IT That Actually Works in Healthcare
An IT company that builds for pregnant women, Alzheimer’s seniors, spa guests, and ranch animals? That’s not a contradiction.
I’ve learned to be careful with labels.
“IT company.” “Healthcare company.” “Consultancy.” “Product business.”
They’re convenient when you need a quick explanation. They’re misleading when you’re trying to understand what someone actually does and why it works.
That’s exactly what struck me in my conversation with Miloš Tkáčik, the CEO and owner behind Principal Engineering and the broader Principal Group. On the surface, Principal is what many people would categorize as an established Central European technology player: headquartered in Prague, with around 700 people, about 20 years in the market, and branches in Slovakia, Germany, the US, and Canada.
And yet, Miloš is also the person building telemedicine solutions for:
Seniors (including an Alzheimer-focused use case),
Wellbeing in spa environments,
Pregnant women facing a higher risk of hypertension and preeclampsia,
And even veterinary support in the US, where the practical problem is distance, scale, and access.
If you only look at the categories, it feels scattered.
If you listen to how he describes it, it’s the opposite: it’s one capability expressed in different settings.
What Principal actually is (and why that matters)
One of the first things Miloš clarified is that Principal isn’t “only an IT company.” Yes, IT is a major part of the business, but he framed it as roughly half. The other half is the ability to act as a system integrator and provide end-to-end support: consultation, advisory work, and delivering full project lifecycles.
He talked about working across what he called “the whole economy,” government, banking and finance, telecommunications, and utilities.
That range isn’t accidental. It’s a result of building the kind of company that can operate in environments where complexity is normal.
When you work with ministries, banks, telecoms, or large energy-related organizations, you don’t get to pretend the world is simple. You learn to build solutions that fit into existing systems and organizations, and you learn how to deliver.
Miloš named examples of clients and sectors they work with: ministries (including the Ministry of Social Affairs as a major client), banks, O2 in the Czech Republic and Slovakia (supporting backend for data services), GasNet (gas distribution), ČEZ, and ČEP as an energy-sector regulator.
I’m repeating these details intentionally because they’re more than a client list. They explain how an organization develops a certain way of thinking, less about “one app,” more about “what it takes to run something in the real world.”
Expansion: the technology is familiar, the market is not
I asked Miloš about the differences between delivering in Central and Eastern Europe versus Germany or North America. His response was blunt in the best way:
The hardest market is the new market.
Not because the technology changes. He was clear that, from a technological standpoint, you can still program in the same languages and deliver the same types of projects.
What changes is everything else: being established, knowing customers, understanding how business works locally, and earning a place in someone’s decision-making process.
He described expansion as consistently taking longer and costing more than expected; his rule of thumb: twice as long and twice as expensive.
That line stayed with me because it’s not dramatic. It’s practical. It’s what you say when you’ve done it enough times to stop romanticizing it.
When he spoke about the US and Canada, he noted that people can be more open, you can more easily call someone, have a meeting, and start a conversation. But the economics and expectations are different. Clients are used to large international companies. For a company like Principal, starting as a subcontractor was a way to enter the market.
He also pointed out that in North America, they compete with nearshore and offshore options in India, Vietnam, and others. Yet he said that when it comes to technology, quality is recognized, and Czechoslovakia's legacy reputation in IT is known in the US and Canada.
In Germany, the challenge shifted again. Germany is close and a big, obvious strategic direction. But Miloš highlighted a practical barrier: many projects require German-speaking people, especially in government contexts. And the specific combination they need senior expertise in a programming language, willingness to travel regularly, and fluent German doesn’t exist “in big amounts,” as he put it.
So they did what expansion often actually requires: partnerships. They built relationships in Germany and used what they learned in North America to approach Germany more effectively.
I’m not interested in “expansion stories” that are framed as instant success. What I notice here is the grounded way Miloš talks about constraints: language, proximity, expectations, and how you structure your entry.
How telemedicine entered the picture (and why it wasn’t random)
From the outside, telemedicine can sound like a pivot. From Miloš’s description, it’s more like a natural extension of two things already in motion.
First, Principal had participated in software projects for the medical sector in the Czech Republic, including implementations, integrations, and related systems. That exposure matters because it’s a different environment than generic enterprise IT.
Second, Miloš made a separate investment: a senior house for Alzheimer’s patients. He described it as being a pure investor with more ambition than purpose. But it gave him proximity to a real care environment and sparked a decision: he wanted to develop an app for seniors.
That sequence is important.
It wasn’t “we want to be in healthcare.” It was: there’s a real environment, a real population, and a practical need, and they had the capability to build something.
Once they built a platform that could support telemedicine-style solutions, they began applying it to multiple use cases. Miloš put it simply: you can reuse the same parts of the solution. The app is different, but the principles can carry across contexts.
That framing platform, along with adaptable applications, explains why the portfolio looks broad while still making internal sense.
The spa use case: wellbeing that doesn’t stop when you leave
The spa example is one I keep coming back to, partly because it reveals how Miloš views value beyond the obvious.
He called spa healthcare in the Czech Republic “very specific.” It’s not as common in other parts of Europe or the US. Principal saw it as an empty market and decided to build an app for wellbeing.
In the scenario he described, a spa guest could use a ring or a watch, something that monitors them during their stay and reflects back how they’re doing. Then, when leaving the spa, they can see how the stay went.
