Powering Innovation Ecosystems
Regularly Disruptive #12
Most innovation ecosystems have a clear vision. Far fewer have systems that consistently produce results.
That distinction matters more right now. Funding is tighter, competition is higher, and systems that depend on one or two anchor players are more exposed when priorities shift. The ecosystems that move forward will be the ones that create repeatable ways for many stakeholders to work with each other—not just around founding sponsors.
This issue is about moving from activity that looks like progress to systems that actually produce it, and from early validation signals to structures that can sustain real momentum.
Innovator to Innovator: Krista Nelson on Building a Marketplace for Pediatric Innovation
Everyone wants the best for kids. The harder question is how we can help innovators actually deliver it.
This week, we look at a marketplace for pediatric innovation that sees roughly 5,000 monthly users—a remarkable number of early adopters and innovators in the pediatric space using it to find and evaluate solutions that might otherwise never reach them. PedsMrkt is designed to match solution seekers with solutions in a highly specialized and often underserved part of healthcare.
Krista Nelson leads that effort as Executive Director of PedsMrkt. Kristina has spent more than a decade building innovation capabilities at Children’s Mercy Kansas City. With a background in software and product development, she approaches innovation less as a pipeline of ideas and more as a system that either enables or prevents those ideas from moving forward. As she put it during our conversation, “the problem isn’t a lack of ideas—it’s that too many of them stall between invention and adoption.”
Where Good Ideas Get Stuck
Krista described a pattern that extends well beyond pediatric healthcare. Clinicians encounter problems firsthand and often develop practical solutions. Hospitals generate intellectual property, and startups build products around real needs. There is no shortage of motivation or creativity. What’s missing is traction.
The pathways that used to carry innovation forward are changing. Larger manufacturers want later-stage validation before engaging, and venture capital often gravitates toward adult markets where revenue potential is easier to scale. Pediatric innovation, despite its importance, doesn’t always fit those models, which leaves a significant portion of promising work in limbo.
Rather than trying to push individual solutions harder, Krista and her peers stepped back and asked a structural question. If the middle of the pipeline is where things stall, what would it look like to build infrastructure specifically for that gap?
That question became the foundation for PedsMrkt.
A Marketplace Built for Relevance
At first glance, PedsMrkt looks like a B2B marketplace, but Krista is quick to clarify that it’s not about transactions in the traditional sense. “It’s not about transactions,” she told me, “it’s about making sure the right people see what’s possible.”
What she and her team have built is a combination of platform, relationships, and ongoing engagement that helps pediatric innovators and decision-makers find each other more effectively. The emphasis is not on volume, but on relevance—connecting the right solution with the right context at the right time.
She shared a couple of examples that bring this to life. MyHeartArt began with a nurse practitioner trying to explain complex congenital heart conditions to families. What started as hand-drawn diagrams evolved into a digital platform that creates patient-specific visualizations, improving understanding for both clinicians and parents.
SMöLTAP is another example, a device designed to improve how spinal taps are performed on infants by stabilizing positioning and reducing stress for both clinicians and families. In both cases, the role of PedsMrkt was not to create demand, but to reduce the friction of discovery so that the people already looking for solutions could find them more easily.
The difference between traffic and relevance matters. Platforms optimized for traffic often struggle to create value in specialized ecosystems, while platforms optimized for relevance can quietly accelerate adoption. Seeking traffic leads to low relevance, focusing on relevance leads to more traffic.
Rethinking What “Return” Means
For Krista, relevance comes from how value is understood in a mission-driven context. In pediatrics, traditional ROI calculations often fail to capture what actually matters to the staff and families. A child’s well being matter to everyone, yet the patient populations are smaller, and financial projections may never match those of adult markets.
“If we only use adult-market ROI math,” she said, “we’ll consistently underinvest in kids.”
Her approach is to expand the definition of return. Alongside financial sustainability, she looks at return on mission and return on experience. Does a solution improve outcomes, reduce trauma, or help families better understand complex conditions? Does it increase clinician confidence or make care delivery more effective?
This shift does not ignore financial realities, but it changes how decisions are made and what gets prioritized. It also reflects a broader point that came up in our discussion: ecosystems tend to produce what they measure, so the choice of metrics shapes the direction of innovation.
The Work Behind the Platform
As we talked more, it became clear that PedsMrkt is only one part of a larger system. Krista regularly convenes innovation leaders from pediatric hospitals, collaborates with device consortia, and helps connect stakeholders across institutions.
“The platform is one piece,” she said. “The real work is weaving the community together.”
That work shows up in how relationships form and evolve. She spoke about startups seeking validation, hospitals choosing to collaborate rather than compete, and innovators realizing they are not working in isolation. The 5,000 monthly users are less a measure of reach than a signal that these connections are starting to take hold.
For anyone building in a similar space, this balance is instructive. A marketplace without convening becomes a catalog, while convening without infrastructure tends to remain conversation. The impact comes from combining the two in a way that reinforces ongoing engagement.
Designing for the Middle
Throughout the conversation, we kept returning to the same idea: the middle of the innovation process is where things either move forward or stall.
