Hospital systems and nonprofits are looking for ways to reach patients virtually as face-to-face interactions continue to be limited due to the coronavirus. Getty Images

Hospitals across the country are trying their best to limit the number of people coming in and out — but how does that affect patients in need of non-COVID-19 treatment? Hospital systems are implementing new technology and training so that physicians can use telemedicine to connect virtually.

In March following telemedicine training, Houston Methodist began seeing hundreds more daily telemedicine sessions across its system, Josh Sol, administrative director of Innovation and Ambulatory Clinical Systems at Houston Methodist, previously told InnovationMap. And other hospital systems are following suit.

HCA Houston Healthcare's CareNow locations have implemented Virtual Care, a telehealth urgent care service. Patients can check in online during the urgent care center's operating hours to gain one-on-one access to care from a CareNow physician, nurse practitioner, or physician assistant. Providers, via video chat, will evaluate minor conditions and can prescribe non-narcotic medications when indicated.

If the situation calls for it, providers will tell the patient to come onsite to continue care.

"Virtual Care is an extension of our clinical urgent care services and fully supports our purpose to help people return to what they value in their lives, in an even more convenient way. We are proud to provide an easy solution for our patients' healthcare needs at their fingertips," says Dr. Mujtaba Ali-Khan, chief medical officer for HCA Houston Healthcare, in a news release.

Dallas-based CareNow was acquired by HCA in 2015 and has 16 locations in the greater Houston area.

Health care nonprofits are also taking advantage of remote ways to reach patients. Houston-based nonprofit CanCare is in the business of supporting cancer patients and their families and, despite a global pandemic, has not let up on its services to those in need. In fact, cancer patients with their weakened immune system are at greater risk of developing COVID-19 and are in need more than ever of CanCare's one-on-one matching emotional support service.

"The cancer community is in our thoughts and prayers during this time of uncertainty," says CanCare's President and CEO Cristina Vetrano in a news release. "Now more than ever, the community needs the help of our volunteers and support services. Our mission is not only to ensure the safety of clients, patients and caregivers but also to assure the community that they will continue to receive support throughout this challenging time."

Cancer patients can reach support via email at support@cancare.org or by calling the support line support line at 713-364-1652.

The Houston health care ecosystem will continue to see advances in telemedicine and remote care. One Houston startup, Medical Informatics, has created a virtual ICU program, called Sickbay, and the tech tool is being used to remotely monitor patients in Houston Methodist. The program works around the clock from a control hub to use artificial intelligence and algorithms to monitor patients.

"We designed our Sickbay platform to give lost data back to doctors, nurses and other members of the care team so they could save more lives," says Vincent Gagne, vice president of product for MIC, in a news release.

As the world emerges from COVID-19 — whenever and however that happens — telemedicine will have advanced as a viable option for physicians in a quicker way than it would have otherwise, Sol says.

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

A report found that Houston has only 3.35 health care workers for every 100 residents. Getty Images

Report finds Houston is short on health care workers

what's up docs

Houston may be home to the world's largest medical center, but a new study indicates the region is also home to one of the lowest rates of health care workers among major U.S. metro areas.

The study, released by credit-building loan platform Self, shows the Houston metro area has 3.35 health care workers for every 100 residents. That places Houston at No. 10 on the study's list of the major metro areas (at least 1 million residents) with the lowest share of health care workers per capita, including doctors, nurses, and therapists.

The only other major metro area in Texas sitting toward the bottom rung of the ladder is Austin, with 3.17 health care workers per 100 residents. That puts Austin at No. 4 for the lowest rate of health care workers among major metro areas.

Houston's ranking in the Self study is juxtaposed with the city's status as a world-famous health care hub. Over 106,000 people work at the more than 60 institutions within the Texas Medical Center, which includes the University of Texas MD Anderson Cancer Center, Texas Children's Hospital, and the Baylor College of Medicine.

The 1,345-acre medical complex pumps an estimated $25 billion a year into the regional economy.

Despite Houston's stature as a medical magnet, the metro area is witnessing an escalating shortage of doctors and nurses.

