Millions in revenue with a <15 person team
How Vitalize Care prioritized understanding their customers to reach product-market fit
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When I meet a startup, I always try to answer a high-level question: “How well does this company understand their customers?” This can be revealing of many related downstream questions: “Does this company have product-market fit? Are they solving an important problem for their customers? Are they prioritizing the right pieces?”
You may be surprised by the number of startup founders I meet who are out of touch with the reality of their customers’ lives. They get so caught up in all these distractions: investors, hiring, brand, building AI because it’s cool, etc.—and forget what really matters most: delighting their customers. They start treating their customers as cells in a spreadsheet, and lose sight of the nuances that are essential to building a product that people actually want.
The more impressive founders and teams I meet seem to be really on-top of this area. They prioritize their customers, and do not lose focus as the company gets bigger.
A great example of this is when I met Sanketh Andhavarapu, the co-founder of Vitalize Care, a platform that automates hospital operations, starting with staffing and scheduling optimization. Vitalize pulls together dozens of complex data streams to predict patient demand and automate how labor is managed across the enterprise.
He explained to me how he “moved to East Tennessee during the first eight months of the company to be near our first 2 customers. Our first ops hire joined me out there, and we spent months driving back and forth between Tennessee and Ohio. We were basically living out of AirBnBs and rental cars, occasionally even sleeping at the hospital. The number of learnings we picked up during that time was insane. It shaped how we build, how we think about trust, and how we work with customers today. That DNA is still core to the company.”
The result of this customer-obsession? Millions of ARR with a less than 15 person team.
And reviews like this from real customers:
"This feels like a god-given gift. I've seriously been praying for something like this for the last decade"
“Our [current tool] was so bad that I didn’t even use it - we manually printed excel sheets, had staff fill them out, and THEN uploaded them to [current tool]. None of that is my problem anymore! I LOVE it”
“My leaders absolutely LOVE Vitalize. It has made their lives so much easier. They tell me they can’t imagine a world without it.”
I would like to see more companies really take seriously the idea of prioritizing their customers. I think it would result in more impactful products, and more successful startups.
And I think Vitalize Care is a great role model for this “customer-obsessed spirit.” That’s one of the reasons I wanted to go behind-the-scenes with their team (they are also hiring in SF across engineering, operations, and sales). In this Next Play Spotlight, we learn what it’s like to work at the company, how they’ve been able to scale a customer-obsessed culture, and more.
Major thanks to the Vitalize Care team for sharing interesting details with us and supporting the Next Play community!
The founding story of Vitalize Care is great.
Great because it is inspiring to hear. And also great because it reinforces the idea that you should be close to your customers, which is I think a lesson everyone in the tech ecosystem could take more seriously.
Sanketh gave us the transparent account of what happened:
“Funny enough, our original product wasn’t even about staffing. We started by building a mental health platform tailored specifically for healthcare workers, sold as an employee benefit to hospitals. The hypothesis was simple: design something just for clinicians, and they’ll actually use it. Higher engagement, better outcomes, strong ROI for the health system.
We were wrong.
Utilization was low. Selling was brutal. And when we went on-site to talk to staff, they were honest: they wouldn’t be too upset if the product disappeared.
But buried in those conversations was a thread that kept surfacing: staffing operations.
“Staffing and scheduling is the bane of my existence. Until that’s fixed, no amount of mental health support is going to help.”
That insight led to a road trip to 20+ health systems, hundreds of interviews, and the same pain everywhere we went. Pen-and-paper and spreadsheet processes. Hospitals hiring 20+ full-time staff just to identify and manage staffing gaps. And bleeding tens of millions in unnecessary premium labor costs.
So we threw out the old product and mocked up a new one in Figma: a platform to finally bring intelligence and automation to how hospitals manage their workforce. But this time, we made ourselves a rule: no code until we signed multiple health system deals.
Two months later, that Figma prototype landed us our first six-figure pilot. Within four weeks of launching, we turned it into a multi-million dollar deal. We knew we were onto something real.”
At Vitalize Care, “customer-obsession” is not just a mantra written in some internal culture document. As you read, it actually saved the company early on. And even now, it’s more than just some words - it’s a way of working that is directly translated into the priorities of every team member.
This manifests in many ways. For one, they have every team member visit customer sites (in their case, hospitals!) in-person.
“My favorite memories are definitely the customer trips, and travelling across the US together as a team. That's usually a mix of getting feedback from customers, spending time building product, and seeing how what we're building is genuinely a 10x improvement to our clinicians' lives.”
That includes everyone from the founders to new teammates. People are willing to get on a plane to address problems directly.
“We have the usual values of working hard and being transparent, but some of the most important moments we've had have been when shit hits the fan - founders get on the plane with us to go resolve customer problems. Everyone's in the trenches together to make sure we all win.”
