She had spent years on the other side of it. As a clinical nurse, she had answered the call button hundreds of times a shift, walking corridors to deliver a glass of water, adjust a pillow, explain again what tomorrow's procedure would involve. Now she was the one lying in the bed, and she found she could not bring herself to press it.
“I feel bad calling the nurse every time,” Yuka Sawada remembers thinking.
It is a small moment, the kind that passes unremarked in hospitals every day. But Sawada, then working as a hospital management consultant, recognised something structural inside it. Outside the ward, she communicated through LINE, email and Slack, asynchronously, at whatever moment suited her. Inside the ward, there was exactly one channel: the nurse call. Urgent and non-urgent requests travelled the same wire, interrupting the same overstretched person. As she later put it, the problem was that hospital communication “had become disconnected from the way we communicate in everyday life.”
In June 2020, in the middle of the pandemic, she founded OPERe to close that gap.
The arithmetic no hospital can escape
Japan is the world's most aged society, and its healthcare system is absorbing the consequences first. More patients arrive each year with more complex conditions, while the clinical workforce that serves them grows tighter. Since April 2024, overtime caps on physicians have made the constraint explicit: the hours simply are not there any more.
Hospitals have responded by digitising records. Electronic medical record systems are near-universal in Japanese acute care. But records are only half of what a hospital produces. The other half is explanation, and it has remained almost entirely manual.
Consider what happens before a single operation. A patient must understand the procedure, the risks, the anaesthetic, the fasting rules, what to bring, when to arrive, who may visit. A nurse or doctor delivers this by speaking it aloud, often to an anxious person who will retain a fraction of it, then repeats it to the family, then repeats it again by telephone the following week. The same explanation, given hundreds of times a year, by the most expensive and scarcest labour in the building.
Then the information has to come back the other way. Medical history, allergies, medications, questionnaires, consent. Handwritten on paper in a waiting room, transcribed by staff into the electronic record, stored in a cabinet somebody must later retrieve.
None of this is a technology problem in the conventional sense. It is a communication problem that happens to be extraordinarily expensive.
From the ward, to consulting, and back again
Sawada's route to founding a company began with a manga. As a junior high school student she read one whose protagonist was a nurse, and decided that was the work she wanted. She trained and practised as a clinical nurse at St. Luke's International Hospital in Tokyo.
What she encountered there was both the meaning of the work and its severity. Rather than leave healthcare, she moved upstream, joining a hospital management consulting firm because, in her words, she wanted “to build an environment where my colleagues could work with vitality.” Consulting gave her the second half of an unusual education: not only what a ward feels like at 3am, but how hospital operations, budgets and IT decisions are actually made.
Her own hospitalisation supplied the third piece. The company she founded took its name from that diagnosis: OPERe, for renewing the operations of care. Its stated purpose is to use technology to remake how healthcare organisations run, so that medical services can be sustained and improved rather than merely rationed.
And it carries a conviction from her nursing years that shapes the product to this day: “the people who think most about the patient are their own doctor and nurse.” OPERe was never designed to replace that relationship with software. It was designed to give it back the time it needs.
Meeting patients where they already are
OPERe's platform, Pokesapo, begins from an unglamorous but decisive insight: the app you do not have to install is the app everybody uses. Rather than asking patients to download hospital software, Pokesapo runs on LINE, alongside in-facility tablets for those who prefer them.
A patient scans a QR code at the hospital. From that point, Pokesapo delivers explanations against the patient's own timeline. Admission guidance, examination preparation, surgical briefings, sent as video and PDF at the moment each becomes relevant, in the patient's own home, at a pace they control, as many times as they need to watch it. Nobody has to be interrupted for the fourth viewing.
The channel runs in both directions. Medical history and pre-consultation questionnaires can be completed from home rather than on a clipboard in a waiting room, with automatic reminders for anyone who has not finished, multilingual support for patients who need it, and output that flows into the hospital's existing electronic record rather than sitting in a silo. In February 2026, OPERe added AI Window, a retrieval-augmented generative AI layer that answers the routine questions patients ask at all hours, drawing only on that specific facility's own explanatory materials, with data held in Japan to satisfy Japanese healthcare governance requirements.
