Savana’s Evidence-Based Pivot: Why They Killed Their First Product for Doctors

Savana’s Evidence-Based Pivot: Why They Killed Their First Product for Doctors

The logic was impeccable. The technology worked. The user experience was polished. And doctors absolutely hated it.

In a recent episode of Category Visionaries, Ignacio Medrano, Founder and Chief Medical Officer of Savana, revealed why the company’s first product for physicians—Savana Consulta—had to be completely killed despite being built on sound reasoning. The brutal rejection wasn’t about execution or features. It was about something more fundamental: they’d accidentally built a product that violated the core principle of modern medicine.

For B2B founders, Savana’s failed product offers a critical lesson about the difference between elegant logic and market alignment. Sometimes the smartest idea is fundamentally wrong.

The Elegant Logic: Wisdom of the Crowds for Medicine

Savana Consulta was built on an idea that made perfect sense—at least on paper. The company had developed breakthrough natural language processing that could extract insights from medical records and reveal what doctors were actually doing in clinical practice. Why not show doctors what their colleagues were doing so they could make better decisions?

“The idea that because we could deep dive into those health records and extract what was happening in the daily clinical practice, if we gave that information to other doctors, then they would see what their colleagues were doing and they could react to that and they could make decisions based on what the majority is doing,” Ignacio explains.

The inspiration was solid. In most fields, seeing what the majority does provides valuable guidance. “We were thinking about the wisdom of the crowds, the idea that if many people are thinking about that, it means something,” Ignacio says.

They were trying to digitize something that already happened naturally in healthcare. “Were somehow trying to replicate, to mimic what happens when doctors talk to each other during their clinical sessions. And were trying to put that into a piece of software.”

Clinical rounds, where doctors discuss cases and learn from colleagues, are a cornerstone of medical training and practice. Savana Consulta aimed to scale that collaborative wisdom through technology. Show doctors the aggregate patterns of how their peers treat conditions, and they’d make better decisions.

The product name even reflected this philosophy: Consulta, suggesting consultation and collective wisdom. “So the idea made some sense,” Ignacio admits.

Some sense. But not enough.

The Brutal Rejection: When Logic Contradicts Principles

The market’s response wasn’t lukewarm interest or requests for different features. It was visceral rejection. “It was incredibly rejected by my colleagues,” Ignacio recalls.

As a practicing neurologist himself, Ignacio heard the criticism directly from fellow physicians. And their objection wasn’t about user interface or data quality. It was about something more fundamental that Savana had completely missed.

“And the reason was very simple. The fact that the majority is doing something doesn’t mean it’s the right thing to do. And that’s quite opposite to what Evidence means. Evidence means this is the right thing, no matter if few people or a lot of people are doing it.”

This is the moment where elegant logic crashes into foundational principles. Savana had built a product that positioned majority practice as the guide for decision-making. But evidence-based medicine—the paradigm that revolutionized healthcare over the past 30 years—says exactly the opposite: what matters isn’t what most doctors do, but what research proves works.

“In a way, were trying to go against the status quo, which is using the right evidence instead of using the majority, the wisdom of the majority,” Ignacio explains.

The irony is brutal. Savana was trying to help doctors make better decisions. But their fundamental approach suggested that popularity should guide treatment, not scientific evidence. In healthcare, that’s not just bad product design—it’s professionally offensive.

Why This Matters Beyond Healthcare

The Savana Consulta failure reveals a pattern that extends far beyond medicine: every market has foundational principles that trump elegant logic. Violate those principles, and it doesn’t matter how smart your solution is.

In healthcare, evidence-based medicine is that principle. It’s not just a methodology—it’s the epistemological foundation of modern medicine. For decades, medicine fought to replace tradition and authority with randomized controlled trials and systematic reviews. Suggesting that doctors should follow what most of their peers do is asking them to regress to pre-scientific medicine.

But every B2B market has similar sacred principles:

In cybersecurity, it’s zero-trust architecture and defense in depth. A product that requires trusting any component completely violates the field’s foundation.

In financial services, it’s separation of duties and audit trails. A solution that consolidates control might be efficient, but it violates regulatory and professional principles.

In software development, it’s version control and reproducible builds. A tool that makes these harder, no matter how much time it saves elsewhere, contradicts core engineering values.

The lesson isn’t about healthcare specifically. It’s about recognizing that elegant logic can lead you to build something that fundamentally contradicts your market’s identity.

The Salvage: Same Technology, Different Philosophy

Recognizing the problem wasn’t fatal—refusing to acknowledge it would have been. “And we realized before, probably before it was too late, we completely killed the tool,” Ignacio says.

But killing a product doesn’t mean wasting the underlying technology. Savana had invested heavily in natural language processing that could extract structured insights from medical records. That capability was valuable. The philosophy of how to use it was wrong.

“And we use the same natural language processing capabilities, we used them for a totally different thing, which was simply creating reports of disease and how patients are behaving and how disease is behaving,” Ignacio explains.

Instead of showing doctors what their colleagues were doing, Savana pivoted to showing them what the evidence showed about disease progression and outcomes. Instead of collective behavior, they surfaced objective patterns. Instead of wisdom of crowds, they enabled evidence-based analysis.

“And that’s how we started building something more interesting, on top of which we finally could come back to our tools that helped decision making, but in a totally different way,” Ignacio notes.

The new approach aligned with evidence-based medicine instead of contradicting it. Doctors could use real-world data to understand disease patterns, validate treatment approaches, and identify gaps between evidence and practice. The technology was the same, but the philosophical foundation was completely different.

The Framework: Identifying Sacred Principles

How do you avoid building a product that violates your market’s foundational principles? Three diagnostic questions:

What revolution defined the modern era of this industry? For healthcare, it was the shift to evidence-based medicine. For software, it was the move to version control and automated testing. For finance, it was the regulatory reforms after major scandals. These defining moments create principles that professionals won’t compromise.

What methodology or approach do professionals in this field spend years learning? If your product suggests a shortcut that bypasses that methodology entirely, you’re likely violating something fundamental. Savana suggested bypassing evidence review in favor of majority practice—directly contradicting what doctors spend years learning in medical school.

What would make a professional in this field question your credibility immediately? If a doctor suggested treating patients based on popularity rather than evidence, their credibility would be destroyed. When Savana built that into software, they triggered the same reaction.

The Principle: Market Alignment Beats Elegant Logic

Savana Consulta teaches a lesson that applies across B2B: understanding your market’s foundational principles matters more than having elegant logic.

The wisdom of crowds works in many contexts. Aggregate behavior provides useful signals in e-commerce, content curation, and product recommendations. But in medicine, suggesting that majority practice should guide treatment decisions violates the core principle that separated modern medicine from historical quackery.

“I would say that the best thing that we did was to kill our first tool for doctors,” Ignacio reflects. “Now I see it so obvious, but at that time we didn’t. It was a disaster.”

The disaster wasn’t the technology or the team or the execution. It was building something logically sound that fundamentally contradicted how their market defines itself professionally.

For B2B founders, the lesson is clear: before you build, understand not just what your market does, but what principles define how they think about their work. Elegant logic that violates those principles isn’t innovation—it’s a product nobody will buy.

Savana killed Consulta before it killed the company. That decision—recognizing when elegant logic contradicts foundational principles—is what eventually led them to a $44 million business built on actually helping doctors practice evidence-based medicine, not replacing it.