A 2016 report from the Texas Department of State Health Services envisions the supply of registered nurses (RNs) — the largest group of nursing professionals — will climb 38 percent from 2015 to 2030 in the Gulf Coast public health region, compared with a 60.5 percent surge in demand. That equates to a projected shortage of 13,877 RNs in 2030. The Gulf Coast region includes the Houston area.

From 2017 to 2030, the supply of primary care physicians in the Gulf Coast region will increase 19.8 percent while demand will spike 27.5 percent, according to a 2018 report from the Texas Department of State Health Services. Ten years from now, the region will suffer a shortage of 694 primary care physicians, the report predicts.

In a 2019 survey commissioned by the Texas Medical Center Health Policy Institute, about 90 percent of primary care physicians across the country predicted a shortage in their field within five years. Seventy-eight of specialty physicians anticipated a shortage of specialists.

On the consumer side, the survey found 19 percent of patients reported difficulty scheduling an initial visit with a primary care physician, and 15 percent ran into trouble setting up a new visit with a specialist.

"The best way to tell if we have a doctor shortage is by asking patients whether they can easily get an appointment," Dr. Arthur "Tim" Garson Jr., director of the Texas Medical Center Health Policy Institute in Houston, said in a 2019 release. "For now, they overwhelmingly say 'yes.'"

By 2030, Texas will experience the third largest shortage of physicians among the states (20,420 jobs), according to a study published in 2020 in the journal Human Resources for Health. Only California and Florida will see worse shortages, the study predicts. The physician shortage in Texas is being driven by a growing population, an aging population and an aging pool of doctors, according to the study.

Noting the country's growing and aging population, a study published in 2019 by the Association of American Medical Colleges predicts the U.S. confronts a shortage of up to 121,900 physicians by 2032.

The looming national shortage of RNs is also acute.

The country's RN workforce is projected to grow from 2.9 million in 2016 to 3.4 million in 2026, or 15 percent, according to the U.S. Bureau of Labor Statistics. However, the bureau predicts the need for another 203,700 RNs each year from 2016 through 2026 to fill newly created positions and to replace retiring nurses.

"With patient care growing more complex, ensuring a sufficient RN workforce is not merely a matter of how many nurses are needed, but rather an issue of preparing an adequate number of nurses with the right level of education to meet health care demands," Ann Cary, dean of the Marieb College of Health and Human Services at Florida Gulf Coast University, said in a 2019 release

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A few local designers have pivoted to create face masks for local health care workers. Photo courtesy of Magpies & Peacocks

Designers and entrepreneurs fashion face masks for medical professionals in Houston

ready and resourceful

The coronavirus is sweeping the globe and creating new challenges. Notably, companies are not able to keep up with the demand for the N95 masks needed to keep the health care workers safe. Now, Houston's fashion industry is stepping up.

Megan Eddings, founder of Accel Lifestyle, says an article she read about the Centers for Disease Control and Prevention (CDC) advising health care professionals to wear homemade masks or bandanas due to the shortage of the N95 masks inspired her. She was compelled to help combat the COVID-19 pandemic locally and nationwide.

"Accel's Prema fabric was created to prevent the growth of bacteria," Eddings tells CultureMap. "The fabric can be washed up to 100 times and it will still be 99.99-percent anti-bacteria."

Eddings says it dawned on her that she has over 500 shirts made, here in Houston, that could easily be recreated into masks. Her supply chain team consists of 20 sewers and she notes that number can quickly double.

"We have enough supplies here to make 9,000 masks and I have 2,800 yards of fabric sitting at my factory in California," she says. "That's enough fabric to make more than 100,000 masks."

Eddings and her team also tell CultureMap that 47,000 yards of elastic is en route to the Bayou City this week.

"I knew this was serious when the president of MD Anderson responded to my Saturday morning email within three minutes of sending," she says. "He's interested, and they want the infection control team to analyze the fabric."

Other local hospitals interested in Accel Lifestyle's masks are Methodist, Texas Children's, Baylor, and Memorial Hermann. The Memorial Sloan Kettering Cancer Center in New York City has also shown interest as well as Yale's New Haven Hospital in New Haven, Connecticut.

