Savana’s 10-Year Wait: How COVID Finally Created Their Original Market

Savana’s 10-Year Wait: How COVID Finally Created Their Original Market

Being right too early looks a lot like being wrong. The technology works, the vision is clear, customers acknowledge the value—but nobody buys. Not because the product is bad, but because the market infrastructure to support purchasing decisions simply doesn’t exist yet.

In a recent episode of Category Visionaries, Ignacio Medrano, Founder and Chief Medical Officer of Savana, shared the reality of building a healthcare AI company that had to wait a decade for its original market to become viable. This isn’t a story about patience as virtue. It’s about the brutal calculus of survival when you’re ahead of your market and the specific conditions that finally transformed “too early” into “right on time.”

2014: The Vision Nobody Was Ready For

Savana’s founding vision was straightforward: use natural language processing to extract insights from medical records, enabling hospitals to predict patient outcomes and make data-driven decisions. The technology worked. “So we created our prototypes, started going to hospitals and it worked. And so 10 years later we’re here,” Ignacio recalls.

But working technology isn’t the same as viable market. Hospitals in 2014 didn’t have organizational structures to support AI-powered medical record analysis. There were no Chief AI Officers, no VP of Predictive Analytics, no budget lines for this category. “When we launched this tool that is able to go to medical records, apply a lot of validated and scientific natural language processing, the idea was great, but then who would use it? And we found that it was no one’s job to use this kind of tool.”

They found early adopters—”innovators that we found in a sector that is known for being very conservative.” But early adopters don’t make a market. They’re the 2% willing to create new organizational infrastructure. The other 98% won’t follow until that infrastructure already exists.

The Five-Year Detour: Survival Through Pharma

Rather than repeatedly pitching to a market that wasn’t ready, Savana made a pragmatic pivot. “What we did was we started selling this to pharmaceutical companies because they really have this interest of knowing what is happening to patients by certain disease,” Ignacio explains.

Same core technology. Same natural language processing capabilities. Different customer with existing budget and organizational readiness. “So the same technology, the same NLP extraction of data with the provision of hospitals, and then in a de identified way, we started selling it to pharmas.”

This wasn’t the vision. It was survival. “So we stayed there as a company for five years. We survived. We’re incredibly close to die, as probably every entrepreneur would tell you.”

Five years is an eternity in startup time. Competitors launch. Technologies evolve. Investors lose patience. Team members burn out. But Savana stayed alive, kept developing their technology, and maintained relationships with hospitals even while selling primarily to pharma.

They were waiting. Not passively hoping, but actively surviving until the market conditions shifted.

What Changed: The Three Elements of Market Readiness

When Savana finally returned to selling to hospitals around 2020-2021, it wasn’t because they’d improved their sales pitch or refined their product positioning. The market itself had fundamentally changed.

“And then only when the technology evolved, the mindset evolved, the culture evolved around the idea of data, healthcare data, intelligence, especially, sadly, thanks to the COVID situation. Only at that moment, the hospitals were ready to catch up with budgets and with people waiting to use our tools.”

Ignacio identifies three specific changes that COVID accelerated:

Technology evolved. Not Savana’s technology specifically, but the broader ecosystem of healthcare technology adoption. Telemedicine went from niche to mainstream overnight. Electronic health records became essential infrastructure rather than nice-to-have systems. The technology stack that Savana’s product would integrate with became standard rather than cutting-edge.

Mindset evolved. Healthcare professionals who’d spent careers trusting clinical intuition over algorithms suddenly faced a pandemic where data-driven decisions were visibly saving lives. The skepticism about machine learning that Ignacio encountered in hospital cafeterias in 2014—”yeah, that’s cool stuff, but it’s never going to work”—gave way to pragmatic acceptance that AI tools could provide value.

Culture evolved. Most importantly, organizational culture shifted. “The culture evolved around the idea of data, healthcare data, intelligence.” New roles were created. Budget priorities changed. What wasn’t anyone’s job in 2015 became essential infrastructure by 2021.

“Only at that moment, the hospitals were ready to catch up with budgets and with people waiting to use our tools. And that’s how we came back somehow to the original idea, which was selling this to hospitals that could then use their own information, aside from pharmas, for all kinds of use cases.”

The Role of Crisis in Market Creation

The uncomfortable truth is that COVID didn’t just accelerate trends—it created urgency that forced organizational change which would have taken another decade otherwise. Hospitals that had been slowly considering digital transformation were suddenly forced to implement it in weeks.

Ignacio acknowledges this explicitly: “especially, sadly, thanks to the COVID situation.” The “sadly” is important. Nobody wants a pandemic to validate their business model. But the reality is that crisis creates the conditions for rapid organizational change that normal market forces can’t achieve.

This raises a difficult question for founders building ahead of their market: do you wait for crisis to create urgency, or do you find another path to survival?

The Survival Playbook: What Savana Did Right

Looking back at Savana’s decade-long journey, three decisions kept them alive until their market materialized:

They pivoted to a customer with existing budget. Rather than trying to force hospitals to create new organizational infrastructure, they found pharma companies who already had budget allocated for similar value. This wasn’t abandoning the vision—it was finding a bridge customer who could sustain the company.

They maintained technical progress in their core technology. The five years selling to pharma weren’t wasted. They continued developing and refining the NLP capabilities that would eventually power their hospital products. When the market shifted, they were ready to move immediately.

They preserved relationships with their target market. Even while focusing on pharma revenue, Savana maintained connections with hospitals. They understood the technology evolution, tracked the cultural shifts, and positioned themselves to recognize when the moment had arrived.

“For us it was like a journey where went somewhere, then we had to go somewhere else. And then we came back,” Ignacio reflects.

The Framework: Identifying Market Readiness Signals

How do you know when a market that wasn’t ready has finally become viable? Savana’s experience suggests three specific signals:

New roles are being created. When job postings start appearing for positions that didn’t exist before—Chief Data Officer, VP of Digital Health, Director of AI Strategy—that’s organizational infrastructure being built in real-time.

Budget priorities visibly shift. When trade publications report that hospital systems are allocating significant budget to categories that previously had zero allocation, that’s a market signal that transcends individual sales conversations.

Cultural conversation changes. When the industry’s skeptical voices start asking “how do we do this?” instead of “should we do this?”, the fundamental debate has shifted. Savana knew the market had changed when doctors stopped questioning whether AI could work in healthcare and started asking which AI tools to implement.

The Principle: Survival Earns the Right to Timing

The lesson isn’t that every ahead-of-market company should wait a decade. It’s that market timing beats perfect execution, and recognizing when you’re right but early requires a different strategy than when you have true product-market fit.

Savana was correct in 2014 that healthcare needed AI-powered medical record analysis. But correct and viable are different things. The organizational infrastructure, cultural readiness, and budget allocation to support that vision didn’t exist yet.

They could have died insisting they were right. Instead, they survived by serving a bridge customer until their original market became viable. Ten years from founding, that original vision finally has the market infrastructure to support scale.

“And that’s how we came back somehow to the original idea.” For founders building ahead of their market, that phrase—”came back”—is the key. You can be right too early and still win. But first, you have to survive long enough for the market to catch up.