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Start at the moment of communication
The moment of communication
Those moments used to end with a human receiving the information and documenting it in the system of record, the electronic health record. When an AI agent does the recording instead, it can do more with the data than file it away. That is why the record systems are moving toward action while the action layer is moving toward becoming the system of record.
Why a foothold matters
The foothold matters because everyone now has access to the same capabilities, and big labs and incumbents are building in overlapping spaces. A startup should assume others will insert themselves too. The aim is to enter at a strategic surface area and use it to unlock more capabilities, growing into a platform.
From wedge to platform
Companies do not begin by being everything for everyone on day one. They begin with a wedge that earns bottoms-up adoption or shows a clear 10x value, then build out a multi-product solution from there. The same pattern shows up in legal and finance.
Team shapes what happens next. Two teams can take the same entry point, and one stays fixed on it while the other stitches things together and earns enough trust from the customer to be pulled further in. Those teams attract talent and capital, and the flywheel expands.
Why do startups begin with a narrow wedge?
A narrow entry point lets a young company win one customer group completely before it takes on larger rivals. Clayton Christensen described this pattern of entrants starting small in his 1997 book The Innovator's Dilemma. Amazon began by selling only books in 1995, and Facebook began at Harvard in 2004 before opening to other schools. Each used its first foothold to earn the trust, money, and data to move into wider markets.
Why does healthcare still run on fax?
The Health Insurance Portability and Accountability Act, passed in 1996, allows patient records to be faxed with safeguards in place. Many practices run different record systems that cannot easily exchange data with each other. A fax works between any two offices with a phone line, so it became the common denominator. The result is that records often move between clinics as paper pages.
Why is owning the system of record powerful?
The system of record is the database other software must agree with, so every tool built around it ends up depending on it. Moving to a new one means migrating years of data and retraining staff, which creates high switching costs. Salesforce built a very large business by becoming that system for customer data. The term data gravity was coined by Dave McCrory in 2010 to describe how applications get pulled toward large pools of data.
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