Startups don’t just need tech leads: They need an integrator

Why do so many well-funded startups stall just when momentum matters most?

The product is strong. The vision is ambitious. But something goes missing in the execution, and by the time anyone realises, it’s too late to course-correct.

In my years working with startups across MedTech, FoodTech and Digital Health, I’ve seen this pattern too many times. There’s a hidden role that rarely gets filled early enough. I call it the integrator, the person who connects regulation, product, operations, and timing into a coherent go-to-market strategy… And ignoring this role can quietly sink a company!

The problem: When no one connects the dots

Startups fail for all sorts of reasons, but one of the most overlooked is misalignment.

A founder sets a bold vision. The tech team builds what they think will deliver it. Operations scrambles to keep up. Meanwhile, key regulatory steps get delayed, and no one quite sees it coming.

It’s not a question of intelligence. The team is often full of brilliant people. But no one’s actively aligning product, compliance, operations, and market readiness.

This is especially dangerous in regulated sectors like MedTech and FoodTech, where success depends not just on building the right product, but also on getting it approved and on the market fast enough to survive.

Take drug access: EFPIA reports that only 46% of centrally approved medicines reach patients across the EU, and on average, it takes 578 days after approval. That kind of delay can kill momentum, or worse, an entire business.

In MedTech, the situation can be even more dire. A 2023 Science|Business report quoted a startup CEO calling the EU’s CE marking process a “gridlock” under the new Medical Device Regulation, with small firms waiting months or even years for certification.

On the FoodTech side, EU novel food approvals can stretch anywhere from 11 months to six years, according to NutraIngredients. That kind of timeline doesn’t match the reality of startup runways.

The role: What an integrator actually does

The integrator is not a new title. It’s a way of working that can be taken up by a co-founder, a senior hire, or a trusted advisor. What matters is the function: someone who actively connects tech, regulatory, product, and operations into one forward-looking plan.

They’re not just there to push paperwork or manage checklists. They spot gaps early. They ask hard questions before investors or auditors do. And they make sure that what’s being built can be safely, legally, and effectively shipped to the real world.

Unlike a Head of Product, who often owns the feature roadmap, or a Chief of Staff, who might focus on internal priorities, the integrator’s focus is external alignment. They work across compliance, customer needs, and market conditions to de-risk execution.

At the regulatory consultancy I’ve been building in Helsinki, I often play this role when supporting founders. Whether it’s helping a MedTech startup avoid a 510(k) rejection or preparing a FoodTech company for EFSA scrutiny, I don’t just give advice. I act as a bridge between their ambition and the operational reality they’ll face.

Real-life cases: What happens without one

In one medical device company I supported, I was brought in quite late, after the go-to-market (GTM) strategy had already been finalised and key regulatory assumptions were locked in. The fundamentals looked good: strong tech, good traction, solid clinical data. But during due diligence, an investor homed in on the post-market compliance timelines and flagged them as unrealistic.

I wasn’t surprised. I had already raised concerns about downstream dependencies that hadn’t been mapped, but at that stage, the room for course-correction was limited. The regulatory lead hadn’t been included in the early GTM discussions. The ops team was building in isolation from the QMS plan. The investor simply spotted what internal misalignment had obscured.

In another case, a food innovation startup had solid science but overlooked the classification risks. Their product blurred lines between a supplement, a functional food, and potentially a novel food, a point I flagged when brought in to help them. But that ambiguity delayed their market entry and cost them a strategic investor.

These experiences shaped how I now approach early-stage support: not just ticking regulatory boxes, but acting as an integrator, connecting product, ops, and compliance before decisions get locked in.

Practical advice: How founders can empower the role

If you’re a founder in a regulated sector, here are a few steps you can take right now:

• Name the function, even if you don’t hire for it yet. Who on your team is responsible for regulatory–product–operations alignment?
• Put your regulatory lead at the strategy table. Don’t relegate them to firefighting or last-minute sign-offs.
• Map your critical dependencies and timelines. Especially where compliance gates could affect your funding or launch.
• Check your blind spots. What assumptions are you making about approval timelines, testing requirements, or market classification?
• Distribute the mindset. Even if you find a strong integrator, make sure the whole team understands the role they play in cross-functional alignment.

Startups don’t fail because they lack great science or promising tech. They fail when no one connects the dots. The integrator isn’t a luxury; it’s a survival function. Name it, empower it, and build with it from the start. Even if you don’t have an integrator on day one, bring that mindset in, even for a few months. It’s a strategic gap worth closing early.

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