Tuesday, December 30, 2025

Transpose Health – Annual Letter 2025

It is incredible how much can change in a year. One year ago, I had an unsigned contract; today, I’ve honed our data conversion engine (and run multiple test runs) and am working through a few contracts. A few thoughts from the past year of building and running Transpose Health:

1. Clarity of company’s strengths – It’s funny how it takes the better part of a year to nail down what Transpose Health’s impenetrable strengths are (and how I contribute to them). If customers buy Transpose Health, what they are buying is my expertise and “certainty” in the data conversion process. Yes, this comes from my long tenure at Epic and my computer science background, but I think what sells hospital staff is feeling immediately comforted on an initial sales call.

2. Partnerships are difficult – How trite but how true. Earlier in the year, I parted ways with an initial partner – ultimately, we weren’t aligned on urgency and what building a company/brand meant. I ended up finding another partner who could expand what Transpose Health could offer, while also being aligned with the company’s strengths: Epic expertise, long-term partnerships, trust. Again trite, but we don’t always agree – for example, he’d prefer to charge consulting expenses hourly and pass through cloud expenses, while I’d prefer to bundle it into one lump sum (more customer-friendly, and it forces us to have great processes). It took a little frustration before I realized that these disagreements are ultimately productive – especially because I can trust we’re fighting for the same end goal.

3. A little naivete is okay – I committed to an archiving platform before having one built out (or fully knowing how many layers there are to building a good one); I figured I could AI-assist-code a decent prototype in a few weekends. (Perhaps that is one thing AI is good for: hubris.) This naivete (or alternatively, "salesmanship") led me to commit to building an archiving platform ... which ultimately led me to finding a good partner. Things sometimes (often?) work out, but it feels like good entrepreneurs have to get a little over their skis every now and then.

4. Sales are everything – I’ll write more about this some time, but my old company (Epic) hardly had a sales team; hospitals came to Epic, demanded to use the software, and some were turned away. (Epic would tell customers, “Our product won’t meet your needs right now, but maybe in a few years it’ll be a good fit.”) What I learned in business school and VC is … this is a completely anomaly. Companies pay big bucks to win revenue, … and last year, I had somehow managed to make a sale (and have a few in the pipeline). Transpose Health’s data conversion services are a natural complement to data archiving, allowing for a credible way to expand – and add recurring revenue.

5. Trust is gold – Ultimately, the value proposition of Transpose Health is trust: can hospitals trust us to get the job done well? Can they trust us not to overcharge? Can we trust them to tell us when they messed up? Can they trust the company’s people (me) and the people we hire? While everything else (services and software) will devolve into a commodity, trust will continue to be a differentiator worth paying a premium for.

6. Looking ahead – The new year will bring a new organizational structure as the company expands from data conversion services into data archiving. Our primary goals are to (1) ramp up sales, (2) continue to refine the product to allow for (3) easy onboarding processes. I also want (4) to see our current – and first! – client have a successful go-live. An exciting year to come – I’m just trying to revel in all the exciting growth, and make peace with all the anxiety and uncertainty that comes with any new venture

Mike

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