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.

Patients about to undergo brain surgery can use VR to see what their surgeon is about to do to their brain. Courtesy of Methodist

5 new technologies enhancing health care at Houston Methodist

game changers

While hospital systems might have a reputation for being slow adaptors to new technologies, Houston Methodist is single-handedly trying to change that theory. From artificial intelligence to virtual reality, the hospital system is making big moves innovating and introducing cutting edge tools and systems.

Houston Methodist's Center for Innovation, which has really developed in the past few months, is lead by Roberta Schwartz — executive vice president, chief innovation officer, and chief executive officer of Houston Methodist Hospital. She says Methodist has always lead the way within health care innovation in Houston.

"I think we're an industry that is transforming itself. We're either going to be disrupted or we're going to do the disruption ourselves," Schwartz tells InnovationMap in a previous interview. "There's nobody who knows health care better than we do, so if we're going to transform the industry, I want that transformation to come from the inside."

Here are five different new programs the hospital has introduced to enhance patient care.

An automated recruiting tool named Mia

Photo via houstonmethodistcareers.org

Hospital recruiting has always posed a problem for a few reasons, but one challenge has been the lack of HR resources available at all hours of the day or night. To help rectify this issue, Methodist has introduced Mia, a 24/7 chatbot that can answer HR questions from potential applicants.

"We find that we are communicating with night nurses at 1 am asking about benefits," Schwartz says. A lot of the people we are trying to recruit are working at night when we don't have HR staff in the office all night long."

Methodist is one of five in the country to launch the recruiting chatbot. The initial pilot is focused on recruiting medical surgical nurses and medical assistants. In just four months, Mia has chatted with over 800 prospective employees resulting in over 20 hires.

Pre- and post-op automated information

Photo via caresense.com

A crucial time for patients is immediately before and after surgeries or procedures, but doctors and medical staff usually has the most trouble keeping track of patients during these times.

CareSense automated program offers reminders and monitoring questions that better connects the patients with the hospital. In the three months the pilot has been running, nearly 500 Houston Methodist surgical patients reported extremely high satisfaction and over 75 percent of patients are engaged with the program.

Currently, CareSense works with Houston Methodist patients undergoing certain total joint replacement, colorectal, spine, and cardiac procedures. The technology can send texts, emails, website, and video links before and after the procedure. Early data has seen a reduction in missed appointments, lower surgical cancellations, and increased patient compliance. Up next is an expansion into various clinical areas, including mental health, interventional radiology, and oncology.

Virtual reality technology for brain surgeries

Patients about to undergo brain surgery can use VR to see what their surgeon is about to do to their brain. Courtesy of Methodist

Houston Methodist Hospital is channeling a Magic School Bus episode with new VR technology that allows neurosurgical patients and their family members to essentially walk through their brains ahead of their surgeries.

The patient wears a virtual reality headset and gets a 360 degree view of their brain, and the neurosurgeon can walk the patient through the surgery process. According to a release from Houston Methodist, the technology is the first of its kind that combines fighter jet flight simulation with patients' anatomy scans from MRI, CT, and/or DTI processes to make a 3D model.

Virtual urgent care

Screenshot via App Store

Houston Methodist recently went mobile, Schwartz says. About 77 percent of patients are interested in virtual access to physicians, according to the Advisory Board's 2017 Virtual Visits Consumer Choice Survey that included over 5,000 patients across the country — and 19 percent of patients have already engaged with doctors virtually.

"We live in a technology-driven age where people want easy access to services and they are open to seeing a provider via video. With virtual urgent care, a patient can get help for minor illnesses from the comfort of their own home," says Schwartz in a release.

The new MyMethodist app provides a platform for patients to contact doctors virtually, as well as medical records, test results, bill payments, prescription services and more. Some of the conditions included in virtual treatment are cold/flu symptoms, pink eye, skin infections/rash, allergies, cough/fever/headache, and upper respiratory infections.

Scheduling tool partnership with Next Level Urgent Care and Blockit

Photo via nextlevelurgentcare.com

In an emergency situation, a patient might opt for an urgent care center over a hospital visit. Houston Methodist wants to connect the dots in that case in order to best serve its patients. A partnership between Blockit, Next Level Urgent Care, and Methodist has emerged to allow for easier access to follow-up appointments with orthopedic specialty physicians, and an urgent care patient might leave the facility with his or her follow-up visit already scheduled. In the pilot program's first five months into this pilot, over 120 urgent care patients engaged with the program and made follow up appointments from the facility.


