This lesson from Yale's Introduction to Medical Software course tackles the early decisions that make or break a health tech venture. The instructor walks through the foundational questions any founder must answer before writing code: what problem you are solving and who will actually pay for the fix. The lecture covers stakeholder mapping in healthcare settings, where clinicians, administrators, patients, and payers often want different things, and shows how human-centered design methods can surface real user needs instead of assumed ones. Regulatory compliance gets treated as a design constraint from day one rather than an afterthought, and the lesson closes on building a team equipped to handle both the technical and bureaucratic sides of a medical software business. It is a practical, step-based session aimed at students who may go on to found or join healthcare startups.