When I heard that, my mind went to a conversation I’d recently had around longevity and health, where spas were discussed as part of a broader wellbeing journey. The sticking point in that discussion wasn’t the spa experience itself; it was what happens after.
In our conversation, that “after” is exactly where Principal is pushing: Miloš described negotiations with a private spa chain to provide not only the app during the stay, but to let the patient keep it and continue with wellbeing routines.
For the spa chain, it becomes an attraction: a reason for the guest to return, potentially to a different spa in the chain.
This is where I’m comfortable forming an opinion, but I’m keeping it grounded in what Miloš actually described:
A spa app becomes more interesting when it extends beyond the spa.
Not because it promises a transformation. Not because it “solves” wellbeing. But because it stays with the person. And because the spa provider sees a longer relationship rather than a one-time weekend.
Miloš also noted how easily the technology can be translated into different languages, using Korean as his example, emphasizing that localization is not the main barrier at this point. The underlying capability is there.
Veterinary telemedicine: the same principles, a different reality
Another detail that surprised me in the best way was the veterinary telemedicine project in the US.
Miloš described a partner they helped, focused on animal health: imagine a ranch with a thousand cows, and a veterinary doctor who might be a thousand miles away.
That’s not a niche “innovation story.” That’s a practical problem of access and distance.
And it also illustrates Miloš’s recurring point: the principles are reusable. The context changes, the user changes, but parts of the solution can carry across.
I find that kind of example valuable because it’s not theoretical. It’s a scenario where “remote” isn’t a convenience; it’s the only way to make support feasible.
The pregnancy-risk project: how it started, where it is now
The part of our work together that many people may be most curious about is the study for pregnant women with a higher risk of hypertension connected to preeclampsia.
This is not where Principal began in telemedicine. Miloš explained that the pregnancy-risk application emerged from a concrete medical initiative rather than a strategic market entry.
The pilot was conducted in Hospital Šumperk, where MUDr. Karel Huml, the author of the application, initiated the idea to create a digital solution for pregnant women at higher risk of preeclampsia. Principal Engineering collaborated on turning this medical concept into a functioning telemedicine application.
That distinction matters. The impulse did not come from a generic healthcare roadmap, but from a clinician-driven need rooted in daily practice, with technology built around it rather than the other way around.
They agreed and completed an initial pilot, which marked the beginning of this effort roughly two to three years ago. Since then, the work has continued rather than concluded. The pilot phase is over, the application has gone through further development, and the project has evolved into the Penelope study, which we are now conducting together.
Today, the study is active, with more than 100 pregnant women enrolled, all identified as having a higher risk of hypertension and preeclampsia. The application is being used in real clinical conditions, and its development is shaped by ongoing use, feedback, and medical practice rather than by abstract product assumptions.
What matters about this progression is not a promise of rapid expansion, but the sequence itself: collaboration with a real hospital environment, an initial pilot, subsequent iterations of the application, and a gradual, evidence-based broadening of scope informed by real-world data.
I’m deliberately careful not to inflate this into ambitions that weren’t stated. What I find meaningful here is something more fundamental: this work isn’t being built in isolation. It’s being built in close relationship with clinicians and patients, anchored in actual care settings rather than product imagination.
And that grounding is what gives the project its credibility.
The thread that connects everything
If you forced me to compress Miloš’s story into one line, I would not say: “IT company enters telemedicine.”
I would say:
An entrepreneur builds a reusable capability and applies it where there is a clear practical need.
That’s consistent with how he described himself, too. When I asked about his background, he didn’t lead with a polished executive identity. He said the closest label is “entrepreneur.”
That matters because entrepreneurs often move differently from specialists. They can hold multiple lines of business without needing to fit them into a neat narrative for outsiders, provided there’s an internal logic.
In Miloš’s case, the internal logic is fairly clear in his own words:
Principal is not only IT services; it’s also advisory and system integration.
Telemedicine emerged from prior medical-sector projects and a separate investment experience.
The platform can be adapted across multiple use cases.
Expansion is hard, but doable with partnerships and realism about time and cost.
The ambition is to take best practices built in the Czech Republic and expand west (US, Canada, Germany) and also explore activities further east (South Korea, Singapore, Saudi Arabia, UAE).
None of that is a slogan. It’s operational thinking.
What I take from this as a leader
When I reflect on this conversation, I don’t walk away thinking, “Everyone should do telemedicine.”
I walk away thinking something simpler and more useful:
Most opportunities don’t arrive as a straight line. They arrive as adjacent possibilities if you’ve built something sturdy enough to adapt.
Principal started as an IT services company. It became a system integrator across industries. Telemedicine didn’t replace; it extended what they already knew how to do into new contexts.
And that extension wasn’t framed as one market, one patient group, one story. It was framed as a platform that can be applied in different ways: seniors, spa wellbeing, pregnancy-risk monitoring, and animal health.
If there’s a lesson I want to keep for myself, it’s this:
When a business looks “broad,” it’s worth asking whether it’s truly unfocused or whether it’s built around a capability that travels.
Miloš is clearly betting on the second.
And as we continue our work on the study of pregnant women at higher risk of hypertension, I appreciate being in conversation with someone who speaks about expansion, experimentation, and building in real environments in the same tone: practical, direct, and grounded in what’s already been learned.
Pavlina Walter