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Digital Health MedTech

Post-Market Surveillance for SaMD

Staying Compliant Post-Launch

Post-market surveillance (PMS) is required for all devices.

Requirements:

  • Plan for data collection
  • Trend analysis and signal detection
  • Regular updates to clinical files
  • Vigilance reporting (e.g. EUDAMED)

For Class IIa+, submit PSUR every 1–2 years.

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Digital Health MedTech

SaMD Market Access & Reimbursement in Europe

CE Mark ≠ Reimbursement

Each EU country has its own reimbursement process.

Highlights:

– Germany (DiGA): Fast track, 12-month provisional access

– France: Multiple programs (ETAPES, PECAN)

– UK: NICE approval + local commissioning (ICBs)

Evidence needs differ, it can be Randomized Controlled Trials (RCTs) or real-world evidence depending on system.

Learn more on Scaling MedTech: From Product to Market

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Digital Health MedTech

Clinical Evidence for SaMD in the EU

MDR Requirements

SaMD must show:

  • Clinical association (medical logic)
  • Analytical validity (correct processing)
  • Clinical validation (real-world benefit)

Documentation:

  1. Clinical Evaluation Plan (CEP) = how you’ll gather evidence
  2. Clinical Evaluation Report (CER) = full evaluation
  3. Post-Market Clinical Follow-up (PMCF) = follow-up after launch

Use real-world evidence, literature, or clinical studies.

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Digital Health MedTech

The CE Marking Process for SaMD

Get CE Mark

Most SaMD is Class IIa or higher—requiring Notified Body involvement.

Key Steps:

  1. Prepare tech documentation (Annex II, III)
  2. Implement QMS (ISO 13485)
  3. Create clinical evaluation plan (CEP) and report (CER)
  4. Work with a Notified Body

Class-specific routes:

  • Class I: self-certify
  • Class IIa-III: Notified Body review + ongoing surveillance

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Digital Health MedTech

SaMD Cybersecurity and GDPR

Security = Safety

Under EU MDR, cybersecurity is a General Safety and Performance Requirement. Failure to secure software is a patient safety risk.

Technical Steps:

  • Secure architecture and testing (MDCG 2019-16)
  • Access control, encryption, logging
  • Vulnerability management and patches

GDPR Considerations:

  • Health data = special category
  • Explicit consent and purpose limitation
  • DPIA (Data Protection Impact Assessment) required if high-risk AI involved

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Digital Health MedTech

Building a Compliant QMS for SaMD

To enter the EU market, your SaMD must be developed under a Quality Management System (QMS) that complies with ISO 13485.

What You Need

  • ISO 13485: General quality framework
  • ISO 14971: Risk management integration
  • IEC 62304: Software development lifecycle

Best Practices

  • Build your QMS, don’t buy a generic one
  • Ensure continuous documentation and audits
  • Tie QMS to real clinical risk management

Cybersecurity Integration

Use MDCG 2019-16 as a guideline for secure development. Cybersecurity is considered a safety issue under EU MDR, it is not just IT hygiene.

Learn More:

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Digital Health MedTech

Rule 11 Explained: Classifying SaMD in the EU

EU MDR’s Annex VIII, Rule 11 determines how software is classified:

  • Class IIa: Most diagnostic and therapeutic decision-support tools
  • Class IIb: Tools whose incorrect use may lead to serious harm
  • Class III: Life-critical functions (e.g., software controlling pacemakers)

What Determines the Class?

  • The intended use and severity of the condition it addresses
  • Whether the software makes decisions or just informs them
  • If a human-in-the-loop can reliably override the software

Example:

  • Software interpreting chest X-rays → Class IIa or IIb
  • Sepsis detection app triggering alerts → Class IIb or III

References:

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Digital Health MedTech

What Is Software as a Medical Device (SaMD)?

Software as a Medical Device (SaMD) refers to software intended for medical purposes that performs these functions without being part of a hardware medical device.

Under the EU MDR (Regulation 2017/745), it’s officially termed Medical Device Software (MDSW).

Key Definitions

MDSW under EU MDR aligns closely with the global SaMD concept defined by IMDRF.

A software must have a clearly defined intended medical purpose such as diagnosis, treatment, prevention, or monitoring of a condition.

Examples of SaMD/MDSW

– AI-based radiology tools

– Depression treatment apps

– Software for detecting pneumonia in chest X-rays

Regulatory Trigger: Intended Use

Your declared intended use is the most critical driver of classification. Even minor “call-to-action” features (e.g., “contact your doctor”) can elevate a wellness app into a regulated medical device.

Resources

EU MDR text

MDCG 2019-11 guidance

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Digital Health MedTech

Mistakes to Avoid in MedTech Commercialization (and How to Fix Them)

Even with the right product, market, and team — many MedTech startups fail. And the reasons often come down to avoidable commercialization mistakes: misjudging the buyer, skipping regulatory nuance, or assuming your tech will sell itself.

This final post in the Scaling MedTech: From Product to Market series lays out the most common missteps in MedTech go-to-market and how to avoid them — with real-world examples and corrective actions.


1. Building Before Validating the Buyer

Mistake: Launching development without confirming who pays, who uses, and who benefits.

Too many founders build based on clinical need or innovation potential — without validating demand, budget holders, or economic value.

Fix: Use the JTBD (Jobs-To-Be-Done) framework + early payer interviews to design with reimbursement in mind.


