Healthcare has a lot of friction, especially within clinical workflow and patient intake. Tech startup founder Aniq Rahman recognized an opportunity to use technology to tackle these challenges.
His company, Florence, banked $20 million in seed funding backed by Thrive Capital, GV (Google Ventures) and Salesforce Ventures with participation from Vast Ventures, BoxGroup and Atento Capital to scale up its clinical capacity management software.
Starting with emergency departments, the company aims to digitally streamline patient access, increase capacity and drive efficiency for healthcare workers, according to Rahman.
Rahman previously was president of analytics company Moat, which Oracle bought in 2017 for $850 million. The core Florence team includes founders, physicians and leaders across healthcare, enterprise and consumer technology including from Google, Oracle, Palantir, Flatiron Health, Resy, Brigham and Women's Hospital, Johns Hopkins Medicine and Penn Medicine.
Like many healthcare startup founders, Rahman said he was inspired to launch Florence based on a personal experience with the healthcare system.
A few years ago, Rahman's father had a heart attack and spent time in the hospital.
"He's fine now, but I just spent a lot of time in the hospital seeing the heroes that saved his life and the work that the front-line workers, nursing staff did day in and day out. And at the same time, I observed the inherent sort of chaos and dysfunction of a system where technology has not really been brought to the forefront," Rahman said in an interview. "I think there is an opportunity on the enterprise side and there are also consumer opportunities as well, which kind of dovetails with my prior builder experience from my private businesses."
The company aims to create a modern system for managing patient capacity that eliminates hassle for both clinicians and patients. Florence is working with over 40 leading health systems, most recently having launched with Luminis Health in Maryland, to address what it sees as the most significant constraint in care: clinical capacity.
The startup is developing products across multiple sites of care, starting with emergency departments. According to Centers for Disease Control and Prevention data, there were 131.3 million visits to U.S. emergency rooms in 2020.
"When I started talking to health systems, it was clear that emergency departments are one of the most difficult sites of care and obviously, the pandemic showed just how critical ERs are but overall the volumes have grown tremendously over the last 20 or 30 years. It highlights kind of an access problem. It highlights a cost problem and it highlights a throughput problem," Rahman said. "At Florence, we're trying to address all of those with technology. Can we get patients through the door faster? Can we give them a better patient experience? Can we give them more transparency on their journey? Can we reduce the work that's on the documentation burden and clicks that a nurse or physician has to do and can we discharge those patients faster?"
He added, "If we can do that we can help drive throughput and improve labor efficiency and we can get patients better outcomes. I think we can also help drive down the cost of care delivery as well. There are ways that we can radically transform the way that emergency medicine is delivered in this country, and I think technology is certainly a missing piece of it."
Florence designed ER patient intake software that rivals consumer-focused industries, Rahman said. Patients can track their journey via smartphone, update clinical information, control prescription fulfillment, initiate self-discharge when appropriate and schedule follow-up appointments.
"As one of the busiest emergency departments in the country, our nurses and administrative staff immediately saw the benefit of Florence," said Saad Chaudhry, Luminis Health's chief digital and information officer, in a statement. "Nurses are saving time and seeing patients faster in our ED. Patients appreciate the streamlined intake process and the transparency provided by being involved, digitally, from the very beginning."
Florence plans to use the $20 million seed funding to build out its engineering, product and clinical teams. The company also will continue to invest in design, Rahman noted.
"There are a lot of great consumer design-led healthcare businesses that are really focusing on the DTC [direct-to-consumer] segment, but when it comes to the enterprise side or the in-hospital experience, it still feels like you're in the 90s. So there's an opportunity to really punch that up," he said.
Hospitals face major financial challenges as they grapple with inflation and staffing shortages at the same time that ERs across the country are stretched thin with wait times getting longer and more patients leaving the emergency room without being seen by a doctor.
"Healthcare is such a challenging space, especially these days with health systems generally being in a tough spot financially. So I think the ROI imperative is that you have to basically build tools that are actually helping them solve real problems," Rahman said. "We're getting product market fit and traction with the systems that we're working with but we know there's so much more with ER, surgery, perioperative care, oncology and the maternal journey. There are so many things we think that we can bring this technology to in the future."
Florence's digital intake tools enable patients to check in to the ER without downloading an app or using a password. "Once patients are checked in, they have the ability to see where they are in their journey and do their entire nurse intake on their phones," Rahman said. Patients also can schedule follow-up care and initiate self-discharge from the hospital.
"It takes a patient generally about two minutes to go through and do their intake, but it saves the nurse seven to 10 minutes per patient encounter. If you can save 10 minutes per patient, you are saving nurses a lot of time. Some of the systems we've spoken to you have estimated that we're effectively adding an extra nurse per shift in terms of productivity gains," he said.
The solution boosts patient satisfaction, increases clinical capacity and reduces patients leaving without being seen, Rahman claims.
Beyond improving the patient experience, addressing clinical capacity and workflow can result in efficiency gains, cost savings and potential revenue for hospitals, Rahman said.
By streamlining follow-up visits and referrals, Florence can help drive more "PCP or specialist attachment," he said. "There's a cost savings part of the story arc, but there's also an increased revenue part to the story arc where some of the systems we're talking to our reporting being able to generate $2,000 to $3,000 of additional revenue," he noted.
Rahman also is an investor and runs New York City-based venture capital firm Vast Ventures, which invests in healthcare startups like Clover Health and Zocdoc.
He sees big opportunities to scale Florence's technology within health systems as hospitals face increasing competition from consumer-centric companies jumping in to get a piece of the $4 trillion healthcare market.
"We're trying to do more of this omnichannel enablement. I want to build tools that allow the urgent care down the street to have the same capabilities as at Amazon or Walmart. I think it's an imperative for these health systems to really adapt and 'consumerize' as their competition is no longer the health system on the other side of town. It's everywhere. It's online. It's in everyone's phone. We're excited to help these legacy operators, health systems and independent practices evolve and be able to adopt the best-in-breed technology and experience," he said.