Scott Chetham.
CEO & Co-Founder ·
Scott Chetham is a committed clinical and technical research executive with extensive experience developing innovative solutions to complex medical challenges. His career spans private startups, hospitals, university research laboratories, venture capital, and patient advocacy organizations. Scott has a proven track record of building partnerships between leading academic medical centers, community clinics, advocacy groups, and government organizations to address complex clinical syndromes. He also brings strong technical expertise in working with large and complex datasets, electromagnetics, and human disease research.
Guest
Scott Chetham
CEO & Co-Founder
Location:
San Diego County, California, United States
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Faro Health: How Selling on Proxy Metrics Unlocked Enterprise Pharma Before the Real Data Existed

The vaccine trials that defined the pandemic were designed in a table in Microsoft Word.

Not a prototype. Not a legacy system waiting for budget approval. A table in Microsoft Word — used to decide what to measure in patients, how often, and when, across programs that cost between one and two billion dollars per drug and succeed 9% of the time. Scott Chetham had spent nearly 25 years in clinical development watching this. Large pharma, small pharma, MedTech, a company that went public, one that was sold, one that failed. The process never changed.

"The vaccines for the pandemic — the actual trial was designed in a table in Microsoft Word. That was state of the art," Scott said. "We made big decisions about what we're going to measure in people and when we're going to measure it and how we're going to measure it. And we did it all in a table in Microsoft Word."

When he founded Faro Health, the thesis was structurally inevitable: clinical trial design had to be automated. The only question was whether the market was ready. It wasn't.

Selling to Believers Before the Measurement Existed

In a recent episode of BUILDERS, Scott shared the GTM reality of being early to an enterprise market: you often cannot measure what customers actually care about. Faro's product could improve clinical trial design, but proving downstream impact on cost and timelines required data that took time to accumulate.

Their solution was to sell on surrogates — proxy metrics that credibly pointed toward the outcome customers wanted, without being the outcome itself. The early sales strategy was not to find all of enterprise pharma. It was to find buyers sophisticated enough to accept a proxy as sufficient signal.

"In the beginning, we had to use surrogates and sell to the people who believed that surrogate was a good measure for the actual thing you really want," Scott said. "The earlier sales were people who were more believers that if you could measure this surrogate for what we really want to do, that's a strong enough case to keep going."

The non-obvious implication: your earliest customers are a qualifying filter, not just a revenue source. Buyers who accept a credible proxy are analytically sophisticated by definition. They are more likely to drive internal adoption and protect the vendor relationship when results take time to materialize. That's the profile you want in your first five enterprise accounts regardless of industry.

As measurement matured, surrogates gave way to direct proof. A paper with Merck documented cost avoidance from eliminating unnecessary data collection — Scott described the figure as "a bit over something like $100 million." Deal sizes grew. The pilots that once took nearly a year to prove value began closing within a single quarter.

Compressing Time-to-ROI as a Product Investment

That compression was not a sales motion. It was a years-long product and process investment Scott treats as one of Faro's primary competitive assets.

"It used to be nearly a year," he said. "We invest heavily very early on, within a few months, to being able to show a return on investment... the strongest unlock is being able to do that in a quarter."

The mechanism behind that speed matters. Faro hired former consultants into their professional services team — not for implementation, but specifically to help customers redesign workflows end-to-end and report measured value back to leadership. The hiring profile is deliberate: people who know how to map organizational process and build the internal business case, not just configure software.

This addresses the actual adoption problem in enterprise: "This isn't a problem of if you can build it, we've shown you can," Scott said. "It's having a system that people actually want to use and will want to displace. That's the trick."

If a customer can show leadership measurable impact before a quarter closes, internal advocates have something concrete to defend. Without that infrastructure — both the measurement capability and the people who help customers use it — a demonstrably superior product stalls in the organization it just sold into.

Staying Enterprise While the Market Caught Up

Faro was approximately two years early. Scott's response was deliberate: don't pivot to smaller, more accessible buyers. Use the time to mature the platform to enterprise deployment standards.

"We mistimed the market a little bit... We're a little early for the market, probably by about a couple of years. But you're also selling to enterprise, so you also have to have a certain level of platform maturity," he said.

About 14 months before the episode recorded, the market inflected. Inbound demand arrived without advertising. Conference themes Faro had been defining alone for years suddenly had dozens of companies claiming the same space. Scott was direct about the tradeoff: early market timing that once felt like a liability became a brand and trust advantage the moment competitors arrived.

That inflection created harder problems. Scale. Quality. The ability to deliver for a rapidly expanding customer base without diluting the thing that earned their trust.

"Every one of our customers thinks they're the most important customer on the planet to us," Scott said. "What keeps me awake at night is scaling and keeping that reputation."

The Retention Posture Behind the Growth

Scott's chairman — described in the transcript as the first CEO of Upwork — repeats the same line after every signed contract: "Congratulations. Now the real sales work begins."

In high-trust enterprise markets touching multi-billion dollar R&D pipelines, that's an operational posture, not a sentiment. Retention is not a function of product quality alone. It requires active daily delivery and the organizational infrastructure to prove value continuously — the same infrastructure Faro built to compress their pilot-to-ROI cycle in the first place.

The through-line across Faro's GTM is that proof has to be manufactured deliberately at every stage. Proxy metrics to close the first deals. Compressed ROI cycles to convert pilots into expansions. Consultants embedded in professional services to drive internal adoption. None of it happened by default. Each was a specific investment made before the revenue justified it — which is precisely why it compounded when the market caught up.

Five takeaways from this conversation.

Actionable for Healthcare Tech founders

  1. Make ROI measurable before you can measure what you actually want.
    When Faro couldn't yet directly quantify what customers cared most about, they identified credible surrogates and sold to customers willing to treat those proxies as sufficient signal. This unlocked early enterprise revenue while the measurement infrastructure matured. As Scott put it: "The earlier sales were people who were more believers that if you could measure this surrogate for what we really want to do, that's a strong enough case to keep going." The lesson: don't wait for perfect measurement. Find a defensible proxy, be transparent about it, and find the buyers sophisticated enough to accept it.
  2. Compress time-to-ROI as a primary product investment.
    Faro spent years iterating specifically on the speed of value proof — getting it from nearly twelve months down to a single quarter. That compression is not a sales tactic. It's a structural product and process investment that compounds: shorter pilots close faster, expansions follow sooner, and the fundraising narrative tightens. Scott is explicit that this took years of disciplined iteration, not a single insight.
  3. Change management is not a services line — it's a retention mechanism.
    Faro's professional services team includes specialists — described as former consultants — whose job is not implementation but process redesign. They help customers map current workflows, define new ones, and report measurable value back to leadership. Without that function, even a product with clear ROI sits unused in entrenched organizations. Scott frames this as one of the most critical investments to their success.
  4. Mistiming the market is survivable if the thesis is structurally sound.
    Faro was approximately two years early for enterprise pharma readiness. Rather than pivoting toward an easier segment, they used that time to mature the platform to enterprise deployment standards. When the market inflected — Scott dates it to roughly 14 months before the recording — they were positioned to capture pull demand without advertising. The lesson is not "be early." It's that a structurally inevitable market shift can absorb a timing error if you survive long enough with discipline.
  5. Signing a contract is the start of the sale, not the end.
    Scott's chairman — described as one of the first CEOs of Upwork — tells the team the same thing after every closed deal: "Congratulations. Now the real sales work begins." In high-trust, high-stakes industries, retention is built on daily delivery. This isn't a platitude — it's an operational orientation that shapes how Faro allocates attention post-close.