Sebastian Coates

A YesPress Profile

Most healthcare horror stories are not about doctors. They are about a missed text, an unreturned voicemail, a portal login nobody remembers, a form faxed into the void. Sebastian Coates looked at that mess and saw plumbing. Tellescope, the company he runs, is his answer: a single HIPAA-compliant place where a digital health company can talk to a patient by SMS, email, voice, video, or secure message, and have all of it tied to one profile.

That is the work he does now. The path there was anything but linear. Coates is a Tufts University computer science and mathematics graduate who spent his undergraduate years collecting the kind of resume most people would split across a decade. He analyzed trade finance for a bank. He prototyped blockchain systems for a pharmaceutical giant. He studied pure mathematics at Oxford. And then he went to Cupertino and wrote software for the Apple Watch.

What ties it together is a single instinct: build the thing, do not just talk about it. Coates is a technical founder in the literal sense. He did not hire engineers to translate his vision; he was the engineer. When Tellescope started in 2020, the product was his to write, and to a meaningful degree it still is.

The origin: a friendship over clinical trials

The Tellescope story does not begin in a garage. It begins at an internship. While at Vertex Pharmaceuticals, Coates worked on applying blockchain to clinical trials, the kind of forward-looking, slightly-too-early project that big pharma funds to see what sticks. There he met Derek Strauss. The two clicked over a shared frustration: healthcare had enormous ambition and embarrassing infrastructure. The future was being imagined in conference rooms and bottlenecked by software that could not keep up.

That frustration became a thesis. Digital health companies were multiplying, especially as COVID-19 forced medicine online overnight, but each one was rebuilding the same patient-communication scaffolding from scratch. Coates and Strauss decided to build it once, properly, and rent it to everyone. Coates became CEO. Strauss became COO. The company they founded in 2020 went on to join the UnitedHealthcare and Techstars accelerator that same year.

What Tellescope actually is

Strip away the category labels and Tellescope is a customer relationship manager for patients. Except a patient is not a customer, and healthcare is not retail, so every part of the system has to bend to rules that ordinary software ignores. It has to be HIPAA-compliant. It has to be SOC 2 certified. It has to integrate with electronic health records that were designed in a different era. And it has to do all of this while feeling modern enough that a venture-backed telehealth startup will actually want to use it.

So Tellescope built an API-first platform. There is a shared, compliant inbox that pulls every channel into one view. There is patient relationship management across the entire lifecycle, from a lead who has not yet enrolled to a long-term patient who needs follow-up. There is scheduling, intake forms, a white-label patient portal, and no-code workflow automation so a care team can set up appointment reminders without writing a line of code. And under it all there is a developer-friendly healthcare API for the companies that want to wire it into their own stack. The company's own GitHub organization publishes open-source resources for building modern digital health applications, a small tell about how Coates thinks.

The contrarian part: staying small

Here is where Coates stops sounding like a typical 2020s startup founder. He did not raise a giant round and chase a giant valuation. Public records point to a modest total of roughly a few hundred thousand dollars, backed by StartUp Health, Techstars, the UnitedHealthcare Accelerator, and others. More striking than the number raised is the number not raised. Tellescope has reportedly been profitable for years, serving around 150 healthcare organizations with a team you could fit around a large dinner table.

In an industry addicted to the next mega-round, choosing durability over dilution is a statement. It says the founder would rather own a real business than rent a hot one. It is also, frankly, the kind of decision an engineer makes: optimize for the system that keeps running, not the one that looks best in a deck.

Where it is going

In 2024 Coates led a rebrand he described as years in the making, and Tellescope partnered with Opkit to fold AI-driven phone-call automation into the platform. The throughline is consistent. Every release is about removing one more piece of friction between a care team and the person they are trying to reach. Coates is not promising to reinvent medicine. He is promising that the message will get through. In healthcare, that turns out to be a radical thing to promise.