The Challenge
A Series A healthcare AI company with $6M ARR had built clinical decision-support agents that integrated directly into EHR workflows at integrated delivery networks. The technology was credible. Two reference health systems were live. The forward-deployed engineering motion was working in pilots.
Enterprise sales cycles were averaging 11 months. Deals stalled in the same three places — clinical governance review, CISO review, and CFO commercial review. Each stall added two to three months. The AEs were running a SaaS-era cadence built around discovery calls and demo loops. The buying committee at a 12-hospital IDN had moved on before the second meeting was booked.
The founder had read every motion as a "champion problem." The actual problem was that the company was running a Wedge motion (product-led, individual-buyer) against a Cathedral-shaped buyer (clinical governance, CMIO, CISO, CFO, procurement, compliance). The motion and the buyer center were structurally misaligned. No amount of sales coaching was going to close that gap.
The Foundational Plan: Motion and Buyer Center Realignment
Across the first two weeks of The Clinic, we mapped the company's last 18 closed-won and closed-lost deals against the 52-motion taxonomy. Two motions were quietly closing deals. Six were consuming AE time without producing revenue. We re-anchored the stack to the Operator archetype — forward-deployed engineering, paid pilots, outcome-based commercial structure — and retired the SaaS-era cadences.
Supporting deliverables included:
- Buyer center maps for the top 20 IDN accounts, naming the CMIO, CNIO, CISO, VP of Clinical Informatics, and CFO by name, with public-record commitments and recent board commentary cross-referenced
- A clinical governance pre-read designed to land before the first governance meeting, not after it
- A senior conversation playbook for the CMIO and CFO conversations the AEs had been losing
- Commercial restructuring from per-seat SaaS to outcome-based pricing tied to a clinical and financial metric the CFO already tracked
Ongoing Production: Senior-Led Account Intelligence
The Signal on 24 named IDN accounts (Months 1–3): Nine-section intelligence briefs built per account — the system's published clinical priorities, the unfinished informatics layer, recent CMIO and CIO public commentary, board-level commitments to value-based care, the three bets we would ship first inside their environment. Sourced to public filings, board minutes, earnings transcripts of parent systems, and HIMSS commentary. Each Signal hosted on a page under the client's domain.
Buyer center refresh (quarterly): Maintained as the committees changed. Two CMIO transitions and one CISO hire were caught within the same week they were announced and folded into the active deals.
Senior-led coaching: A senior operator on every account review. Joined eleven CMIO and CFO conversations in the room across the first 90 days. The AEs went from running discovery to running structured reads.
The hand-off playbook: By Day 90, the client's RevOps lead owned the Signal production cadence with a junior researcher we trained.
Business Impact & Results
Sales cycle compression: Enterprise sales cycles compressed from 11 months to 6.8 months across the cohort — a 38% reduction. Three deals closed in the first 90 days that had been open in the pipeline for over nine months.
NER lift: New Enterprise Revenue grew from $1.4M in the prior two quarters to $3.6M in the two quarters following engagement start. Average ACV moved from $180K to $310K as the commercial structure shifted to outcome-based.
Buying committee depth: Average deal touched 9.2 stakeholders in the buying committee, up from 4.1. Clinical governance review moved from a stall point to a structured step the team could prep for.
Pipeline quality: Six IDNs that had previously gone dark re-engaged after receiving the Signal on their own organization. The CMIO at one health system forwarded it to the CEO unprompted.
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