On Demand

Houston startup connects the dots between contract nurses and medical facilities

Houston-based NurseDash is the Uber of staffing nursing shifts in medical facilities. Photo via nursedash.com

It's no secret that there's a shortage of nurses nationwide — and in Houston, the situation is no different. As baby boomers reach old age, the need for healthcare is only becoming more dire. Most facilities see a turnover rate of between 30 and 180 percent among nurses, leaving jobs open and shifts in need of being covered. Ideal staffing is a 5:1 patient-to-nurse ratio, but many sites are getting by with more like 8:1.

The solution for most healthcare facilities, whether they're hospitals, doctors offices or nursing homes, is to contact agencies to fill those spots. But agencies charge a high percentage for placement and lack transparency, says Andy Chen, former CFO for Nobilis Health Corporation. That's why he and Jakob Kohl created their app, NurseDash.

"Historically, some local agencies will promise you that they'll have somebody for you at 7 a.m. tomorrow, then start calling their people. They promise they'll send somebody, but they don't even know who it is," says Chen.

"The other thing is [facilities] would typically call multiple agencies so you're kind of on the hook with first-come-first-serve basis. And they were incentivized to say, 'Yes I've got somebody for you,' then find the person rather than finding the right candidate for that particular shift," adds Kohl, a principal at Everwise Healthcare and an attorney.

The two men were convinced that they could do better. They wanted to make sure that high-quality, accredited nurses could match with the medical sites where they were the perfect fit, for shifts that worked for both of them. NurseDash is the platform that makes the idea a reality.

NurseDash launched in 2017 and is the product of Belgian designers and developers in Russia. The project manager for the app is in New York, but official headquarters in Houston's Galleria area, where a staff of five works with the team spread out around the world.

Since its debut, NurseDash has attracted 40 facilities in Houston, including hospitals, surgery centers, and senior living, and about 400 nurses. Chen says he isn't sure just what to call his technology yet, but compares it to the ride hailing of Uber or Lyft and calls it "a virtual bulletin board."

The healthcare site posts shifts that it needs to fill. Nurses who fit the requirements see the availability and can choose what suits their schedules, then apply within the app. Everything takes place within the app, including payment and asking questions about the job. Nurses have already been vetted before they're able to apply, with comprehensive credentialing including license checks and drug screenings. The percentage that NurseDash takes from the transaction is about 30 percent less than an agency would take, says Kohl.

It's clear why medical facilities need such a service, but how does it benefit the nurses? It depends on where they are in their careers. Experienced nurses can pick up extra shifts on top of their full-time jobs, if they so desire. Practitioners returning to the game after having children can find times that work with their busy schedules. And fledgling nurses can use the opportunities to get a foot in the door at hospitals where they'd like to work full-time someday.

"They can work on their schedule, on their terms," says Kohl.

NurseDash has already expanded beyond Houston to northeast Ohio, which the founders say has a similar competitive dynamic to the Houston market. The next goal is to hit the rest of the top 10 largest cities in the United States. The next markets, says Kohl, will roll out at the request of major hospitals with locations both in Houston and those other cities. Ultimately, the goal is to become the go-to marketplace for nurses across the country. One shift at a time, NurseDash is making healthcare better.

The new tech hub at Houston Methodist has trained hundreds of physicians in telemedicine practices. Natalie Harms/InnovationMap

Houston Methodist's recently opened its new Center for Innovation's Technology Hub in January, and the new wing has already been challenged by a global pandemic — one that's validating a real need for telemedicine.

The 3,500-square-foot tech testing ground was renovated from an 18-room patient wing and showcases new digital health technologies like virtual reality, ambient listening, wearables, voice control, and more. The hub was focused on giving tours to medical professionals and executives to get them excited about health tech, but in the middle of March, Josh Sol, administrative director of Innovation and Ambulatory Clinical Systems at Houston Methodist, says they saw a greater need for the space.

"We turned the technology hub into a training center where physicians could come on site and learn telemedicine," Sol says. "We had some foresight from our leadership who thought that telemedicine was going to be heavily utilized in order to protect our patients who might go into isolation based on the outbreak."

The hub has trained over 500 physicians — both onsite and digitally. Sol says that at the start of March, there were 66 providers offering virtual care, and by March 25, there were over 900 providers operating virtually. On March 12, Houston Methodist had 167 virtual visits, Sol says, and on March 25, they had 2,421. This new 2,000-plus number is now the daily average.

"Telemedicine is here to stay now with the rapid adoption that just happened," Sol says. "The landscape will change tremendously."

Another way new technology has affected doctors' day-to-day work has been through tele-rounding — especially when it comes to interacting with patients with COVID-19.

"We are putting iPads in those rooms with Vidyo as the video application, and our physicians can tele-visit into that room," Sol says.

It's all hands on deck for the tech hub so that physicians who need support have someone to turn to. Sol says the hub used to have a two-person support team and now there are eight people in that role.

Sol says the iPads are a key technology for tele-rounding and patient care — and they are working with Apple directly to secure inventory. But other tech tools, like an artificial intelligence-backed phone system, an online symptom checker, and chatbots are key to engaging with patients.

"We're looking at how we can get our patients in the right place at the right time," Sol says. "It's very confusing right now. We're hoping we can streamline that for our patients."

The hub was designed so that in case of emergency, the display hospital rooms could be transitioned to patient care rooms. Sol says that would be a call made by Roberta Schwartz, executive vice president and chief innovation officer of Houston Methodist Hospital.