By now, the pandemic pivot has become an essential part of the entrepreneur’s tool kit. The catchy phrase describes the often-desperate transformation that organizations, and the people who work for them, have gone through to survive the COVID-19 years. One Toronto-based startup, Verto Health, changed its course to help hospitals and clinics schedule vaccinations for Ontarians. Although Verto wasn’t created for this purpose, its core value proposition — to streamline healthcare data to improve patient outcomes — fit the mission and by the middle of this January, Verto’s booking system had been used to digitally shepherd 6 million shots.

Of course, Verto’s success wasn’t inevitable — and an examination of the path they took can offer some insight into a smart response in a time of crisis.

The product

Michael Millar, a former provincial public servant, founded Verto in 2017 to solve a problem he’d experienced: important health information getting lost in the shuffle from one institution to the next.

Around that time, a loved one of Millar’s was in pain and no one could nail down a cause. “They were bouncing around from doctor to doctor,” he says. And key changes in their symptoms fell through the cracks when this person forgot to mention them at each new intake. When the diagnosis eventually came, it was cancer.

Striving to solve this problem for Canadians, Millar developed a platform called Digital Twin that creates a seamless, virtual representation of a person’s journey through various healthcare institutions — something that any doctor, or even the patient, can access at any time. More than just a way to organize data, the platform can send reminders, check with a patient for updates and even send alerts when it notices a data point — like a suspicious increase in pain — that requires immediate investigation.

The pivot

At the beginning of 2020, Verto employed 15 people, had 10 clients and was in the middle of seed fundraising. But when the pandemic struck, Millar’s entire sales pipeline dropped out as hospitals refocused their resources to combat COVID.

“We looked at our technology and asked, ‘How can this be more usable during COVID-19?’” says Millar. In August 2020, Verto raised $2 million in seed funding led by MaRS Investment Accelerator Fund, along with Amplify Capital, Verstra Ventures and a group of strategic angel investors, and began to explore possible applications of its tech.

The answer became apparent that September, when one of Verto’s partners, McMaster HealthLabs in Hamilton, asked the company to develop a tool for a study to assess the risk of transmission from cross-border flights. Verto quickly developed a scheduling system to book voluntary COVID-19 tests for international arrivals at Toronto Pearson Airport and then track participants’ results and health status for up to 14 days. Verto had already created the technology to book an appointment, but the complexity of tracking participants over more than one appointment in sometimes multiple labs required new layers to their system — and the company redirected 80 percent of their team to the job.

Verto’s success with the airport project brought a business opportunity for a similar task at a much greater scale. An existing client — one Millar can identify only as “a large urban hospital partner” — called him late in 2020 requesting a vaccination booking system as soon as possible. As the COVID-19 vaccine was beginning to roll out, this client needed a way to ensure doses would make it to the long-term care homes, nursing homes and senior centres where the virus was taking the most lives. To fulfill the request, Verto designed a web portal that enabled the hospital to book both public appointments, but also private ones reserved for vulnerable populations. Millar says Verto quickly became known for its ability to roll out this product within 48 hours. By the beginning of 2022, they had done so for eight hospitals and six public health units — and were booking about a quarter of all vaccinations in Ontario.

The future

Millar believes a company’s ability to successfully respond to a crisis begins before it arrives, by creating a team unified behind a clear vision. “And if you are actually true to that vision, then when a pivot comes and it’s also aligned with what you want to do, the team will follow,” he says. Importantly, though, he adds that once the ball is rolling, the CEO needs to trust that team, and let them level themselves up in their own domain without micromanaging.

In the case of a crisis that will eventually end, thinking about the pivot back is also key — it’s crucial to manage staff levels and investor relations. “I saw lots of people during the pandemic take what they knew was maybe one-time revenue and cast it as long-term revenue,” Millar explains. “That does a lot of weird things with the valuation of your company, with where you need to focus, and how many employees you need to hire.” He credits his executive team with keeping Verto’s headcount, which has now grown to 38, at a level that can be sustained post-pandemic.

Last November, Verto re-joined startup hub OneEleven (the company is also in MaRS Growth portfolio), and Millar is now excited to continue pursuing clients for the company’s Digital Twin product. With staff shortages across healthcare institutions, Millar believes saving time by automating transitions in care is more important than ever.

In the long term, however, Millar’s goal is more ambitious than just saving time and costs. Without all the data at their fingertips, healthcare providers tend to give the same type of care to everyone. But with a platform like Verto, which can objectively and holistically analyze a patient’s conditions and health status, a more individually tailored treatment may soon be possible. “Our system helps a doctor understand how you are different from the normal,” says Millar. “That’s not how we treat medicine right now, and that’s where Digital Twin is going.”

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