Ideation is visible, and scaled success is easy to point to. What sits in between—validation, partnerships, readiness—is slower and often harder to navigate. “Hospitals are being asked to push solutions further down the pipeline,” Krista noted, “and that gap needs deliberate support.”
She sees PedsMrkt continuing to evolve to better serve that need, helping connect dormant intellectual property, startups looking for complementary capabilities, and organizations seeking validated solutions. Rather than forcing a new model onto the system, she is designing around where the current one falls short.
What I Took From It
PedsMrkt is remarkable, but I didn’t leave the conversation inspired about how this affects innovators beyond pediatric healthcare. What stood out was how recognizable the pattern is across different ecosystems: strong ideas, motivated stakeholders, and a gap in the middle where progress slows.
What Krista has built is one response to that gap. It combines a marketplace with ongoing engagement, defines value in terms that reflect the mission, and focuses on making meaningful connections easier.
It is still evolving, as she readily acknowledges, but it offers a tangible example of what it looks like to design the connective tissue that many ecosystems assume will form on its own.
If you are working in a different sector, the specifics will vary, but the underlying challenge is likely familiar. And hearing how she approaches it—particularly in the middle portion of the conversation—adds another layer of clarity to how these systems can be built over time.
Takeaways:
The platform is what powers the ecosystem—not the ecosystem itself or any single solution—because it creates the repeatable way stakeholders connect and create value.
Design for the middle of the journey, where validation, partnerships, and readiness happen, because that is where most innovation efforts either move forward or stall.
Optimize for relevance over reach by helping the right stakeholders find each other and act, rather than trying to attract a broad but less engaged audience.
For metrics, focus on measures of value that matter to your stakeholders—no one cares about your web traffic, but they care deeply about how you are helping them succeed on their respective missions.
Explore More:
Leader’s Lens: Nodes not Ideas
When a large stakeholder in your ecosystem leans in, it can feel like validation. Their enthusiasm, visibility, and resources create momentum, and it is easy to believe you have found your market as activity begins to form around their needs. The risk is subtle. Over time, the ecosystem begins to organize around serving that one dominant player. Activity may look strong, but much of it depends on that stakeholder continuing to engage.
As Dan Garretson of Counterflow Solutions has pointed out for the space sector he serves, a major customer like the federal government can create the appearance of a functioning market even when broader demand has not formed. It becomes difficult to tell whether value is being created across participants or simply recirculated from the same source. The result is fragility. When that one big stakeholder’s priorities shift, the system slows with it, revealing that what looked like momentum was actually concentration. He and his team have even developed a diagnostic tool to detect this fragility before it has major negative impact
Research from Shamil Ibragimov and colleagues at MIT Sloan offers a useful lens for addressing this fragility. Fragile markets are not idea-scarce—they are node-scarce. What matters is not just the presence of innovation, but the number of active, connected participants creating value with each other. That is what turns isolated activity into a functioning system.
A healthier ecosystem reflects that principle. Instead of optimizing around one buyer, it enables many-to-many relationships. Startups engage multiple customers, partners collaborate across boundaries, and value flows through a network rather than a single point. Program design is where this becomes real. Activities that bring multiple stakeholders into the same conversations—shared challenges, cross-sector cohorts, collaborative pilots—create more opportunities for value to emerge and reduce dependence on any one relationship.
Measurement needs to follow the same logic. Meaningful signals include the number of unique relationships formed, how often solutions are adopted by different buyers, and whether participants continue to collaborate without direct orchestration.
One large player can be a powerful starting point. But ecosystems that sustain and scale are the ones that move beyond that center and begin to function as markets.
Takeaways:
A highly engaged anchor stakeholder can create the appearance of a market without actually forming one
Ecosystems become fragile when activity concentrates around a single dominant player
Healthy systems enable many-to-many value exchange across participants
Network density and repeatable interactions are stronger indicators of ecosystem health than flagship wins
Explore More:
Space companies fail due to unscaleable markets, not tech — Dan Garretson on LinkedIn
Diagnostic: Is This Actually a Market?— Dan Garretson’s CounterFlow Solutions
Growth markets are node-scarce, not idea-scarce — Shamil Ibragimov at MIT Sloan
Shout-Outs: Systems That Are Moving
A few signals this week from ecosystems that are doing more than talking about progress—they are creating it through collaboration, partnership, and deliberate system design.