The design discipline throughout is worth noting. AI Window does not improvise medical advice; it answers from the hospital's own approved content. Pokesapo does not ask a hospital to rip out its record system; it feeds it. This is software built by someone who knows how quickly clinical staff abandon a tool that adds a step.
Delivering information is not the same as being understood
The harder problem, and the one OPERe has increasingly organised itself around, is verification. A hospital can prove it handed over a leaflet. It cannot usually prove the patient understood it, which is precisely what informed consent, safe discharge and treatment adherence all depend on.
Because Pokesapo delivers explanation digitally, it can also observe it: what was watched, what was left unopened, what was answered, where a patient stalled. That turns explanation from an event into a measurable loop, and it turns consent from a signature into something closer to evidence.
The results the company reports point the same way. Pokesapo is now deployed at more than 130 medical institutions across Japan, concentrated in acute-care hospitals and obstetrics and gynaecology departments, with patient satisfaction above 95% and operational improvement reported by 92% of adopting facilities. Those two numbers rarely move together. Most healthcare software improves the institution at the patient's expense, or the reverse. OPERe's own framing for this is sanpo-yoshi, the old Japanese merchant principle that a transaction should be good for all three sides.
Becoming infrastructure
A communication layer is only as useful as the systems it can reach, and OPERe has spent the last two years connecting outward rather than building alone.
In March 2024 it entered a capital and business alliance with Seiko Epson, pairing Pokesapo with Epson Connect to bridge the reality that Japanese hospitals still run on a mixture of smartphones and paper. It has integrated with Gakken Medical Clip to widen its library of patient explanation video. And in June 2026 it opened a proof-of-concept with Seiko Solutions, linking Pokesapo to the Compact In electronic consent service so that a patient can scan a QR code and complete legally compliant electronic consent entirely inside LINE, with no separate app, no additional login, and no paper form for anyone to file or retrieve.
Each of these makes the same argument. OPERe is not trying to own a feature. It is trying to become the place where communication between a hospital and a patient happens, whatever the underlying system. Sawada has been explicit that the ambition extends beyond the hospital wall, towards connecting hospitals with pharmaceutical and medical device companies, whose information currently reaches clinicians and patients through channels barely changed in decades.
Where Vertex Ventures Japan comes in
Vertex Ventures Japan invested in OPERe's ¥400 million Pre-Series A round in June 2025, alongside JAFCO Group and DNX Ventures, with the capital directed at in-hospital communication features and deepening the engineering team.
Three things drew us to the company.
The first is founder-market fit of a kind that cannot be manufactured. Sawada has stood at the bedside, sat in the hospital boardroom, and lain in the bed. Healthcare is unforgiving of software designed from the outside; the graveyard is full of elegant tools that assumed a clinician had thirty spare seconds. OPERe's product decisions consistently reflect someone who knows they do not.
The second is that the market is not waiting for permission. Japan's demographics, the physician overtime caps and the operational pressure on acute care are not forecasts. They are current conditions, and they make patient communication a budget line rather than an aspiration.
The third is what the company is quietly accumulating. Every explanation delivered and understood inside Pokesapo builds a record of how patients actually receive medical information, at what moments comprehension fails, and which materials work. That is a genuinely difficult asset to replicate, and it compounds.
“Most health tech digitises records. OPERe digitises understanding, and then verifies it, at the exact moments a patient's care depends on it. In a system carrying more patients with fewer clinicians every year, that closed loop is not a nice-to-have. It is the foundation of the communication hub every hospital will need.”
Naonori Kurokawa
General Partner
Vertex Ventures Japan
Vertex Ventures Japan backs founders turning hard domestic problems into companies of global relevance, and few problems are more exportable than this one. Japan is simply first to a demographic position that Korea, Taiwan, China and much of Europe are approaching. A system that has worked out how to care for more patients with fewer clinicians, without asking either side to accept less, will have built something the rest of the world eventually needs.
OPERe describes its goal as becoming the communication hub between patients and healthcare providers, and its purpose more simply still: to make medicine that truly gets through the new normal in society.
It began with a nurse in a hospital bed, deciding not to press a button.
For more information on OPERe, visit:
https://www.opere.jp/