Recently, we were thrilled when our startup, Iodine, made an agreement with a large online pharmacy, a big player with serious consumer reach that would get our brand in front of its customers. And our new partner went right to work on integrating our API into its next product release--a release that, it turns out, won't be ready to go live until the fall. That's nine months from start to finish. Turns out, ASAP can still mean slow.

For a little startup like ours, this is an all-too-common phe­nomenon. Because we're small, we're nimble. Being able to move fast is one of our core advantages, but it's also necessary to our success. We have a lot to prove in a little time--specifically, that we can make it as a business. But repeatedly, when we've had the chance to work with big players in our industry, we've watched the timeline drag out into an imponderably distant future. It's like we're a little engine stroking away in a high gear that is then forced to downshift all at once to first. The transmission is going to grumble.

This fast-slow disconnect has caused no end of consternation for us as we try to plan and prioritize opportunities, and we find that our timeline more often than not just doesn't sync with the needs or capacity of potential partners.

It doesn't help that we're working in health care, which is extremely averse to change. Since we're developing tools for patients, which carry special risks and costs, potential partners have been meticulous about putting our services through multiple layers of review and sign-off. For good reason: People's lives are at stake. We need to put some points on the board--closing deals and showing real revenue--as quickly as possible to demonstrate that we're serving a real need in the marketplace. But, as much as we try to move into the fast lane, we still find ourselves subject to quarterly review boards and 18-month strategy documents. For a startup, that stuff can be death by a thousand conference calls.

Part of the disconnect is bureaucratic. But it's also about tolerance for risk. Frankly, in any engagement with us, an established business has to be comfortable with some risk. After all, we're new and we don't have much of a track record, and committing resources and opportunity costs to a contract with a company in our position isn't for everyone. So vetting us, and making sure we're going to stick around, is part of the deal here. Hell, they may just be waiting to see if we are going to survive.

It's also easy to get stuck in pilot mode. Health care in particular is fond of pilots and tests before a full contractual deployment, and there's a high bar for proving both effectiveness and meaningful ROI. Again, that makes sense. I understand the perspective. But the danger for us is getting stuck in low-yield, long-slog tests that don't connect to revenue fast enough. So even as we've signed up for a few pilots, we've tried to press our partners on how, exactly, this will convert to real revenue at the earliest opportunity. Honestly, some paths are clearer than others.

Like so much in Startup Land, this all comes down to balancing opportunities and tradeoffs. So far, our strategy has been to embark on slow, long-term discussions (there are always months of discussions) only when the potential upside serves several strategic objectives, such as letting us prototype a product and providing revenue. That hasn't spared us entirely from some false hopes and fruitless conversations, but it has helped us avoid a few.

The ultimate goal here is to make sure we stay nimble and fast, to jump when opportunity strikes--and to make sure the long game is part of our plan too.