Kansas City (Energy & Grid Resiliency)
Shout-out to the Smart Energy Consumer Collaborative for their best practice awards, and to Evergy, ecobee, and Uplight for advancing a more customer-centered approach to grid resilience in the Kansas City region that SECC lifted up. This work highlights how large systems evolve not just through infrastructure, but through how people engage with them. Sources: SECC and Uplight
Geospatial data into real world investment
Kudos to Geotab for their work in publicly recognizing early adopters’ succcesses. Through their Geotab Innovation Awards, they lifted up early adopting Pilot Company who was able to use Geotab’s Altitude technology to to turn telematics data into over $1B in real-world investment decisions - and then called attention to this success. This is a strong example of an ecosystem where data is not just collected, but used to shape how infrastructure evolves and how value is delivered across a network. Source: Geotab
Biomanufacturing (Continuous Production Systems)
Shout-out to Pow.bio and Bühler for partnering the way forward for continuous fermentation, a huge technological initiative for the growing biomanufacturing industry. This kind of progress rarely comes from technology alone; it requires partnerships like this between strategics and disruptors to transform existing industries with new capabilities. It is a reminder that scale in complex industries is built through integration. Sources: Pow.bio and Bühler Group
Chicago (Quantum Ecosystem Development)
Chicago continues to establish itself as a serious hub for quantum innovation. With specialized labs and the On-Ramp program at Illinois Quantum and Microelectronics Park supported by mHUB, plus and IBM Ventures’ investment into startups emerging from Chicago’s quantum accelerator, the region continues to build paths from lab to market in this deep tech space. Sources: Illinois Quantum and Microelectronics Park and IBM Ventures
Quantum Industry (Market Formation Signals)
A specific nod to IonQ for surpassing $100M in annual revenue, the first quantum tech company to do so. Milestones like this matter not just for the company, but for the ecosystem around it. They signal that a field is beginning to move from research and promise toward real market activity. Source: Quantum Insider
Each of these examples reflects the same underlying shift. Progress is coming from systems that connect stakeholders, enable action, and create pathways for adoption—not just from isolated innovation efforts. What are you celebrating?
Tactic Worth Trying: Use Bounties to Turn Intent Into Biomanufacturing Action
Niko McCarty wants bio innovation to move faster. He put out a set of $10,000 bounties to improve the speed and cost of wet-lab biology experiments, defined the problems clearly, and invited anyone to contribute—all without waiting for someone else to fund them. Using his Substack publishing community, he had more than 400 responses within a couple of weeks.
What’s notable isn’t just the volume of ideas—it’s how quickly people moved once there was something concrete to move toward. A clearly framed problem, a visible reward, and a simple way to engage were enough to activate a network that already existed.
That’s the gap many ecosystems face. There is no shortage of ideas or interest, but without a mechanism to focus effort, progress tends to stall in conversation. Bounties work because they replace general alignment with a specific next step.
The most effective ones are anchored in outcomes rather than activity. Instead of asking people to collaborate, they define what “done” looks like—a validated use case, a working integration, or a pilot that produces real data. That clarity lowers the barrier to entry and makes it easier for participants to act without heavy coordination.
The reward does not have to be complex. Financial incentives can help, but access, visibility, or the chance to move something forward can be just as motivating. What matters is that the incentive aligns with what participants are already trying to achieve.
What Niko’s example shows is how little infrastructure is required to get started. He didn’t build an ecosystem first; he created a focal point that allowed one to begin forming. The responses themselves became a signal of where interest exists and who is ready to engage.
For ecosystem builders, this is a practical starting point. If there is a friction point that keeps surfacing, define it, attach an incentive, and make it visible. That alone can begin to shift the system from intent to execution.
Takeaways:
Clear, outcome-based challenges convert interest into execution
Incentives should align with participant goals, not just funding
Visible progress attracts additional engagement and builds momentum
Start small with one focused bounty to test and refine the approach
Explore More:
Check out Niko McCarty’s $10,000 bounties for ideas to speed up or reduce costs for wet-lab experiments - announcement and how he’s gotten 400+ responses in 2 weeks
Call to Action: How Do You Power Your Innovation System?
Most ecosystem leaders can describe what they are trying to achieve. They know the stakeholders, the opportunity, and the impact they want to create. What is often less clear is how those elements come together to consistently produce results.
This is where many ecosystems begin to stall. Even with strong participation, progress can feel uneven or dependent on a few key players. When that happens, it is usually not a problem of vision, but of structure. The system itself is not yet doing enough of the work.
The ecosystems that move forward develop more deliberate, repeatable ways for stakeholders to engage, solve problems, and build on what works. Over time, these interactions become a cycle that produces collaboration, evidence, and confidence rather than isolated efforts.
This is the shift from running programs to operating a system. Events, accelerators, and funding still matter, but they become outputs of a structure designed to generate outcomes consistently. The focus moves from organizing activity to enabling progress.
In practice, this takes different forms. Some ecosystems build continuous pathways between startups and multiple customers, while others create shared infrastructure or recurring engagements that lead directly to pilots and partnerships. What they share is repeatability and usefulness for participants.
That leads to a practical question for this week. Beyond the initiatives you are running, what actually powers your system? What consistently brings stakeholders together, produces outcomes, and makes it worthwhile for them to engage again?
If the answer is not yet clear, it may be worth examining how your current activities connect, where they depend too heavily on a single stakeholder, and what could be designed to work across a broader set of participants. Small structural changes are often enough to unlock more durable momentum.
Ultimately, the goal is not just to sustain activity, but to build a system that can sustain itself.
If this describes you… let’s talk.
📩 dan@openlydisruptive.com
Thanks for reading. Regularly Disruptive is written by Dan Reus, Founder & Chief Instigator of Openly Disruptive, a boutique consultancy dedicated to helping innovation leaders deliver transformational impact. If you found value here, forward this issue to a colleague in your innovation network and let’s expand the circle.