Accel's masks are made out of their specialty anti-bacteria fabric. Photo courtesy of Accel

When Chloe Dao made the decision to temporarily close her Rice Village boutique last Tuesday, offering shopping requests by appointment only, she posted a video to her Instagram account the following day about the emotional roller coaster she's been on surrounding the COVID-19 outbreak.

In the video, Dao says she wanted to play a role in helping her community by creating a pattern and hand sewing 100 washable face masks with pockets. She noted in the caption that the pocket allows for extra filtration but that because it's a fabric mask, it does not stop the spread of the virus. Dao also recommends washing the mask before wearing it.

With production underway since her initial 100 masks, available in small/medium and medium/large, Dao and her team have produced close to 1,000 masks for Houstonians who reached out via social media.

"The requests are overwhelming," a representative for the label tells CultureMap. "We're now shifting our focus to help those on the front line of the coronavirus outbreak; the doctors, nurses, family members of doctors and nurses."

For those who would like to donate to Dao's efforts to continue producing these washable masks, click here.

Houston-based, internationally recognized nonprofit design house, Magpies & Peacocks, and Inclán Studio, a local women's ready-to-wear fashion label, are upcycling together to create nonwoven polypropylene masks, which will be distributed to Houston-area hospitals.

Founder and CEO, Sarah-Jayne Smith and vice president and director of communications/PR, Ahshia Berry, tells CultureMap that partnering together was never a question for either of our brands but more "how can we pull our resources together and help during these trying times."

Clarence Lee, a designer at Inclán Studio, tells CultureMap he searched the studio to find elastic cording that didn't get used in past collections.

"Waste as a resource and upcycling material for good use has never been more important than it is right now," Magpies & Peacocks writes on an Instagram post.

Houston Arts Alliance and Visit Houston donated excess promotional products and now, are deconstructed to reuse the material for these masks.

"It's actually a spun plastic, not a fabric, so it works effectively as a filter, and is more moisture resistant," Magpies & Peacocks tells CultureMap. "It's more compliant and efficient for the current exposure to the service industry in the midst of the crisis."

Lee, who is also a lead designer for Magpies & Peacocks, and serves as an executive board member for the nation's exclusive nonprofit design house, tells CultureMap that for them, it simply boils down to help in any capacity, especially after seeing what's happening across the country with the shortage of supplies.

He notes that they may not have all the supplies, but they do have the capability and time to sew to help those that are on the frontline, fighting and sacrificing everything they have.

"[Houston] is our home, and we all have a part to play in helping fight this," he says. "The [fashion] industry has a major role, and now is definitely the time to show how valuable it can be."

Magpies & Peacocks and Inclán Studio aim to produce 500-600 masks, and hopefully more, should they come across more materials, Lee tells CultureMap. Seven volunteers are helping to sew these nonwoven polypropylene masks.

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This article originally ran on CultureMap.

Texas ranks worst in the nation for access to health care. Getty Images/fstop123

New study rates Texas among the 10 worst states for health care

Time for a checkup

Health care is already one of the hottest topics in the country, and a new study comparing systems at the state level offers even more to talk about — especially in Texas, which is rated one of the worst in the country.

Personal finance website WalletHub compared all 50 states and the District of Columbia in terms of access, outcomes, and costs to determine the best and worst states for health care. Texas ranks 43rd, the ninth-worst in the nation, for 2019.

The Lone Star State lands in the bottom half of the rankings for all of the aforementioned categories, coming in dead last, No. 51, for access to health care.

Texas has the lowest rates of insured children and adults in the nation, according to the study, as well as consistently low numbers of physicians, physician's assistants, and nurse practitioners per capita, all of which fall in the lowest quadrant of states studied. Alarmingly, Texas also has one of the worst EMS response times, 8.37 minutes, but it ranks surprisingly well for retaining medical residents, No. 5 overall.

Texas does slightly better, 38th, in outcomes, which considers such factors as infant mortality rate, life expectancy, and the share of patients readmitted to hospitals after being discharged. For all of those factors, the state receives middle-of-the-road rankings.

