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How Feedback PLC Turned Medical Device Constraints Into a Blue Ocean Opportunity

The most interesting pivots often come from seeing opportunity where others see constraints. In a recent episode of Category Visionaries, Thomas Oakley shared how he transformed a declining 20-year-old medical imaging company into a high-growth clinical collaboration platform by embracing the very regulations that others saw as limitations.

When Thomas took the helm of Feedback PLC in 2019, he inherited a company that had been “over promised and often under delivered” to shareholders. Their legacy medical imaging products were being overtaken by industry giants like GE, Phillips, and Siemens, creating what seemed like an impossible competitive situation.

But rather than try to compete head-on, Thomas saw an opportunity to leverage their medical device certification in an entirely new direction. “The medical device has both a real term advantage for us, but also creates that slight friction because we can’t be as agile as we’d like to because we have to conform to quality standards as we develop the product,” he explains.

This apparent constraint became their competitive moat. While other companies could build chat interfaces or integration tools, none could combine these with certified medical image viewing capabilities. As Thomas notes, “We are certainly in the UK, the only clinical collaboration platform that is certified as medical device for image display.”

This positioning unlocked entirely new markets. They were selected to run “the UK’s first end-to-end care pathway between GPs in primary care hospitals, in secondary care, and these new community diagnostic centers.” Why? Because they were “the only provider that had the capability to stitch the IT infrastructure together in the background and then present it in a collaboration environment.”

Building in a Regulated Environment

The team had to solve a fundamental tension between agile development and medical device requirements. As Thomas explains, “If you are developing software in an agile way, you rapidly create a new version of a product, see what works, see what doesn’t, and then iterate those changes back into your product. You can’t do that in a clinical environment where if you get something wrong or there’s a bug in your software that could have an impact on patients.”

Their solution was developing a unique approach to regulated agile development. Instead of rapid iteration, they “risk assess everything that you’re doing, anticipate risk and try and remove it from the product before you ever put it into the hands of clinicians.” This created a high barrier to entry while still enabling customer-driven development.

The Sales Marathon

The sales cycle reflects the complexity of selling into healthcare environments. Thomas is candid about the persistence required: “It takes anywhere between ten to thirty engagements before you get to the point of contracting. Then you typically go through procurement, and that procurement process can take six to nine months.”

Rather than trying to shortcut this process, they embraced it. The team maintains an “absolute obsession with sitting close to the customer,” using their input to drive product iterations. During COVID, this led them to develop capabilities allowing consultants to treat patients in Manchester while being at home with family in Delhi.

This customer-centric approach extended internationally through strategic partnerships. Working with AWS and an AI company called Cure AI, they adapted their technology to enable TB screening in rural India. By developing capabilities to push imaging over mobile networks – originally created for veterinary use in the UK – they enabled “AI-powered TB screening diagnosis within about 30 seconds of an x-ray being taken anywhere in India where you had 3G connectivity.”

The Results

The transformation has delivered consistent 74% year-over-year growth for three years running, with an 89% increase in sales in their latest period. More importantly, they’ve demonstrated the ability to reduce patient wait times in the NHS by 70% without adding clinical staff.

Looking ahead, Thomas sees their technology becoming “essentially a digital glue that pulls healthcare environments together and through party technologies can be deployed to a national or international healthcare audience.” By embracing rather than fighting regulatory constraints, they’ve created a unique position in healthcare technology – one that larger competitors can’t easily replicate and smaller ones can’t easily enter.

The lesson for founders? Sometimes the most promising go-to-market opportunities come not from avoiding constraints, but from turning them into competitive advantages that others can’t easily replicate.