MediShout navigates high-stakes enterprise negotiations with Miller Growth Advisory

Complex enterprise engagements that make the difference.

When I met MediShout, they had already proven their solution works. Their platform helps medical device manufacturers track and manage their products through hospitals - hospitals were using it, early supplier relationships were solid, real value was being delivered.

But navigating complex commercial conversations with industry giants required different skills. The challenge wasn't product-market fit. It was making fast, high-stakes strategic decisions around exclusivity deals, pricing models, and multi-year commitments that could make or break the business.

Results

Ash Kalraiya, CEO and Founder, and I worked closely together with the following results.

• ARR grew from xx to around xx

• Contracted revenue and credible opportunity to achieve 10x growth over 3 years

• Expansion across more hospitals and increasing traction with top-20 and top-5 manufacturers

• Far greater confidence when navigating exclusivity, pricing, and multi-year agreements

• A capable commercial team through targeted hiring

• Sharper prioritisation of suppliers and opportunities, reducing distraction and protecting resources

These outcomes reflect a more deliberate, structured, and scalable commercial motion.

The Starting Point

When I started working with MediShout the starting point was:

• Clear market pull and early deployments across hospitals

• Strong supplier interest from some of the world’s largest medical-device manufacturers

• All major commercial conversations led directly by the CEO

• Simultaneous need to scale existing customers while winning new ones

• A requirement to maximise market position quickly with limited bandwidth

How We Worked Together

1. Navigating high-stakes commercial conversations

We prepared for major supplier negotiations — exclusivity, pricing, multi-year commitments, and partnership models. This included framing value, structuring meetings, and defining negotiation paths that protected MediShout while enabling scale.

2. Strengthening strategic decision-making

We built a weighted pipeline model to assess ARR potential, strategic value, scalability, and operational complexity. This created clarity on where to focus, where to pause, and where to push back — moving from reactive execution to disciplined prioritisation.

3. Building the commercial team

I supported the CEO through major sales hires, refining role profiles, evaluating candidates, and strengthening the GTM capability around him.

Generalising the learnings:

As companies scale, three themes repeatedly deliver the most leverage:

1. Structured preparation for the highest-stakes conversations

2. Effective prioritisation to invest time where it has meaningful impact

3. Hiring bar aligned with the commercial motion you’re building

These levers create discipline and control when complexity increases, and it always increases faster than headcount.

CEO perspective

“Your support has fundamentally changed how we scale. We’re navigating the largest suppliers in our industry with more confidence, making better commercial decisions, and driving growth in a way that simply wasn’t possible before.” Ash Kalraiya, CEO and Founder, Medishout