By Dr. Sarah Matt, MD, MBA
The graveyard of failed health tech startups is littered with brilliant code and breathtaking valuations. Yet, their failures were rarely technical; they were profoundly human. This article argues that the missing code in digital health is not a better algorithm, but a different kind of leadership. High emotional intelligence (EQ) leaders, who prioritize empathy, trust, and the messy realities of patient care, are the ones who can bridge the gap between shiny innovation and sustainable, real-world adoption.
Let’s be brutally honest. For every dollar invested in health tech, a graveyard of well-funded, beautifully coded failures grows larger. We’ve seen telehealth platforms once valued at nearly $2 billion go bankrupt. We’ve watched AI-powered diagnostic tools fail to gain traction despite flawless algorithms. The post-mortems often blame market timing or reimbursement hurdles. But they’re wrong.
The real reason health tech fails so spectacularly has little to do with the tech itself. It fails because of a profound leadership gap. It fails because it’s often led by people who understand code but not chaos. They understand data, but not despair. They can build a seamless user interface, but can’t navigate the messy, high-stakes, deeply human ecosystem of actual healthcare.
As a surgeon who pivoted to technology strategy early in my career, I’ve had a foot in both worlds. I’ve seen the promise of digital tools firsthand, but I’ve also lived the frustrating reality of their implementation: the endless clicks in an EHR that pull your eyes away from a patient, the “pilotitis” of a revolving door of disconnected apps that overwhelm clinicians, and the cold, hard truth that technology cannot fix a broken system.
The missing code isn’t a new programming language. It’s high emotional intelligence (EQ) in the C-suite. High-EQ leaders are the essential bridge between the sterile environment of a tech incubator and the unpredictable reality of a clinic, a hospital ward, or a patient’s home. They build systems that don’t just work in theory but thrive in practice. Here’s how:
High-EQ Leaders Build for Trust, Not Just Tech
Low-EQ leadership is obsessed with the “what.” What does the algorithm do? What is the ROI? What are the features?
High-EQ leadership is obsessed with the “who” and the “how.” Who will this serve? How will it earn their trust? They understand that in healthcare, trust is the ultimate currency. Without it, the best technology is just expensive vaporware.
Look at the programs that succeed. They aren’t just dropping tech into a community; they are co-designing solutions. In Syracuse, New York, Dr. David Lehmann’s street medicine team provides care to the unhoused population. The innovation isn’t a fancy app; it’s the consistent, reliable presence of a doctor on a sidewalk. The trust they build is what unlocks the ROI, dramatically reducing costly emergency room visits. High-EQ leaders know that technology can only scale what’s already there. If trust doesn’t exist, you’re just scaling alienation.
They Design for the Five Pillars of Access, Not Just a Single Metric. In The Borderless Healthcare Revolution, I frame access around five interdependent pillars: Physical, Financial, Cultural, Digital, and Trust/Knowledge. Low-EQ leaders tend to focus on just one or two; usually the digital and financial pillars. They build a great app but forget that a patient may lack the broadband to use it (a Digital Pillar failure) or that the language in the app doesn’t resonate with their cultural background (a Cultural Pillar failure). We saw this in rural Alaska, where Medicaid policy forced indigenous patients to take a floatplane to a clinic just to log into a telehealth appointment, a perfect example of a system blind to its own flawed processes.
A high-EQ leader sees the entire ecosystem and thinks about the full system. They ask the tough questions:
- Will this work for someone on a weak cellular signal? (Physical/Digital)
- Does this account for the fact that a patient might not trust a doctor who doesn’t look like them? (Cultural/Trust)
- Is this truly affordable, or are we just shifting costs? (Financial)
They design for the messy reality of a patient’s life, not the clean logic of a spreadsheet.
They See People, Not Just Data Points
One of the most dangerous myths in health tech is that data is neutral. It’s not. AI algorithms trained on historically biased datasets don’t solve underlying problems; they amplify them with terrifying efficiency. A high-EQ leader understands this isn’t an academic debate; it’s a direct threat to performance, market access, and the bottom line. They demand diversity not just in their teams, but in their training data. They push for “fairness audits” and build governance structures that ask, “Which populations will this fail, and what will that failure cost us?” They know that an algorithm that works perfectly for a white male in Silicon Valley might be dangerously inaccurate for a Black woman in rural Alabama. An algorithm that fails for a significant portion of the population is not a breakthrough; it’s a liability that will show up in lawsuits, reputational damage, and a shrinking market share.
Exhibit 1: Low-EQ vs. High-EQ Leadership in Health Tech
| Focus of Low-EQ Leaders | Focus of High-EQ Leaders |
| The technology and its features | The problem and the people it impacts |
| Return on Investment (ROI) in dollars | ROI in trust, adoption, and outcomes (and of course the $) |
| Scaling the product | Scaling the solution within a system |
| Data precision and algorithm accuracy | Data representativeness and fairness |
| Building a “disruptive” tool | Building a sustainable, integrated system |
The Ultimate Algorithm is Empathy
The future of healthcare won’t be won by the company with the smartest AI or the sleekest user interface. It will be won by leaders who have the courage to embrace the complexity of being human. It will be won by those who understand that you can’t code compassion, you can’t automate empathy, and you can’t build a trusting relationship with a chatbot (yet!).
We have enough shiny objects. What we need now are leaders with the emotional intelligence to see beyond the code and see the full system. We need leaders who recognize that the most powerful algorithm we have is, and always will be, our ability to earn the currency of trust. That’s the code that will finally bridge the border between what technology can do and what healthcare must be.
Dr. Sarah Matt, MD, MBA
