Now is Houston's chance to create a modern economic cluster around health information and knowledge exchange. Photo by Dwight C. Andrews/Greater Houston Convention and Visitors Bureau

For the most part, Houstonians were either born here or came here in pursuit of economic opportunity — a job of some sort that brought us to Houston, either directly or indirectly. Economic opportunity is part of the DNA of this city. The breadth of opportunities our city affords people from all over our country and all over our world are seemingly endless.

Houston's growth in the 20th century was fueled by large, strategic, capital investments in our region's infrastructure. Railroads, Hobby and Bush airports, the Port of Houston, the Texas Medical Center, NASA's Johnson Space Center, the Astrodome, and our surrounding petrochemical facilities have all been enormous economic drivers of investment, jobs, and prosperity for our region.

We are all familiar with the names of our early city visionaries and leaders. Were it not for their vision and leadership, Houston would still be a backwater town on the bayou, 50 miles inland from the closest seaport. Many of these leaders of early Houston had both a legitimate self-interest and a sense of civic virtue that inspired them to give back to a community that nurtured their success. They strongly believed in building a better Houston both for themselves and for succeeding generations with a can-do community spirit. Much of their success in developing Houston into the international city of today was a result of employing innovative mechanisms for matching private and public funding.

Today, the Texas Medical Center located in Houston is comprised of over 50 hospitals, medical schools, and other institutions that are all dedicated to public health. The TMC itself has an intertwined and symbiotic relationship with Houston and is a case study in how public and private institutions can work together to create such a unique medical complex that has benefited so many — and will benefit so many more in the future.

The good news is that today most institutions and physicians have electronic medical records. The bad news is that there is still a problem sending a patient's data across the street to a different health care provider electronically. This problem is called a lack of "interoperability" of health records, and this remains an unsolved problem nationally.

Making the data available to enable access to the right information at the right time to deliver the right care, is a challenge for every health care community in the country. That unresolved national problem can be Houston's opportunity to offer solutions and to leverage one of its largest industries.

We can transform health care delivery by enabling access to comprehensive electronic patient information when and where needed. There is now a strong consensus that new health information and communication technologies have a critical role to play in building a twenty-first century health care system that is safe, effective, patient-centric and equitable.

Most consumers today carry a powerful computer in their pocket called a smartphone. These consumers, also known as patients, are the most underutilized member of the health care delivery team and the only constant factor in the delivery of care. Moreover, the patient should care most about effective delivery of care and outcome. Notably, the added cost to have the patient involved is essentially zero in relation to the cost of delivery so patients would get better care at less cost.

We grew up thinking that doctor knows best, but that was until Dr. Google showed up able to make virtual house calls, whenever, and on demand. How many industries have we witnessed that were disrupted by the Internet? All indications are that this transformation will increase is size, scope and speed and is set to disrupt the largest industry in the largest economy in the world. We are at the dawn of the consumerization of health care.

Because of the enormous social challenges, there is currently no community in the United States that is an economic cluster for health information technology and health information exchange. Houston has the resources to become that community and create a health care hi-tech economic cluster. This suggestion is no more bold than a proposal to dig the Ship Channel 50 miles, or creating the first domed stadium in the world, or landing a man on the surface of the moon and returning him safely to Earth.

Now is Houston's chance to create a modern economic cluster around health information and knowledge exchange. If we are successful, Houston can then not only legitimately claim to be the home of the largest medical center in the world, but also the best.

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Manfred Sternberg of Manfred Sternberg & Assoc. PC Attorneys at Law has practiced consumer and commercial law for over 30 years.

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

Houston medical organizations pivot to telemedicine and remote care amid COVID-19 crisis

online care

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

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Houston is poised to lead 5G growth in Texas, according to a new report

leading the stream

Based on one key measure, Houston sits at the forefront of a telecom revolution that could spark a regional economic impact of more than $30 billion.