When it comes to costs, however, Texas has a couple of redeeming rankings. The Lone Star State is No. 28 overall, but it boasts the country's eighth-lowest cost of a medical visit ($97.99) and the 16th lowest average monthly insurance premium ($544). Offsetting those are its No. 32 ranking for share of out-of-pocket medical spending (11 percent) and No. 43 ranking for share of adults who haven't seen a doctor because of the cost (19 percent).

The best health care in the country, says WalletHub, is available in Minnesota. At the very bottom of the list is Alaska, the worst state for health care in 2019.

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This story originally appeared on CultureMap.com.

Paying a per-employee fee, companies can give their team access to a one-stop-shop approach to medical care with Crossover. Courtesy of Crossover

California B2B medical care concept enters Houston market with HP Inc. already signed on as a client

One-stop shop

Information technology provider HP Inc. and other major employers in the Houston area are exploring a new way to offer medical care to their employees.

A California company called Crossover Health just opened a 5,300-square-foot medical clinic in Spring. The clinic — Crossover Health's first in the Houston area — enables several self-insured employers to share one provider of primary healthcare services for their employees in an effort to cut costs and promote convenience.

Aside from primary medical care, offerings at the Spring clinic include physical therapy, and chiropractic, acupuncture, and fitness services. Each employer pays a monthly per-employee fee for access to Crossover Health.

At the Spring center, Crossover Health seeks to act on its "belief that healthcare should be convenient, simple to navigate, affordable, and personalized."

The Spring location, at 28420 Hardy Toll Road, features four rooms for primary care, and two each for physical therapy, acupuncture, and health coaching. At the outset, the clinic employs 13 people, but more hires are planned as Crossover Health adds clients there.

Palo Alto, California-based HP is the only client of the Spring clinic that Crossover Health is permitted to identify. In February, HP moved about 2,400 employees into its new two-building, 12-acre campus at Springwoods Village, a master-planned community just west of the Crossover Health clinic. Later this year, San Jose, California-based Hewlett Packard Enterprise Co., a sister company of HP, is scheduled to kick off construction of a new campus at Springwoods Village.

Neighboring employers include ExxonMobil, Southwestern Energy, and the American Bureau of Shipping.

For employers, Crossover Health operates medical clinics that are at or near worksites. Outside the Houston area, Crossover Health's corporate clients include Apple, LinkedIn, and Visa.

Larry Boress, executive director of the Dallas-based National Association of Worksite Health Centers, says clinics like Crossover Health's can reduce travel time for employees heading to medical appointments and, as a result, can improve productivity.

"The value of a worksite health and wellness center for both large and small employers in Houston is that it offers the ability to gain real value on their healthcare investment," Boress says.

Aside from trimming healthcare costs, such centers can boost employee satisfaction and decrease absenteeism, he says.

"These centers have also been found to help employers be an employer of choice, benefiting recruitment and retention of employees," Boress says.

A 2018 survey by consulting firm Mercer and the National Association of Worksite Health Centers found that in 2017, one-third of U.S. employers with at least 5,000 employees provided worksite medical clinics, up from almost one-fourth in 2012.

A different survey — this one conducted in 2018 by the National Association of Worksite Health Centers and Benfield, a market research, strategy, and communications consulting firm that focuses on the healthcare industry — showed that among large employers with some sort of medical arrangement, 63 percent offered on-site clinics, 16 percent offered nearby clinics, and 21 percent offered a mix of the two.

"The hope with on-site or near-site clinics is to make healthcare more convenient for employees, and along the way ideally cheaper by cutting down on visits," Business Insider reported in 2018. "Crossover says it can save as much as $970 per member compared to what employers would be paying if that employee went through the traditional healthcare system. That savings can add up for a company with thousands of employees."

Crossover Health already has brought its brand of healthcare delivery to Austin and San Antonio. Now that the company has planted its flag in the Houston market, it's eyeing its first location in Dallas-Fort Worth.

"Texas, which has consistently ranked as the top U.S. state for business and job growth, is one of our most important markets as we continue to expand our national footprint," Dr. Scott Shreeve, co-founder and CEO of Crossover Health, says in a release. "The new Spring center allows us to introduce our new model of primary care to an increasing number of corporations moving to the Lone Star State."


features four rooms for primary care, and two each for physical therapy, acupuncture, and health coaching.Courtesy of Crossover Health

Houston researchers are commercializing their organ 3D printing technology, a local hospital has a tiny medical device with a big impact, and more in health tech. Jordan Miller/Rice University

3 health technologies developed in Houston that are changing the industry

Game changers

There's a huge opportunity for breakthrough medical technology in Houston thanks in large part to major universities, the Texas Medical Center, and other resources within health care startups.

