things. In our view, there are three fundamentally different types of platforms.

1. Technology Platforms
Technology platforms allow third parties to build products and services on top of a core technology.

Examples:

Android
iOS
Amazon Web Services
Salesforce

Their value lies in expanding an ecosystem around a technology.

2. Transaction Platforms
Transaction platforms facilitate the exchange of products, services, or information between participants.

Examples:

Amazon Marketplace
Airbnb
Uber

Their value lies in reducing transaction costs and organizing interactions between supply and demand.

3. Platforms as a Business Model
This is the type of platform that interests us the most.

A platform as a business model is a multi-sided system that brings together different groups of participants, services, and monetization models in such a way that each new participant increases the value of the ecosystem for everyone else.

Or simply:

A product creates value.

A platform enables others to create value.

A company sells a solution.

A platform creates an ecosystem.

Unlike a transaction platform, a platform business model combines multiple participant groups and supports multiple monetization models simultaneously.

In many ways, a modern healthcare organization is itself becoming a platform with multiple stakeholders and business models operating within one ecosystem.

How Do We Know If Something Is Truly a Platform?
In our view, there are five criteria.

1. More than two independent participant groups
A simple seller-buyer relationship is not yet a platform.

Even seller-intermediary-buyer relationships are often closer to marketplaces than true platforms.

A healthcare platform typically connects patients, physicians, hospitals, insurers, pharmaceutical companies, technology providers, data owners, and researchers.

2. Participants create value for one another
If value is created only by the company itself, it is likely a product.

If participants create value for one another, it is likely a platform.

3. Network effects exist
Every new participant increases the value of the ecosystem for others.

More physicians create more expertise.
More patients create more data.
More technologies create more use cases.
More partners create more value.

4. Multiple monetization models exist
Platforms rarely rely on a single source of revenue.

Subscriptions.
Commissions.
Analytics.
Data.
Licensing.
Marketplace fees.
Professional services.
Integrations.

5. The platform combines multiple services and participants to solve a complex problem
Healthcare platforms go far beyond simple marketplaces.

They combine clinical processes, data, technologies, financing, regulation, and incentives across multiple stakeholders.

That is why we often say:

If value is created only by the company, it is a product.

If value is created by participants for one another, it is a platform.

Why Platforms Change the Logic of Venture Investing
The State of Healthcare Platforms 2025 report (link in the first comment) paints a fascinating picture.

Although platform companies represent only around 16.5% of digital health companies, they create disproportionately large value.

According to the report:

platform companies generate 16.7x returns from Seed to Series D;
reach later stages approximately 14 months faster;
command valuations approximately 2.1x higher;
account for around 33% of healthcare unicorns;
are approximately 1.8x more likely to participate in M&A transactions;
and their average M&A transaction size is approximately 2.1x larger.

Yet less than 15% of digital health investment goes into platform companies.

In our view, this is one of the biggest investment opportunities in healthcare.

But there is another important observation.

We frequently hear stories from investors who have had to write off investments in mono-product companies. Not because the technology was weak.

But because bringing isolated solutions to market and integrating them into established healthcare delivery systems is extraordinarily difficult. This is where many startups die.

At the same time, we increasingly see venture funds investing in complementary companies that could potentially create value together.

Yet this synergy often never materializes. Why?

Because there is usually nobody responsible for systematically integrating portfolio companies, creating platform relationships, and designing collaborative strategies.

Funds invest in companies. Rarely do they invest in the architecture of interactions between companies.

This is why the Platform Economy requires a rethinking of venture investing itself.

Investors need more than great startups. They need mechanisms that can transform complementary companies into platforms.

This is where Venture Builders begin to play a new role. Not only creating companies. But also designing the relationships between them.

Platforms Are Becoming an Alternative to Traditional M&A
For decades, corporations solved complexity through acquisitions.

Buy.
Integrate.
Repeat.

This is how vertically integrated holdings were built. But practice shows that M&A does not always create value. We have repeatedly seen situations where:

technology integration proved far more difficult than expected;
founders and key employees left;
entrepreneurial cultures were destroyed;
anticipated synergies never materialized.

Sometimes both sides lose. In some cases, M&A destroys the very value it was intended to create.

Platforms offer a different model: M&A builds vertical integration. Platforms build networked collaboration. Platforms do not require ownership of every participant.

They require orchestration of collaboration. Each company retains:

its own team;
its own strategy;
its own capitalization;
its ability to raise capital;
its ability to generate cash flow.

And yet becomes part of a larger ecosystem.

This is why we believe the platform model may become the next stage of Corporate Venture Capital. Instead of acquiring companies at increasingly high valuations, corporations can:

invest in platforms;
support independent ecosystem participants;
create investor syndicates around platforms;
develop complementary companies without necessarily acquiring them.

Unlike traditional M&A, every participant in a platform remains an independent and attractive investment asset.

Its success increases the value of the entire ecosystem. But for this to work, platforms require two critical functions.

The first is a platform architect.

Someone who defines the rules, standards, and long-term strategy of the ecosystem.

The second is an investor or preferably, a syndicate of investors.

Someone who supports the financial stability of participants and helps the ecosystem develop as a unified system.

If M&A integrates ownership, platforms integrate capabilities.
If M&A builds vertical integration, platforms build networked collaboration.
If M&A acquires companies, platforms allow companies to strengthen one another while remaining independent.

This is why we believe that the future leaders of healthcare will not build the best products.

They will build the best ecosystems. And perhaps the question of the next decade is no longer:

"Which startup should I invest in?"

But rather:

"Which platforms are being built today—and who is capable of building them?"

At 4PM Ventures, we believe that the future of healthcare will not be built around isolated products.

It will be built around platforms that unite technologies, entrepreneurs, corporations, and capital.

This is why we do not simply build startups.

We design future healthcare platforms.

Do you believe the next healthcare unicorn will be a company… or a platform built by a network of independent companies?

P.S. Resonates?

If you believe that the future of healthcare will be built around platforms rather than isolated products, we'd love to continue the conversation.

Whether you'd like to discuss collaboration opportunities, platform strategies, investments in 4PM Ventures, or our portfolio companies, please feel free to reach out to Aleksejs Kornevs and Yuri Fedotkin

Let's build the future of healthcare together.