I founded my company, ClickMedix, a healthcare technology company, as a global business from the start. We provide mobile and web technologies to allow doctors in Africa to serve patients remotely through mobile smartphones. The business now operates in 16 countries, from Africa to the US and other parts of Latin America and Asia. We tested many markets in parallel both through strategic analysis as well as the shoot-in-the-dark approach to see what stuck.

In hindsight, building a global business can be simplified into 3 main steps, with each step helping to inform whether the market or country would generate sustainable revenues and help expand the business.

1. Identify your target markets and determine whether there are viable revenue streams.

Identifying target markets can take two major forms: outbound, where you select a specific market and advertise to them, or inbound, where you advertise generally and let the customers find the business. Your approach depends on the type of product or service you offer.

For our global healthcare technology business, where most markets / countries have a need for better, faster, more affordable healthcare services, we've found the inbound approach more cost-effective to help customers find us. By attending and speaking at conferences, providing online demos, and partnering with thought leaders in healthcare, we've attracted interested customers from hospitals, governments, insurance firms, physicians and patients from our general visibility.

Questions to ask yourself:

  • What markets do you want to serve?
  • Is there a need and ways to pay?
  • Can your business grow in that market?

Given our mission to improve healthcare for over a billion people, we aim to serve every market, but also must prioritize. First, we prioritize by revenue streams and ask who will pay, how much will they pay, and whether our software-as-a-service subscription model would be accepted.

To ask these questions effectively, you must have in-country partners or an in-country team.

2. Identify trustworthy in-country partners / team to test the market

Having done business in more than 16 countries, who to trust is key. After many trials and errors, I have learned how to select in-country partners and recruit the team by aligning incentives and assessing the consequences for poor performance.

Questions to ask yourself:

  • What incentives do my in-country partner/team have to help grow the business?
  • What else can my partner gain by helping me?
  • What potential damage can be done with the partner? And how would I mitigate?

As a mission-driven health technology company, first and foremost, all of our partners need to embrace the vision of improving healthcare. Secondly, for a partnership to be successful, there needs to be a win-win. For all of our partners and team members, there is clear alignment of incentives as well as a transparent compensation process and frequent checkpoints to ensure the partnership is continually aligned and that multiple parties are working together optimally - and if not, there are ways to terminate the partnership. As the business grows, and the product is gaining adoption, recruit additional team members as well as synergistic partners to avoid a single-point of failure.

Next, as with almost any product or service, localization may be needed to tailor the product or service so that it meets the needs of the users for that market.

3. Determine product-market fit and customize local product

Most products are not one-size fits all, and we have found that working with local partners or customers are one of the easiest ways to determine what changes are needed to gain adoption in a new market.

Questions to ask yourself:

  • What will my customers learn about the product?
  • How do I get adoption in the market?
  • What are my distribution channels?

We've developed a platform to make changes quickly to fit the needs of our customers. Our customers learn about our product through our marketing efforts as well as in-country partners. Most of our adoption comes from getting the first pilot deployment setup and showing results of how the product improves health outcomes and lower operational costs while serving more patients. As more pilots are implemented with positive results, it becomes incrementally easier to expand its usage either with the same customer or associated customers.


After going through the 3 steps, rapidly test for product-market fit and don't hang on to a market if it is not viable. Depending on your solution, test multiple markets in parallel if you can and the lessons learned will inform ways to improve market penetration to scale your global business.


Ting Shih founded ClickMedix, an award-winning healthcare technology enterprise born out of MIT Media Lab to enable health organizations to serve more patients through its eHealth platform. Her areas of expertise include mHealth solution design, competitive strategy, lean/Six Sigma process improvement and operations management. She spent five years implementing mobile health programs across 15 countries in North America, South America, Africa, and Asia to develop financially sustainable health programs through ClickMedix. The programs equipped health workers, nurses, pharmacists, and physicians with smartphones to capture patient symptoms information, images, and other related health data to be transmitted to remote specialists who can provide diagnosis and treatment advice.

Ting is the Cartier Women's Initiative Laureate 2012 for North America. She holds an MBA and MS in Systems Engineering from MIT. In addition, she holds a BS in Computer Science and MS in Software Design and Management from Carnegie Mellon University.