Last week, I spoke at a session at the Indian Air Force Information Warfare School, where military strategy was discussed in the context of information warfare. As I listened to the speakers, it hit me: healthcare startup founders have a lot to learn from military models — especially when it comes to risk, resilience, and foresight.

Let’s start with a hard truth: most healthcare startups don’t fail because their tech is bad. They fail because they didn’t see the iceberg coming.

That iceberg might be:

• A sudden policy change.
• A stealth pivot by a competitor.
• A shift in patient behaviour your model wasn’t built to handle.

That’s why I want to introduce a mental model that could reshape your startup strategy. It’s called the Known/Unknown Warfare Model — and although it originates from military strategy, it’s ideally suited for navigating healthcare’s complex, high-stakes ecosystem.

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🧠 The Known/Unknown Model Explained

Picture a 2×2 grid.

• One axis: Known to Us vs Unknown to Us
• The other: Known to Others vs Unknown to Others

This gives us four powerful quadrants — each with strategic insights for healthcare founders.

🔷 Known-Known (Blue): The Stuff Everyone Sees

This is the territory of obvious problems:

• Chronic disease burden (e.g., diabetes in India)
• Gaps in rural healthcare access
• Low EMR usability

Everyone is aware of these issues — from investors to regulators.

✅ Upside: It’s a validated market.
❌ Downside: It’s crowded.

🔍 Startup strategy: Differentiate with design, UX, execution, and GTM. Don’t just identify the problem — solve it better.

🔺 Unknown-Known (Red): They Know. You Don’t.

This is a danger zone.

Think:

• Teleconsultation price caps you weren’t tracking
• A competitor quietly acquiring your pilot site
• A policy draft that undermines your billing model

These are external insights that haven’t reached your radar.

🔍 Startup strategy: Stay plugged in. Use:

• Investor updates
• Policy surveillance
• Mentorship from sector veterans

The goal is to turn Unknown-Knowns into Known-Knowns before they hit you.

🟩 Known-Unknown (Green): Your Strategic Edge

This is your secret sauce:

• Insights from pilot data
• User feedback loops
• Niche clinical workflows you’ve cracked

This is the quadrant of early traction and IP.

🔍 Startup strategy:

• Invest in feedback
• Build stealth
• Capture proprietary learnings that can’t be copied easily

🟨 Unknown-Unknown (Yellow): Black Swan Territory

Here lie the future shocks:

• Your partner wearable platform shuts down
• Clinical evidence changes
• A new health behaviour emerges post-pandemic

You can’t always predict these — but you can prepare.

🔍 Startup strategy:

• Scenario-Test your model
• Diversify tech dependencies
• Stay agile and build optionality

I can use this matrix to summarise the four areas. I have used some examples, but you can apply this model to any scenario you are working on.

🧭 The 4R Framework for Startup Risk Planning

Let’s make this actionable. So how can healthcare startup founders respond to this? To make sense of this, I have developed the 4R Framework, which healthcare startup founders can use to start planning mitigation strategies based on the Known/Unknown scenario. In some case,s this is also called scenario planning.
Here’s how to use the Known/Unknown Model with a quarterly lens.

1. 🔵 Reveal (Blue)

List all obvious risks and opportunities.
Validate assumptions with real-world data.

2. 🔴 Reassess (Red)

Ask: “What do others know that we don’t?”
Track competitors, regulators, and adjacent markets.

3. 🟢 Refine (Green)

Protect your edge.
Guard pilot data and double down on real user traction.

4. 🟡 Resilience (Yellow)

Stress-test for disruption.
Ask what could derail your model — and build flexibility into your ops and pricing.

📈 Why This Model Matters in Healthcare

Healthcare is slow to move and fast to punish. Something that works brilliantly in Bengaluru could fail miserably in Chennai or Nagpur. Meanwhile, new players — regulators, insurers, AI platforms — can rewrite the rules overnight. The Known/Unknown Warfare Model gives founders a lens to:

• Spot threats early
• Convert risk into foresight
• Build startups with both ambition and resilience

So let me leave you with one final question:

👉 What quadrant is your most significant risk sitting in right now?