Investors care about many things, but when they say scale, they mean revenue. Two times, five times, ten times… whatever the directive, it’s centered on revenue growth. For leadership teams, the focus on revenue milestones is more nuanced. Each one matters to investors, yes. But each also marks a strategic shift. The decisions, disciplines, and structures required to hit $100 million in revenue are different from those required to hit $500 million.
Scale, and by extension, growth, is structural. It brings with it certain advantages, a fact we’ve seen play out across multiple sectors, most recently tech — although the connection between scale and revenue has been decoupled somewhat there. In Life Sciences, the advantage of scale was perhaps most evident in the contract research organizations (CROs) of the 1990s, the leaders of which successfully 100x their revenues to $5 billion within twenty years.
Clinical research will likely be the next big growth story within our sector. Protocols are more complex than ever, data requirements are growing, and eligibility criteria are narrowing. Many Principal Investigators participate once and don’t return, and clinical staff availability is waning. Sponsors want predictability, consistency, and faster execution. But many sites haven’t built the infrastructure to deliver on those expectations and don’t have the systems in place to buffer against the headwinds clobbering the industry. It’s a pattern that closely mirrors the CRO sector of the 1990s, when fragmentation, inefficiency, and regional silos gave way to more scalable operating models.
Their growth wasn’t driven by sales alone. It was made possible by global infrastructure, centralization, automation, and standardization, which turned loose networks into coordinated platforms. The site sector is on a similar path, with independent sites becoming part of larger networks that have the resources to drive consistency.
Not Just an Arbitrary Goal
Certain revenue thresholds create structural breakpoints. The next for Velocity is $500 million, a level that can’t be reached by simply increasing headcount to match volume. This is the point where manual scaling no longer works, and tools like enterprise resource planning (ERPs), protocol-level tracking, and automation become a necessity.
Reaching this level also brings new expectations for leadership. At $500 million, Sponsors are trusting you with sizable portions of their portfolios. They expect you to deliver, regardless of any uncertainties buffeting the wider industry.
Infrastructure as Strategy
One of the hardest transitions at this stage is the shift to repeatable, standardized, data-driven processes. Spreadsheets and good instincts just don’t cut it. Siloed data, inconsistent reporting, and manual processes limit visibility and actively hinder throughput. This is one of the first milestones at which headcount and revenue aren’t correlated, and it requires a fundamental shift in management strategy towards prioritizing systems that can support your profitable growth.
Velocity made the choice to move from entrepreneurial growth to structured, systematic delivery some years ago. The number of sites we have now is roughly five times what we had about four years ago. This rapid expansion not only necessitated investment in tools, systems, and processes, but the increased scale has enabled us to ramp up our investment in technology. In 2021, our tech investment was in the low seven-figures; as of this year, it’s 5x that, with plans to grow by at least 20% next year.
We’re investing in automation across the board and developing tools that will increase efficiency throughout the organization. That includes automating patient prescreening and stipend payments with our VISION Engage mobile app, as well as helping sites anticipate which participants are likely to show up so they don’t have empty exam rooms.
Scaling for a Purpose
In the late 1990s and early 2000s, CROs that invested in standardization and infrastructure were best positioned to capture growing demand as outsourcing accelerated. We’re seeing a similar shift now across the site sector.
Our own pipeline reflects that change, with far more high-value, complex studies than we had this time last year. It’s a clear signal that, as expectations increase, Sponsors will look more and more towards site networks as strategic partners, with the reach and systems to deliver.
Growth milestones aren’t about chasing numbers. They mark the points where strategy has to evolve. At Velocity, we’re building for consistency, efficiency, longevity, and scale to stay ahead of what the next era of clinical research will demand.