From a new tiny implant that can deliver medicine into the patient remotely to printable human tissue, here are three health technologies coming out of Houston innovators to look out for.

Houston Methodist's tiny drug delivery implant

This tiny implant can have a big effect on patients. Courtesy of Houston Methodist

Houston Methodist nanomedicine researchers have developed an implant the size of a grape that can deliver medicine via a remote control. The device has applications in arthritis, diabetes, and heart disease treatment.

The battery-powered nanochannel deliver system uses Bluetooth technology and can dole out continuous, predetermined dosages for up to a year without refills. A proof-of-concept for the device published in Lab on a Chip.

"We see this universal drug implant as part of the future of health care innovation," says Alessandro Grattoni, chair of the nanomedicine department at Houston Methodist. "Some chronic disease drugs have the greatest benefit of delivery during overnight hours when it's inconvenient for patients to take oral medication. This device could vastly improve their disease management and prevent them from missing doses, simply with a medical professional overseeing their treatment remotely."

The devices can be programed for different dosage sizes and different release settings, which affect the voltage for the medicine delivery.

Houston Methodist has a number of new technologies it's introduced into its hospital system — click here to read about a few more.

NurseDash's resourceful scheduling tool

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

Filling open nursing shifts has always been a challenge for hospitals and medical centers, and they've been forced to rely on outsourced companies to coordinate nurses to fill the shifts. NurseDash puts the power back in the hands of freelance nurses and the medical institutions that want to hire them.

Andy Chen, former CFO for Nobilis Health Corporation and co-founder of NurseDash, says the standard practice is hiring these agencies to fill shifts, and, while they promise to send someone, they don't even know who they'll be sending for a shift just hours away. This antiquated system prioritizes who comes in first, rather than a nurse's specialties or qualifications.

Since its debut, NurseDash, which is based in Houston's Galleria Area, 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 company 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. To read more about the app and startup, click here.

Volumetric's human tissue-printing technology

Rice University bioengineer Daniel Sazer prepares a scale-model of a lung-mimicking air sac for testing. Jeff Fitlow/Rice University

In a world where organ transplants means an incredible amount of time, money, and patience, there might soon be another option on the operating table. Volumetric is a startup that came out of a human tissue-printing technology developed at Rice University.

Jordan Millar developed the 3D printer in his lab at Rice, and still has ongoing research within the technologies. However, Miller says he very strategically chose to launch a for-profit company in 2018 — mainly, to provide access.

"If we want to do translational research, commercialization is important," reasons Miller. "We need to build the market to get that technology into the world."

Right now, the device is printing scaled down organs, and a contraption that looks a bit like a futuristic beehive, graced the cover of the May 3 issue of the journal Science. It's a working air sac complete with blood vessels, the beginnings of a technology that is perhaps only a decade from being implanted in humans. To read more about Volumetric, click here.


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CultureMap Emails are Awesome

Overheard: Local innovation leaders share what they see has changed in Houston for venture investing

Eavesdropping online

Houston's seen a growth in startup and venture investment — even amid the pandemic — and a group of Houston innovators sat down for a virtual event to discuss what's lead to this evolution.

The Greater Houston Partnership hosted an installment of its Houston Industry Series focused on Digital Tech on Thursday, September 24. The panel of experts, moderated by Krisha Tracy of Google Cloud, discussed how they've observed the paradigm shift that's occurred in Houston over the past few years — and why.

Missed the discussion? Here are some significant overheard moments from the virtual event.

“I think there really is an interest for venture capital here, both locally and also welcoming it from outside of Houston. … There’s something magical happening in Houston, and [VCs] want a piece of it. I think that magical piece is a renewed interest in collaborating.”

