Jonathan Baut started Gabi SmartCare with a personal mission at its heart: to save children’s lives by better monitoring their health. Over the last decade, Jonathan has been through the ups and downs of entrepreneurship, from successfully launching a product in 40 hospitals to ultimately selling the company. He shares the lessons he learnt along the way and reflects on the meaning of success and failure.

The idea behind Gabi SmartCare started with a personal experience. Can you tell us more?

A week after my daughter was born, she caught a very severe form of bronchiolitis. This is common in children, but as a newborn she had no immunity. She turned blue in less than two hours and was admitted to the hospital’s intensive care unit, where she stayed for two weeks.

It was terrifying for my wife and I, especially as first-time parents. When our daughter was discharged, the doctors told us a relapse was possible and we should watch out for symptoms, especially at night. But the truth is that we didn’t know how to identify these symptoms. So we’d left the safe environment of the hospital for our home, where we felt helpless.

We didn’t understand why the care our daughter had in hospital couldn’t continue at home. And why medical innovation – which seemed to be flourishing in so many other areas – often didn’t stretch to issues facing newborns. So I quit my job as an investment banker and started a company. The aim was to build a solution that would give a continuum of care for children after hospital discharge.

How did the early stages go?

In 2018, we launched a smart baby monitor for parents, as there wasn’t anything like this on the market at the time. We wanted a device that was easy to use and would reassure parents that their child was doing okay.

But as we worked more closely with doctors, they explained how this resonated with their needs and suggested we move toward a medically certified device, so we pivoted and developed a clinical solution for hospitals instead. We built a remote patient monitoring (RPM) solution – a small device to monitor vital signs.

We had loads of medical advisors, strong traction for clinical studies and even remarkable commercial traction in research. This allowed us to commercially deploy our solution in more than 40 hospitals across the US, all before receiving clearance from the Food and Drug Administration (FDA). But we also faced setbacks. We initially thought we had validated the business model in depth, only to realise that the insights we gathered verbally from advisors were not enough to convert interest into sales. We discovered that commercial demand was concentrated on very small patient populations, which limited our ability to reach the revenue levels that investors were now expecting. Despite excellent satisfaction among hospitals, we had to re-explore the most relevant use cases to meet these new expectations. This led us to pivot once again, this time towards addressing paediatric sleep disorders.

You pivoted a lot. Did Biopôle’s Vanguard help on this front?

When we pivoted towards the medical market, we had doctors supporting the company but struggled to raise funds. We were about to close the fundraising round, but investors changed their minds because of COVID-19. This is when we joined the Vanguard Accelerator programme.

Through this, we got confirmation that the medical route was the way forward for us. We were introduced to corporate companies and investors. But more than anything, Vanguard was incredibly useful to help us shape our strategy – the story behind our product and how to position Gabi to attract investors. We got to test our narrative on lots of different people.

You mentioned challenges during the COVID-19 pandemic. Were there any others?

There have been quite a few… Where to start? A massive change for us was the new EU Medical Device Regulation (MDR), which came into effect in 2021. Without going into the fine details, it became incredibly difficult, risky and lengthy to get devices approved. Ultimately this is what pushed us to the US.

In 2022, the Ukraine–Russia war disrupted global supply chains and caused a shortage of electronic components. My co-founder did an outstanding job securing what we needed, but it was a demanding and time-consuming effort.

In 2023, the medtech investment bubble burst. For years, venture capital had flowed into start-ups with little concern for profitability, but rising interest rates and greater risk aversion suddenly changed the rules. By the time we secured FDA clearance, the market had already collapsed. Capital was scarce, demand remained high and investors had turned to lower-risk opportunities. FDA approval alone no longer sufficed – raising a round now required US$3–5m in revenue. For an early-stage company, this shift was particularly tough.

In 2024, the FDA proposed changes to its guidelines for certifying SpO₂ monitoring devices for blood oxygen saturation. The announcement alarmed investors and industry players, as it would have multiplied clinical testing costs by ten and created severe bottlenecks in accredited labs. Although the FDA head was later dismissed by the Trump administration and the rule has not been enforced, uncertainty still hangs over the sector.

And in 2025, further headwinds appeared, with new tariffs on products adding yet another layer of complexity for companies across the industry.

Many of our readers work in the healthcare space as entrepreneurs. What lessons did you learn during this transition that others might benefit from?

Perhaps the biggest lesson was that pivoting is an important part of the journey. It makes me smile when people say, ‘You pivoted? What was the problem?’ They see it as a negative. When you start a company, it’s very common to need to pivot once you’ve done some R&D. And if you understand this is essential, it comes more easily.

Resilience is useful, but only up to a point. In Europe, we’re often resilient past the point of usefulness. We’re so afraid to fail that we push the resilience too far. This makes it harder to pivot, because we feel we need to cling to our initial idea, even if it isn’t working. When you’re not afraid to fail, you can let go and move on to something else – wasting less time and money.

In my network of entrepreneurs in the US, it’s not unusual for an entrepreneur to launch between five and ten start-ups before succeeding. This seems crazy, but it leads to success in the end. They launch a company, they test it and they make a decision. If it’s not working, they let go and move on.

Any other advice?

Where possible, choose simplicity. I didn’t always keep this in mind when I launched Gabi. For me, difficulty was something to overcome, to get through. But now I’ve learnt that even the simplest way is far from simple.

What I’m saying, I suppose, is that there will be many unexpected challenges. If you’re building a solution in the medical space, start by looking at the need and make sure that need remains at the centre of your solution. We all know this at the beginning, but as development progresses it’s essential to keep testing the product against that original need. Along the way, you’ll often discover new insights that reshape your understanding, which may even render some developments useless. That’s when you need the courage to strip away anything that doesn’t directly solve the problem – sometimes even starting from scratch. It’s not easy, especially for investors or partners to hear, but success ultimately depends on product–market fit.

The second, equally critical element is the business model. Solving a need is one thing, but who benefits most from that solution, and are they willing to pay for it? In healthcare, this requires perfect alignment between patients, physicians, hospitals, insurers and sometimes pharmaceutical companies. Too often, the patient is the main beneficiary, but if other stakeholders see no value, the only viable model becomes B2C. And then comes the key question: will patients actually pay, or do they expect insurers to cover it? This may sound basic, but many companies fail because they overlook this alignment and never find a sustainable model. What’s more, your business model will shape the type of investors you attract. If you bring on the wrong category of investor early, pivoting later to a model outside their scope becomes extremely difficult.

You’ve now sold Gabi SmartCare. How do you feel about this decision?

This could be seen as a failure because the sale wasn’t a financial success. But looking at it only this way would be too simplistic. In many respects, it was a moderate success. We achieved our ultimate goal – saving children’s lives – a few times. We’re also convinced that we brought a meaningful contribution to the field by putting the most advanced technologies towards the service of children. In this sense, Gabi was a true pioneer, helping the industry realise this was a real necessity and pushing it to take the first step forward.

I won’t pretend this was a resounding success because we did fall short. But that’s okay. When you ‘fail’, you often learn more than when you succeed. Now, I want to share these learnings with others. We usually hear about the big success stories, but not enough about the lessons that can truly help other entrepreneurs.

I’ve learnt a huge amount and accrued experience you can only get through working in the trenches and navigating challenges. I feel I’m in a strong position to build on this experience, and I can’t wait to launch something new.