AQP Interview with David West – CEO & Co-Founder of Proscia

David West is the CEO and Co-Founder of Proscia, a software company that is accelerating pathology’s digital transformation to change the way we understand diseases like cancer. Proscia’s Concentriq digital pathology platform and powerful AI applications are advancing the 150-year-old standard of research and diagnosis towards a data-driven discipline, unlocking new insights that accelerate discovery, improve patient outcomes, and fulfill the promise of precision care.

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Nina: What was the inspiration behind founding Proscia, and for those who aren’t familiar, tell us a bit about what you’re building?

David: My background is in computational biology. I studied biomedical engineering at Johns Hopkins and fell in love with the pathology space when I worked with some scientists at Hopkins medicine who were doing work in this field of research that they called “quantitative nuclear morphometry,” which is definitely a mouthful! Today we would probably just call it AI in pathology or computational pathology. Essentially, we were looking at images of biopsies and using machine learning and computer vision to predict cancer outcomes. Cancer is something that runs in my family and has had a personal impact on my life with seeing family members go through that journey.

I’m personally passionate about the intersection of software and medicine. I partnered up with my co-founders to help take some of this technology that we were seeing in an academic field and bring it to the real world. I guess you could say I’m an entrepreneur at heart and I didn’t have much patience for a PhD, so we started building software. What began as a humble project with a big vision, turned into my full-time job in 2016. Now Proscia has over a hundred employees and great customers in life sciences and diagnostic labs. Our software today helps labs manage image-based pathology work. Rather than using microscopes and glass slides to diagnose, conduct cancer research, or do any type of work that is dependent on understanding tissue, we provide a solution that helps labs manage their workflows using these really big images called “whole slide images,” which is a growing trend in science and medicine. We also develop AI applications that identify areas of interest and help accelerate workflows.

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Nina: Can you share some information about the company’s growth?

David: By the end of last year, Proscia’s platform was in 10 of the top 20 pharmaceutical companies and we really solidified our position as the product leader in the digital pathology and life sciences space. We are doubling down on that position, pushing on commercial growth, and expanding those accounts. We know that once a customer starts using the Proscia platform, they fall in love with it and the average account spend almost doubles in their second year versus their first year. We will continue building upon on top of this strong foundation that we ended 2021 with.

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Nina: With all that momentum, what are you most proud of?

David: I’m probably preaching to the choir here to say that the thing I’m most proud of is the team. For me, on a personal level, I get to work with incredibly smart people who are remarkably talented in their areas of expertise. One of the most rewarding things about being an entrepreneur is that I am a generalist in a sense, who gets to work with amazing specialists. It is awesome to have so many of the world leading experts in this niche field on our team who are part of our journey and share this mission with us.

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Nina: What has been the most challenging part of growing Proscia?

David: They say that building a company is like “eating glass.” That is a truism in more ways than I initially realized when starting a company. This was just a fun project that turned into a real business. There are a lot of ups and downs, and the most challenging part is all about persistence. I think even if you talk to the most successful entrepreneur, they will tell you that there are downs. I just heard the story about how before Facebook IPO’d, they took about a 50% haircut on their valuation in a down round just to bring in more cash to be able to “out survive” their other competitors. Even very successful companies that were high growth and profitable go through these challenges. When growing a company, you have to be able to lead a team through that.

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Nina: You guys had to retrench when Covid first rolled in. What did you learn about yourselves through that?

David: During COVID, as for many companies, we were fundraising right when it started. Then all of a sudden, within a week, we went from kicking off the round to investors saying, “actually I’m not taking meetings” or “we’re going to see how this thing plays out here.” Fortunately, a few weeks after that, a couple of things happened. We closed massive deals and we were growing 10x in bookings year-over-year in 2020. Then the world started opening up again and investors started saying, “you know we’re not doing the in-person thing, but we will probably invest without ever meeting in-person, so let’s jump on Zoom.” And we did! We found an investor who was amazing that led our Series B a few months after COVID. We made some decisions to make sure that we had a good runway, reserved cash, buckled down, and ended up coming out on top and stronger than ever. Persistence matters a lot especially in healthcare, which is hard because the cycles of innovation are long.

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Nina: Based on that experience, what of that do you think you can apply to the correction we’re most likely facing in the months ahead?

David: For growth-stage software companies, the reality is that cash flowed very freely for the past couple years and it’s now drying up. LP’s are pulling back from venture funds. Venture funds are slowing down on investment. They say there’s about a quarter trillion dollars in dry powder still sitting out there, but that’ll probably be deployed more slowly. For us what that means going back to the basics, making sure we have a good strong business, and prioritizing capital efficiency. They talk about being “default to live” in the venture/startup world, which in many ways means we don’t want to be addicted to venture capital. I think that is especially important in this environment with the trend of investors paying double, triple, or 10x the Series A investment in a Series B round. That is probably not going to happen anymore. The best businesses are going to survive and thrive, and probably take the lion’s share of this market. We want to lean into that, and I think we have good foundations to be able to do that. As a business that’s been through ups and downs, we know how to manage through that, and we have the confidence to do things right.

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Nina: What keeps you up at night at this stage?

David: We have a great team and a great culture. That is just so important to our story, our future, and our ability to have that strong DNA. We’ve been in this remote and hybrid work environment for the past 2 years now, and I continue to think about how we lead in that context. That definitely keeps me up at night. I don’t think I have the answers, and I don’t know if anyone has the answers. Historically, it has been a very competitive talent market. I think that maybe some of those effects of the asset bubble are going to cool off and make it more favorable for companies to not have to sacrifice culture to get great talent, but I think that there were companies that probably caved on culture. We want to make sure that we never do that and that we keep this an authentically Proscia place.

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Nina: On that note, can you elaborate on the culture at Proscia?

David: We are a mission-driven company at our core. We’re here because we think that the world of medicine is in great need of great technology and that scientists and pathologists have been shortchanged. There are going to be ups, and there’s going to be downs. We say that in our culture that we want to win as a team, and we want to share in our disappointments and in our successes. I think people really feel that here. People come to Proscia and know we’re building a plane while flying it. They know it’s messy. It doesn’t take away from the fact that sometimes the going gets tough. There are tight deadlines, and it feels like we are balancing a million things at once, but I think it’s the culture and the mission that keeps people moving forward.

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Nina: If you could go back in time to when you first founded Proscia, what advice would you give yourself?

David: People matter way more than most would want to admit. The decisions around people are tough, and they’re tough for a good reason. I think that the important thing is to just find great people, double down on great talent, and don’t waste too much time with bad talent.