Stephanie Campbell, managing director of Houston Angel Network and co-founder of The Artemis Fund. "I think a lot [of this progress] is due to the GHP, Houston Exponential, and the founding of the HX Venture Fund to bring those venture funds to Houston to say, 'what's happening here?'" Campbell adds, saying that this connectivity and collaboration that's happening in Houston VC is unique.

“I think there’s a misconception around all we do is oil and gas and life science in Houston, but when you think about what VC-backable companies look like, they’re tech, they’re B2B SaaS, they’re highly scalable, and they don’t tend to be capital-intensive types of things we see corporate venture backing.”

Campbell says, adding "the connectivity and the interest in VC is really taking off. It's an exciting time to be in Houston and Texas in general."

“Plug and Play’s ventures team is based in Silicon Valley and one thing they enjoy about meeting Houston-based founders is valuations tend to be more reasonable than in the Bay Area."

Payal Patel, director of Plug and Play Tech Center in Houston. "There are gems to be found," she adds.

“I don’t know what it is — if it’s something in the water or just Texans being very friendly, but the investors here share deal flow. It takes a village, and I think we all understand a rising tide lifts all boats."

Patel says on the collaborative nature of Houston. "It's really magical."

“What you’re witnessing is a city that has been waiting for industrial innovation to reach the point where it can be adopted at a really high scale, and that happened around 2017.”

Jon Nordby, managing director at MassChallenge Texas in Houston. Nordby adds that MassChallenge in Houston hasn't been keen on consumer tech, or the "grilled cheese delivery apps," as he describes. "We like companies that are in love with problems, not so much in love with solutions. … We build really meaningful tech."

“Over the last year or two, we’ve seen that sleeping giant get awoken. Open and external innovation is newly adopted by more legacy industries where it wasn’t before — and that’s just created a mountain of opportunities for startups and investors alike.”

Nordby says on the shift toward this meaningful, problem-solving technology, which Houston is full of, as he observes.

Houston's Brené Brown rises strong with new podcast and exclusive Spotify deal

now streaming

For two decades, renowned Houston thought leader and researcher Brené Brown has delved into the human condition, studying and exploring themes such as courage, vulnerability, empathy, and shame. Her work has made her a national figure as a five-time New York Times bestselling author and as a host of one of the most popular TED Talks of all time.

Now, Brown is leaping forward with her self-help work with an exclusive new multi-year deal with Spotify. The Houstonian will host a new podcast, "Dare to Lead," which will premiere exclusively on Spotify on October 19, according to a press release. Fans can also look for her beloved "Unlocking Us" podcast to move to Spotify in January 2021.

Brown said in a statement that it was "very important to me to build a podcast home where people could continue to listen for free."

In an added treat for those who love Yacht Rock (and who doesn't, frankly?), Brown is taking over Spotify's Yacht Rock Playlist and has added her favorite tunes (look for smart picks such as Christoper Cross, Doobie Brothers, TOTO, and more).

As for the podcast, "Dare to Lead" will feature conversations with "change-catalysts, culture-shifters and more than a few troublemakers who are innovating, creating, and daring to lead," according to a statement. It mirrors Brown's bestselling book of the same name.

"I've partnered with Spotify because I wanted a home for both podcasts," Brown added, "and I wanted it to be a place that felt collaborative, creative, adventurous, and full of music — like my actual house, where you'd find guitar stands in every room and framed pictures of everyone from Willie Nelson and Aretha Franklin to Freddy Fender, Mick Jagger, and Angus Young hanging on my walls."

When she's not overseeing her multimedia brand, podcasting, writing, hosting, and programming Spotify playlists, Brown serves as a research professor at the University of Houston where she holds the Huffington Foundation – Brené Brown Endowed Chair at The Graduate College of Social Work. She is also a visiting professor in management at The University of Texas at Austin McCombs School of Business.

She is also the author of four other No. 1 New York Times bestselling books, including The Gifts of Imperfection, Daring Greatly, Rising Strong, and Braving the Wilderness. Her 2010 "The Power of Vulnerability" TED Talk has consistently been rated one of the top five most-watched of all time, with more than 50 million views. She is also the first researcher to have a filmed talk on Netflix; her "The Call to Courage" debuted on the streaming service in 2019.

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This article originally ran on CultureMap.