Great Science Is Only the First Step Toward U.S. Healthcare Success

For years, when Taiwanese biotech and digital health startups discussed global expansion, the United States was almost always the first destination. Silicon Valley, meanwhile, was often viewed as the avalon for entrepreneurs and investors seeking international success. However, for those deeply familiar with the U.S.–Taiwan innovation ecosystem, this perception no longer reflects today’s reality.

“America is not just California, and California is not just Silicon Valley.” 

That was the key message from Dr. Min-Yi Shih, Chair of the Due Diligence (DD) Committee at TCA Venture Group, during an exclusive interview with GeneOnline. He noted that many Taiwanese startups immediately think of Silicon Valley when considering U.S. expansion.

Dave Whelan, Venture Consultant at Wavemaker Three-Sixty Health and a leader in advancing Los Angeles’ healthcare innovation ecosystem, offered a different perspective. “But if your goal is to build clinical partnerships, validate your business model, and truly enter the U.S. healthcare market, Los Angeles may actually be a better starting point.”

From choosing the right innovation ecosystem and validating business models to navigating healthcare reimbursement, investor expectations, and startup strategies in the AI era, Whelan and Shih emphasized a central point: the biggest barrier preventing companies from entering the U.S. market is often not technology and science, but a lack of understanding of how the market works.

Innovation Beyond the Big Three

For the past two decades, Silicon Valley, Boston, and San Diego have been widely recognized as three of the leading hubs for healthcare innovation in the United States. This perception also shapes how many Taiwanese entrepreneurs think about entering the U.S. market, with Silicon Valley often seen as the default destination. However, as remote collaboration, AI tools, and global innovation networks continue to mature, Whelan believes healthcare innovation is becoming increasingly distributed across regions.

“Innovation happens everywhere. AI is further lowering the barriers to innovation. It is not only giving smaller teams the opportunity to challenge larger companies, but may even enable the rise of one-person biotech companies in the future.”

In Whelan’s view, a company’s success depends less on the reputation of a city and more on whether its ecosystem offers the resources, connections, and support needed for growth. This belief has shaped his efforts in recent years to position Los Angeles as a global hub for healthcare innovation.

Compared with the Silicon Valley ecosystem familiar to many entrepreneurs, Los Angeles offers a distinct set of advantages for healthcare startups. The region has a deep life sciences talent pool and the second-largest healthcare market in the United States, supported by a dense network of academic medical centers and leading healthcare institutions. UCLA, USC, UCI, and Caltech anchor the region’s academic and research ecosystem, while Cedars-Sinai, City of Hope, Kaiser Permanente, Providence, and other leading healthcare institutions provide extensive clinical capabilities.

Los Angeles also has a growing life sciences industry, with companies ranging from Kite Pharma, now part of Gilead, to an expanding presence from Eli Lilly and Company, AstraZeneca, and other pharmaceutical and biotechnology companies. Its research infrastructure is further strengthened by institutes such as The Lundquist Institute and the Terasaki Institute, alongside a broader network of medical device and healthcare companies. The region’s family offices, angel investors, and highly diverse population add further depth to an ecosystem that spans research, clinical care, investment, and commercialization.

“Every part of healthcare innovation, from researchers and clinical trial participants to physicians and patients, is becoming increasingly diverse. Los Angeles is uniquely positioned to support that shift,” Whelan said.

The city’s advantages extend more than its healthcare infrastructure. Los Angeles is also home to one of the largest Taiwanese communities in the United States, with established connections across healthcare, academia, and industry. For Taiwanese startups entering the U.S. market for the first time, these networks can provide access to local partners, expertise, and opportunities.

Shih noted that many Taiwanese startups still view Silicon Valley as a symbol of international success. Yet for many early-stage companies, the reality can be far more challenging.

“Many Taiwanese companies go to Silicon Valley only to become background noise.”

Silicon Valley attracts some of the world’s most ambitious startups and investors, creating an environment with intense competition for attention and resources. While Taiwan has invested heavily in helping startups enter Silicon Valley accelerators, Shih believes the more important question is whether those efforts are helping companies find the right conditions to grow. Product-market fit is essential for success, he argued, but business-ecosystem fit is equally critical.

For healthcare companies seeking to establish themselves in the U.S. market, Los Angeles may offer a more relationship-driven environment with strong clinical connections and fewer barriers to visibility. For startups still building their commercial foundation, that ecosystem can provide a more practical entry point.

Shih emphasized that the larger challenge extends beyond choosing the right location. Taiwan must also reshape how the global market views its role in healthcare innovation.

“Many people still associate Taiwan only with TSMC, OEM, and ODM.”

For him, this perception has been shaped in part by Taiwan’s own global positioning. For decades, Taiwan has emphasized its manufacturing capabilities and supply chain expertise while placing less emphasis on communicating its strengths in clinical medicine, healthcare data, and biomedical innovation. As a result, many international partners have yet to fully recognize Taiwan’s potential as a healthcare innovation partner.