Data published recently by the Texas Comptroller's Office points out that as of last November and December, Houston led all cities in Texas for the number of so-called "small cells." Small cells are a key component in the rollout of ultra-high-speed 5G wireless communication throughout the Houston area and the country.

As the Texas Comptroller's Office explains, small cells are low-powered antennas that communicate wirelessly via radio waves. They're usually installed on existing public infrastructure like street signs or utility poles, instead of the big communication towers that transmit 4G signals.

The comptroller's tally shows Houston had approved 5,455 small-cell sites as of the November-December timeframe. That dwarfs the total number of sites (1,948) for the state's second-ranked city, Dallas.

"Houston is in the vanguard of small cell permitting in Texas, and not just because it's the state's largest city; advocates have lauded its proactive approach to 5G. Other cities, particularly smaller ones, are lagging well behind," the Comptroller's Office notes.

According to CTIA, a trade group for the wireless communications industry, 5G holds the promise to deliver an economic impact of $30.3 billion in the Houston area and create 93,700 jobs. The group says industries such as health care, energy, transportation, e-commerce, and logistics stand to benefit from the emergence of 5G.

"Maintaining world-class communications infrastructure is a requirement for success in a rapidly changing global economy. Small cells and fiber technology are the key foundational components for network densification and robust 5G. Cities like Houston that have embraced the need for this infrastructure will see the benefits of 5G faster than others," Mandy Derr, government affairs director at Houston-based communications infrastructure REIT Crown Castle International Corp. and a member of the Texas 5G Alliance, tells InnovationMap.

Derr says leaders in Houston have embraced the importance of small-cell technology through "reasonable and effective" regulations and processes aimed at boosting 5G capabilities. Three major providers of wireless service — AT&T, T-Mobile, and Verizon — offer 5G to customers in the Houston area.

"More small cells and fiber provide greater and faster access for the masses, enabling the connectivity that is essential to our businesses today — whether it's accepting payments on a mobile card reader, completing a sale on the go, or reliably reaching consumers where they are," Derr says.

In a blog post, Netrality Data Centers, which operates a data center in Houston, proclaims that Houston is shaping up to be a hub of 5G innovation.

"Houston has always been on the frontline," Mayor Sylvester Turner said during a 5G roundtable discussion in 2019. "It is who we are. It is in our DNA. We are a leading city. We didn't wait for somebody else to go to the moon. Or to be the energy capital of the world. Or the largest medical center in the world. But you don't stay at the front if you don't continue to lead."

Houston lands on list of nation's top spots for millennials on the move

migration destination

The Bayou City is shining as an attractive destination for young people on the move.

According to the fifth-annual study from SmartAsset, millennials are fleeing cities like Los Angeles and Chicago and migrating to other areas in search of work and a better quality of life, with Houston landing as the No. 18 spot for young professionals age 25 to 39.

In order to compile the list, SmartAsset dug into U.S. Census Bureau data from all 50 states, the District of Columbia, and 180 specific cities. According to the findings, 18,035 millennials moved in to Houston in 2019, while 15,838 moved out. That makes a net migration of 2,197, per the study.

When it comes to migrating millennials, the Lone Star State is tops, landing at No. 1 for states where millennials are moving, with more than 187,000 young people heading to Texas in the pre-pandemic year. Though some 154,000 millennials left Texas during the same time period, this results in a net gain of more than 33,000 millennial residents, the biggest net gain for the group in the country, giving Texas the lead in millennial migration for the second year in a row.

In news that is hardly shocking, Austin landing as the No. 4 hot spot overall.

While Austin ranks as the top Texas city where millennials are moving, one other Texas spot landed in the top 10, the Dallas suburb of Frisco (No. 6), with a net migration of 3,516 out-of-state millennials in 2019.

Dallas just missed the top 10, landing at No. 11 on the list, with a net millennial migration of 2,525 in 2019. San Antonio (No. 22) showed a net migration of 1,865 millennials.

The top city overall for millennial migration in 2019 was Denver, followed by Seattle.

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This article originally ran on CultureMap.