2. Relying on Pilots Without a Conversion Plan

Mistake: Dozens of pilots, zero sales.

Pilots are easy to get — but unless there’s a conversion path, they drain resources and confuse investors.

Example: Many DTx startups in Germany listed under DiGA saw high downloads but failed to convert to revenue due to unclear therapeutic ownership.

Fix: Design pilots with: – Pre-negotiated success KPIs – Budget source for scale-up – Procurement-ready documentation


3. Ignoring Procurement and IT Requirements

Mistake: Gaining HCP interest, but failing at hospital onboarding.

Even if clinicians love your product, procurement, legal, and IT may reject it due to data compliance, MDR classification, or lack of integration.

Fix: – Include procurement in early demos – Prepare GDPR/Data Processing documentation – Get listed in hospital or GPO vendor systems (e.g., GHX)


4. Misunderstanding Regulatory Signals

Mistake: Confusing CE marking or FDA approval with market readiness.

Regulatory clearance allows sales, but doesn’t guarantee adoption or reimbursement.

Fix: Align your commercial roadmap with regulatory + access strategy (e.g., CE mark + DiGA listing or NICE submission).

Resource: See MDR timeline & guidance from the European Commission.


5. Over-Investing in the Wrong Channel Early

Mistake: Hiring a large sales team before validating CAC or message fit.

Burning capital on outbound reps without understanding the sales motion leads to churn and stalled traction.

Fix: Run test campaigns with fractional reps, digital outreach, or advisor-led selling before hiring full-time field force.


Summary Table: Mistakes & Fixes

MistakeFix
No buyer validationConduct payer & JTBD interviews
Pilot fatigueDesign conversion-ready pilots
Procurement blockersInvolve early, prep documentation
CE mark ≠ market fitLayer regulatory + access planning
Premature sales hiresValidate channels first

Final Word

Commercialization in MedTech is not just execution — it’s sequencing. Avoiding these five traps increases the odds of landing not just pilots or press — but scalable, reimbursed adoption.


Explore more: – Why Pear Therapeutics failed despite FDA clearanceHow Bigfoot Biomedical sequenced product + payer strategy

This wraps our series on Scaling MedTech — let us know what topic you want next.

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Digital Health MedTech

Commercial Channels That Actually Work in MedTech

For MedTech startups, success hinges not only on product quality, but also on how you reach, convince, and support stakeholders. Whether selling to hospitals, doctors, or patients, early-stage companies must design a channel strategy that reflects the healthcare buying process — slow, risk-averse, and influence-driven.

This post breaks down the most effective commercial channels in MedTech, based on what’s actually working in 2025.


1. The MedTech Sales Funnel Is Nonlinear

In traditional B2B, a sales funnel moves from awareness → interest → consideration → purchase.

In MedTech, it looks more like:

Clinical KOL → Hospital Committee → Procurement → IT → Payer → Rollout

Each stage requires a different communication style and sometimes different messengers. Sales success is more about building internal champions than pure outbound volume.

Insight: On average, a hospital sale in Europe involves 5–7 decision-makers (McKinsey MedTech Commercial Benchmark).


2. Channels That Work in Early-Stage MedTech

a. Key Opinion Leaders (KOLs)

  • Clinical influencers who help validate product utility
  • Invite early as advisors or co-authors of case studies
  • Ideal for high-specialty tools (robotics, diagnostics, DTx)

Example: Impulse Dynamics used KOLs to validate its cardiac neuromodulation tech pre-launch.

b. Medical Science Liaisons (MSLs)

  • Hybrid of sales and education
  • Often paired with clinical trials or early access programs

c. Virtual Selling Platforms

  • Tools like Veeva Engage or Showpad support rep-driven or rep-less demos
  • Crucial for digital products, AI tools, and DTx

Statistic: 75% of HCPs in Europe now prefer hybrid or remote interactions (Accenture HCP Preferences)

d. Peer-to-Peer Learning & CME Platforms

  • Hosting webinars, masterclasses, or contributing to Univadis and Medscape
  • Builds credibility and engagement in clinical communities

3. Choosing the Right Channel by Product Type

Product TypePrimary ChannelSecondary
Surgical toolsKOLs + in-hospital demosProcurement-led tenders
DTx & SaMDVirtual platforms + payersPrimary care orgs
Diagnostics (AI)MSLs + evidence portalsRadiology or lab heads
Monitoring devicesPeer-to-peer pilotsDistributors

4. Global Commercial Trends in 2025

  • Digital-first detailing is mainstream. COVID catalyzed a shift to Zoom-based product detailing and asynchronous video walkthroughs.
  • Field force is shrinking. Reps are more specialized, often scientific or hybrid profiles.
  • Channel orchestration is key. Companies using Salesforce, HubSpot, or Aktana orchestration outperform on conversion.

5. Building a Channel Strategy: Questions to Ask

  1. Who influences vs decides vs pays?
  2. Can you pilot the sales motion before full deployment?
  3. Can one channel (e.g. KOLs or CME) drive multiple buyers?
  4. Can data from pilots be repurposed for access and pricing?

Tip: In early-stage MedTech, channel feedback is often better than user feedback — it tells you what blocks growth.


Up next in the series: 📌 Mistakes to Avoid in MedTech Commercialization (and How to Fix Them)

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