Also, in rare cases, depending on your pitch and network, if the customer (hospital in this case) is impressed and gives you the order, you can ask for a token amount which can help you get off the ground and work towards the product in discussion.
I wouldn’t call this a rare case. It’s a pretty common strategy in enterprise b2b startups. You develop a PoC that solves a real problem for customers with real money, and they’ll pay you to be one of the first customers if you can implement their feature requests.