Taiwan brings several valuable assets to the next generation of healthcare innovation, including a high-quality healthcare system, one of the world’s most comprehensive national health insurance databases, and extensive clinical expertise accumulated by physicians. Together, these resources provide a strong foundation for advancing AI healthcare and precision medicine.

“What we truly need to change is not just our market strategy. We also need to change how the world understands Taiwan by telling a story that resonates internationally.”

FDA Is Only the Start

If Silicon Valley represents the most common misconception about entering the U.S. market, commercialization represents the challenge many startups underestimate. For many Taiwanese teams, developing a product, securing regulatory clearance, and obtaining FDA approval can feel like the final milestone before reaching global markets. Whelan sees it differently. The companies that successfully enter the U.S. healthcare system often begin addressing a more fundamental question long before launch: Who will actually pay for this product?

“A company preparing to enter the U.S. market cannot rely on technology alone,” Whelan said. Success requires evidence of product-market fit, paying customers, sustainable revenue, and continued adoption beyond the proof-of-concept stage. Shih added that many Taiwanese teams mistakenly view completing a POC as a sign that they are ready for the U.S. market.

“It still has to go one step further,” he cautioned. A company does not need to be profitable at that stage, but it must demonstrate that customers are willing to pay for its solution. “When someone is willing to pay, you have moved more than the stage of ‘this is just a good idea’ and started building a real business.”

Even products that have gained traction in Taiwan face a fundamentally different challenge in the U.S. healthcare system. The complexity of American healthcare extends far beyond regulatory approval and clinical validation. Shih summarized this reality in one sentence:

“The user is not the payer. The payer is not the decision maker.”

Taiwan’s national health insurance system provides a relatively unified reimbursement structure, making payment pathways more straightforward. In the United States, adoption depends on a broader network of stakeholders. Insurers must determine whether they will provide coverage. Hospitals must decide whether to purchase the technology. Physicians must incorporate it into clinical practice. Patients must trust the value it provides.

“Every stakeholder can influence whether a product ultimately reaches the market,” Shih stated. Healthcare commercialization therefore requires navigating an interconnected ecosystem of reimbursement, purchasing decisions, clinical adoption, and stakeholder incentives.

Stories Build Market Trust

If commercialization tests whether a startup truly understands the market, the next challenge is helping the market understand the company. During the interview, the conversation turned to a familiar pattern among Taiwanese startups: significant investments in international competitions, industry awards, and prestigious accelerators. Shih pointed to a common tendency among Taiwanese startups: “Many companies spend a lot of time chasing awards, but winning awards, or even winning many awards, does not equal market success.”

He was not dismissing the value of global competitions or industry recognition. Rather, he emphasized that these achievements should serve as tools to build credibility and open doors, not as the ultimate objective. The key question is whether that recognition can translate into meaningful business opportunities.

For healthcare startups, the challenge often lies in connecting scientific innovation with real-world adoption. A breakthrough discovery may demonstrate technical excellence, yet still struggle to reach the market if it cannot clearly address the priorities of patients, physicians, hospitals, payers, and investors.

To scientists, innovation may represent a novel platform, a more accurate algorithm, or a significant research breakthrough. The market, however, asks a different set of questions: What problem does it solve? Who benefits from it? Why does it matter now? And perhaps most importantly, who will pay for it, and how much? As Shih explained, “Many scientists are very good at explaining the technology, but not necessarily at explaining why the market needs it.”

He argued that healthcare startups must learn to translate scientific language into commercial value. This does not mean simplifying the science or reducing its depth. It means communicating the same innovation through perspectives that echo with different stakeholders. Investors want to understand the market opportunity, business model, and growth potential. Hospitals focus on clinical impact, implementation costs, and workflow integration. Patients care about safety, effectiveness, and whether a solution can improve their quality of life.

“An innovation can be the same product,” he noted. “But its value needs to be explained from different angles.”

Why Networks Matter More Than Names

They also discussed the role accelerators play in helping startups expand internationally. For many Taiwanese teams, joining a well-known accelerator has long been seen as a key gateway to the U.S. market. Whelan, however, believes an accelerator’s true value lies in what happens behind the brand name.

“The most important thing is people.”

A strong accelerator ecosystem does more than offer recognition. It provides access to experienced mentors, industry relationships, and market insights built through years of working with companies and stakeholders. This support is especially valuable in healthcare, where entrepreneurs must navigate a complex network of the former stakeholders. Without guidance from people who understand the local ecosystem, startups can spend years navigating unfamiliar markets on their own and risk missing critical opportunities.

“Capital itself is not scarce. What is truly scarce is knowing how to use capital effectively.”

For Whelan, great mentors do not make decisions for founders. They help entrepreneurs avoid mistakes that other companies have already encountered and shorten the learning curve. That is why he encourages startups to evaluate accelerators based on strategic fit rather than reputation alone, choosing programs that align with their development stage and business needs. Los Angeles, he noted, offers a growing range of accelerator programs and support networks, including the Cedars-Sinai Accelerator, Larta Institute’s Heal.LA, Taiwan Taoyuan Global Bridge program, and Techstars. Together, these programs provide startups with different pathways to clinical connections, industry expertise, and market access.

