The most interesting unscripted exchange that occurred during the various panel discussions I attended at the mHealth Summit this week was at one of the final “super sessions” which included high-level executives of three of the largest technology firms in the world and the brazen CEO of one small San Diego startup, Mr. Tom Watlington of Sotera.

Watlington: “Truly disruptive change is something that people resist, and many of the disruptive technologies in this space are undermining the businesses of the major players in the industry. No big technology company is going to go out and invent a disruptive technology which undermines their core business.”

Paul Coss (Phillips Healthcare): “No, we are just going to buy it.”

Watlington: “And THAT is the problem, you are just going to buy it and stick it on the shelf so it never actually gets used.”

I almost jumped out of my seat to applaud Mr Watlington for the no holds barred, in your face approach he chose to take on an issue. I seriously doubt any other mHealth executive in the room would have even had the guts to raise while sitting next to those heavyweights.

Sotera is certainly not your average mHealth startup by any measure. Under Mr Watlington’s leadership, they have raised significant venture capital from strategic investors, including Intel and Qualcomm, two companies that could certainly be considered to fall in the “major industry players” category. The company was founded in 2005 as Triage Wireless and has spent the last six years building a team of over 60 engineers, yet they are still without a product approved by the FDA for sale in the US market.

I had a chance to interview Tom Watlington in the weeks before the Summit and was very impressed by his ability to both articulate his vision for building great products, as well as his depth of understanding of the business models that will ultimately make or break his promising San Diego-based company.

He reaffirmed my initial impression during his performance in the mHealth Summit super session, and frankly he made the gentlemen from the billion dollar company look antiquated in a digital health world. His argument is that big companies, particularly the device makers with whom he shared the stage, do not have an incentive to design products that both perform better and do it at a lower cos. That’s not to say it never happens or that established industry players aren’t innovative. Yet, there are examples in various industries of heavyweights killing or at least trying to kill potentially disruptive innovations. The very word “disruptive” implies overturning existing models. Very few, though, have the guts to point it out like Mr. Watlington.