Hello there,

Attending the emergency ward at a hospital is hardly a pleasant experience, and often it can’t be much fun for the healthcare staff on the front line either. But Opto Health is building a platform that could make urgent care a lot more bearable for all, for healthcare professionals, patients, and the people who plan services for the future.

Scroll down to read all about this impressive startup and how they’re beginning to carve out an intriguing niche in the healthtech space. As ever, PreSeed Now members get the full details.

Meanwhile, congratulations to Versori, who I featured in PreSeed Now back in July and have now been picked for Y Combinator’s next cohort. 🙌

– Martin

Opto Health wants to take the pressure off urgent care

If you’ve tried to get emergency healthcare in the UK recently, you’ll probably know how stretched things are. Even if you don’t have to wait a worryingly long time for an ambulance, there’s a good chance you’ll be waiting 12 hours or more for treatment once you get to Accident & Emergency.

Due in part to pressures on other health services, it can take a long time to triage, let alone treat patients, many of whom might not even be appropriate for emergency care anyway. You probably don’t need to go to A&E with sunburn, for example. And it’s an international problem; unnecessary ER attendance in the USA cost $32 billion in 2018, according to one assessment.

To tackle this problem, London-based Opto Health is building a digital triage system designed for the specific needs of urgent care wards. Patients can complete the flow in four minutes - far quicker than is possible with traditional triage in overstretched A&E wards.

How it works

CEO and co-founder Sami Nur says the system contains around 200 questions designed for urgent healthcare assessment by experienced clinicians. These are built into a decision tree that leads to around 50,000 outputs, linked to appropriate care depending on the severity of the condition and the availability of care in the local area. 

Nur gives the example of someone who has cut themselves while cooking and gone to A&E, where there is an eight-hour wait time. Opto Health might suggest a local pharmacy with a wound clinic that can see them immediately.

“Most people will go to A&E and be presented with our iPads at the front door, or they can scan a QR code and access us from their phone. And they will basically triage and stream themselves,” says Nur. 

“At that point they will be either told to sit down and wait, they'll be told to go home and wait for someone to video-call them, or they'll be accelerated to the very top of the queue because their concerns are actually quite urgent, as opposed to sitting in the queue with everyone else as they currently do.

Once a patient has used Opto Health’s app once, they can triage themselves from home in the future, meaning they won’t need to take a trip to A&E before finding out there are more appropriate routes to the care they need.

Even the check-in process is faster. Nur says the last time he went to A&E it took 30 minutes just to be processed and booked in. With Opto Health, he says it takes just 30 seconds. “We get your name, date of birth, and postcode, map it to the NHS spine, get your NHS number and then you're in the queue.“

The startup has taken care to ensure maximum usability, Nur says, with text written in plain English designed to be easily read by people aged 11 and older. “The biggest compliments and feedback that we get are around how good it looks and how easy it is to use. And we take pride in that because healthcare isn't necessarily known for its UI and UX ratings.”

For patients who have to wait, they’ll be able to check on their phone to see the length of their wait. They can even opt to send automatic progress updates to family or friends who might be worried about them.

Building Opto Health

Nur has a rich background in healthcare. This includes time as deputy head of healthcare at a large prison, as a primary care commissioner, plus time at Public Health England and in digital transformation of health services in London. From there he moved into the private sector, working with digital healthcare companies, before deciding to take the plunge into entrepreneurship.

He co-founded Opto Health with Edd Royal in February this year. Royal has a background as a CTO for various companies and co-founded AmpTech, which has built products for companies including Google and Unilever. 

Nur says the Opto Health team currently consists of six full-time staff, plus various developers working on contract as they complete the product. The startup aims to go live with its product in Q1 of 2023, and plans to sign contracts with its first customers in the next few weeks.

“The product is about 80% complete. The main thing that we're now finishing off is the clinical clinical pathways.”

International rescue

While the UK is an obvious first market, Nur has his eyes on the US and Irish markets, too. 

“One of the major reasons for developing Opto as an urgent care solution, as opposed to what we've typically seen in digital health which has been focused on primary care, is because urgent care is pretty much the same everywhere in the world.”

Nur explains the front-end is easily adaptable to different markets, and the back-end system just needs to be set up with pathways that match the specific care options available. He says discussions about a pilot scheme in Ireland are already underway, while in the US they’re talking to major healthcare providers in New York and Delaware. Canada, Qatar, Australia, and New Zealand are also on the startup’s radar.

“It's the same process [around the world]. You've got to see [patients] and serve their needs, while at the same time knowing that there's very limited money available... It's about maximising your workforce whilst also delivering the highest clinical care that you can, and educating your patients to go to the most appropriate service wherever possible. 

“That's a global problem, and that’s something that we're focused on.”

In addition to easier localisation opportunities, Nur says serving the urgent care market will give Opto Health much better profit margins than are available in primary care.

Value in the data

While Opto Health’s offering is clearly distinct from the many symptom-checker apps on the market, it does have some more direct competition. eConsult says its eTriage system is live in nine NHS urgent care sites, but doesn't have features like virtual ticketing system, telehealth, prescription generation built in, and analytics to help with workforce management, which Opto Health will provide. 

“We're very interested in what we can do with the data, and how that data can be best used to support future population health management and workforce management,” says Nut. “No-one's really capturing that from the very first entry point. 

“Once you have those symptom assessments, and you've got all your data points mapped out and you've got your workforce understood, and you know how many people are coming into the system training as doctors and nurses, you're then really able to develop some really cool population health management workforce planning and demand capacity tools.” 

“That really begins to kind of change the way that you plan your healthcare system and deliver your healthcare system beyond where we are now, which is essentially firefighting, looking for locums, trying to find people to plug that workforce gap, random commitments from the Chancellor of the Exchequer for X amount of billions to go to the system, which aren't really based on evidence...”

Nur says the data Opto Health collects can be used to help predict patient numbers, and how many seriously unwell people are likely to present themselves at A&E in any time period. This in turn can help with planning day-to-day staffing and broader service provision.

“Putting all this in perspective, if we had Opto utilised across the country in January of 2020, the pandemic wouldn't have been as big as it was, because we would have been able to say ‘these are how many patients are coming in with these symptoms. we've already identified that there's this outbreak that's happening from here, we're diverting these patients to stay home and see them from home’. But that didn't happen. None of that happened.

“What we had was patients coming in because they'd got all the symptoms of Covid. We didn't know it was time because we weren't intelligent enough to utilise all the data that we did have on an aggregated mass scale. So we just had all these sick patients coming in and infecting one another and spreading it like wildfire and putting a big proportion of the spreaders where the clinical workforce was.” 

Investment plans and challenges ahead