“Every company has a different path.”

For early-stage healthcare startups, an ecosystem that provides clinical partnerships, market validation, and experienced industry guidance may create more value than entering the most competitive startup hub. In healthcare, where trust and relationships often determine market access, the right network can become one of a startup’s most valuable assets.

AI Raises the Bar for Healthcare Startups

As AI tools continue to advance, both interviewees highlighted a critical shift in entrepreneurship: AI is changing how startups are built, but it cannot replace the human capabilities required to build successful healthcare companies. From market research and competitive analysis to pitch deck creation and business planning, AI can dramatically improve efficiency for early-stage teams. Yet in healthcare, success still depends on understanding the market, patients, and the broader ecosystem.

“AI can help you become more efficient, but it cannot build trust for you,” Whelan emphasized.

He believes AI will continue to lower the barriers to entrepreneurship, enabling more founders to launch companies and accelerate innovation. However, healthcare startups must still earn trust from patients, providers, investors, and other stakeholders. Unlike software markets, healthcare innovation operates within a system shaped by regulation, clinical requirements, and long-term relationships.

Shih pointed out that AI can help companies organize information and improve decision-making processes, but human judgment and engagement remain essential. In healthcare, where trust is built through relationships and personal interactions, that human touch can be particularly difficult to replicate. “As tools become easier to access, the biggest differentiator will be human judgment,” he noted.

As AI reduces the cost of development and expands access to information, competitive advantage will increasingly come from asking better questions and making better choices. Whelan further observed that while more people may gain access to powerful tools, those tools alone will not determine who succeeds. 

For healthcare startups, this distinction is especially important. The challenge has never been simply creating new technology. It is understanding people, understanding disease, and understanding how healthcare systems operate in the real world. In the AI era, the companies that stand out will be those that can transform innovation into meaningful value for patients, providers, and the market.

Finding the Right Ecosystem

Looking back on the conversation, Whelan and Shih did not offer a single formula for entering the U.S. or expanding into global markets. Instead, they returned to a broader message: successful expansion begins with understanding what makes each company and each ecosystem distinctive.

“Every region has its own advantage,” Whelan emphasized.

He believes the future of healthcare innovation will be shaped by collaboration among complementary ecosystems rather than competition to create the next Silicon Valley. Silicon Valley continues to lead in technology innovation and venture capital. Boston remains a powerhouse for biomedical research. Los Angeles brings together a diverse population, clinical resources, and a broad healthcare network. Lasting competitive advantage, Whelan argued, comes from building on the strengths each ecosystem already possesses rather than trying to replicate another.

For Taiwan, that begins with recognizing its own role in the global healthcare value chain. Shih believes Taiwan’s international reputation has long been defined by manufacturing excellence. From semiconductors and electronics to supply chain management, “Made in Taiwan” has become synonymous with reliability. Yet in an era shaped by AI, precision medicine, and data-driven healthcare, he believes Taiwan has a much broader innovation story to tell.

That shift could extend from “Made in Taiwan” to what Rohit Shukla, CEO of the Larta Institute and a key figure in the Los Angeles healthcare innovation ecosystem, has described as “Made Possibly by Taiwan.” The idea reflects a broader opportunity for Taiwan to be recognized not only for what it manufactures, but also for the healthcare innovation it helps create, develop, and bring to global markets.

“Taiwan is not just manufacturing.”

Taiwan already possesses several critical assets for healthcare innovation, including a high-quality healthcare system, a comprehensive national health insurance program, extensive clinical expertise, and decades of accumulated medical data. In the AI healthcare era, these resources could become powerful competitive advantages.

As AI models become increasingly dependent on data quality and real-world clinical applications, Taiwan’s healthcare infrastructure and clinical datasets provide a valuable foundation for innovation. “AI is not just an algorithm problem,” Shih explained. “It is a data problem, and it is an application-scenario problem.” Still, strong assets alone rarely translate into global impact. Companies must demonstrate why those advantages matter to customers, partners, investors, and healthcare systems in different markets.

Achieving global growth also requires understanding how each healthcare market operates. A technology that succeeds in a Taiwanese hospital may not automatically succeed in the United States, where reimbursement models, clinical workflows, regulatory pathways, and stakeholder expectations differ significantly. Companies expanding internationally must adapt their products, commercial strategies, and business models to local realities if they hope to achieve lasting adoption. That is why Whelan encouraged entrepreneurs to remain open when deciding where and how to grow. “Do not just look for a place where your company can succeed,” he said. “Look for an environment where your company can grow.” 

For healthcare innovators, global success will come from understanding the strengths of each ecosystem, identifying where a company can create the most value, and building the partnerships needed to turn innovation into meaningful impact. It will not come from replicating a single successful model.

Author

Steven Chung

紅杏枝頭春意鬧固然是眾人所追求的風景，但我願意說，青蘿拂行衣更能湧生感嘆。 願在海量晦澀的生醫資訊中，為您點亮一座心燈塔。鐘煌翔