“There's definitely a do-er culture, and everyone's willing to jump in at any point.”
While visiting customers, they “watch users interact with the platform, ask questions, and build trust. That trust gives us access to raw, unfiltered feedback that you just can't get over Zoom. ”
“We work with nurses who often are in this lifelong career. They often have a very unique sense of what's important to them and their work, and it's crucial to hear them out and make them feel heard. This is very different from building for a tech-first user, and has very interesting challenges from the design and UX perspective.”
“Many people on our team have high EQ and empathy, strong sense of customer-driven design and product, and a willingness to do things that don't scale. We have many deeply introspective people that intentionally reflect on every customer interaction, and can read between the lines during customer discoveries.”
They are looking for a particular type of person who has this sort of mentality. They want people who are open to doing whatever it takes to win (even things that don’t scale!).
Many of the people on the team said they joined because they very much believed in the long-term mission.
“I joined due to the mission! I was on a clinician-scientist pathway, and got exposure at various levels to healthcare policy, system wide processes, and hospital-enablement technology. I quickly realized that the practitioners were constrained by the limits of the healthcare system, and wanted to work on system-optimization technology that would help these clinicians practice better medicine.”
“I have family that works in hospitals and understand how rough the schedules can be. I was excited to help tackle that problem, and work somewhere solving a problem that is deeply ingrained.”
“I joined Vitalize because I saw a chance to build something that could tangibly improve the day-to-day experience of nurses, something I wish I had during my own time at the bedside. The company was tackling a real pain point with a thoughtful, user-centered approach that resonated with both my clinical and operational background. It felt like the rare opportunity where my lived experience could directly shape the product and its impact.”
“Growing up, I always wanted to be a physician. I spent hundreds of hours working across clinical settings, from large academic medical centers to small, low-income clinics. No matter where I was, I kept seeing the same thing: dusty binders, Excel spreadsheets, whiteboards, and pen-and-paper running the show. It felt like the entire system was being held together with duct tape.”
Many startups these days do not have very compelling or tangible missions. Even in the very successful scenario, they are building something that just does not sound especially impactful or important. That’s I think one of the reasons why companies have a tough time hiring very mission-aligned people—because they are building a product or tool in an area that does not really lead to lots of impact.
Vitalize Care is in a bit of a different situation. They are building a product that very directly impacts their customers (and anyone who participates in the healthcare ecosystem).
“We’re building the intelligence layer for hospital operations, something that impacts real lives, every single day. The product matters, the stakes are high, and the work you do has a direct impact. There’s no bureaucracy, no waiting for permission. You’ll be trusted with real responsibility from day one.”
“If you've in SF, then I think you'd agree that it feels like a bit of a ".ai" bubble right now. VCs are basically shipping buckets of money at all these AI startups, hoping one of them is going to be the new hot ChatGPT wrapper. I really appreciated that Vitalize stood out from the crowd in that regard by going beyond AI to provide such impact and ROI to its customers. The fact that the startup was in the healthcare space was the pinnacle of that, since I think healthcare is one of the industries most ripe for disruption by startups, and the American healthcare system can use all the help it can get.”
“We are building something that every staff member (including cafeteria!) in the hospital uses at least weekly. We are solving root issues at the hospitals, and helping patients get help faster through proper staffing and day of movements.”
Impressively, Vitalize Care has reached mid 7-figures in ARR without hiring a salesperson (outside of the founders).
That’s partially because Veeraj Shah, co-founder and CEO of Vitalize Care is great at sales.
“Absolutely GOATed salesman.”
“Veeraj is cracked. He is insane at sales, can take very harsh feedback, does his best to listen, and wants the best for everyone.”
(As a related note, I think many startup founders very often delegate important pieces of the company too early on, and as a result lose touch with the customers. It is always great to see founders working closely with new and current customers, refining their pitch and incorporating real-time feedback into the priorities of the company.)
The team’s success is also because they have very much prioritized understanding the customer and building high-impact products.
Vitalize Care is also avoiding the all-too-common mistake of overhiring just to fill seats. Hiring just to hire rarely leads to a productive culture because you end up needing to spend so much time micromanaging people as you lower your bar for quality.
They are doing the opposite, and instead keeping the team intentionally small, focused, and *customer-obsessed.*
“If you want to be surrounded by smart, humble people solving real problems in healthcare, this is it. We’re a small and scrappy team. We have folks that dropped out of Stanford, Columbia, and Cambridge. We have former math Olympians repeat founders, and clinicians.”
If you are inspired by the Vitalize Care mission, and thinking about what to do next, they are hiring in SF for roles across sales, engineering, and operations. Apply here.
(Oh, and by the way, they also host poker tournaments :))
And if you are looking for more opportunities, be sure to check out Next Play.
Founder that’s good at sales + customer obsession is quite a solid combination!
This is such an inspiring story. Thank you for sharing.