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Houston-based Fervo Energy bumps up IPO target to $1.82 billion

IPO update

Houston-based geothermal power company Fervo Energy is now eyeing an IPO that would raise $1.75 billion to $1.82 billion, up from the previous target of $1.33 billion.

In paperwork filed Monday, May 11 with the U.S. Securities and Exchange Commission, Fervo says it plans to sell 70 million shares of Class A common stock at $25 to $26 per share.

In addition, Fervo expects to grant underwriters 30-day options to buy up to 8.33 million additional shares of Class A common stock. This could raise nearly $200 million.

When it announced the IPO on May 4, Fervo aimed to sell 55.56 million shares at $21 to $24 per share, which would have raised $1.17 billion to $1.33 billion. The initial valuation target was $6.5 billion.

A date for the IPO hasn’t been scheduled. Fervo’s stock will be listed on Nasdaq under the ticker symbol FRVO.

Fervo, founded in 2017, has attracted about $1.5 billion in funding from investors such as Bill Gates-founded Breakthrough Energy Ventures, Google, Mitsubishi Heavy Industries, Devon Energy (which is moving its headquarters to Houston), Tesla co-founder JB Straubel, CalSTRS, Liberty Mutual Investments, AllianceBernstein, JPMorgan, Bank of America and Sumitomo Mitsui Trust Bank.

Fervo’s marquee project is Cape Station in Beaver County, Utah, the world’s largest EGS (enhanced geothermal system) project. The first phase will deliver 100 megawatts of baseload clean power, with the second phase adding another 400 megawatts. The site can accommodate 2 gigawatts of geothermal energy. Fervo holds more than 595,000 leased acres for potential expansion.

Cape Station has secured power purchase agreements for the entire 500-megawatt capacity. Customers include Houston-based Shell Energy North America and Southern California Edison.

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This article originally appeared on our sister site, EnergyCapitalHTX.com.

Texas university's new flight academy opens at Houston Spaceport

cleared for takeoff

The vehicles may not have “student driver” stickers on them, but Texas Southern University has moved a dozen planes into its new training facility at the Houston Spaceport, opening the way for student flyers to use the facility.

TSU previously reached a deal with Houston Airports and the City of Houston in 2023 to house its prospective Flight Academy at Ellington Field. At the time, TSU had a small fleet of nine planes for student use, but a $5.5 million investment from the city greatly expanded the space available.

The Flight Academy includes a 20,000-square-foot hangar that serves as a TSU satellite campus. The school now has a fleet of 12 Cirrus SR20 aircraft that were acquired last year through state and alumni funding. An additional 4,500 square feet is used as classroom and office space. An 8,000-gallon fuel tank will support flight training operations.

TSU first launched its Aviation Science Management program in 1986 and added a professional pilot program in 2016. The school is now part of the United Airlines pipeline program and has also forged relationships with Delta and Southwest.

“I want to commend Texas Southern University and Houston Airports for their leadership and partnership in advancing aviation education right here in our city,” Houston City Councilwoman Dr. Carolyn Evans-Shabazz in a press release.

“It connects our students to high-paying, high-demand careers in aviation and aerospace. This is how we grow a city in the right way—by investing in workforce development, aligning education with industry and making sure our residents are prepared to lead in the industries of tomorrow. Houston is already a global leader in aerospace and projects like this strengthen that position even further, especially here at Ellington, where innovation and opportunity continue to take flight.”

The City of Houston signed an agreement to continue funding the academy for five years.

Amazon launches ultrafast, 30-minute delivery service across Houston

Amazon Now

More than 20 years after it redefined fast shipping, Amazon is preparing to raise the bar on consumer expectations again by offering to fulfill customers' most urgent product needs in Houston and other parts of the world in a half-hour or less for an extra fee.

The company, which revolutionized online shopping in 2005 with two-day deliveries for Prime members, is rapidly opening small order-processing hubs in dozens of U.S. and foreign cities to cater to shoppers who can't or don't want to wait for cough medicine to relieve flu symptoms or tomatoes for tonight's dinner salad.

The ultrafast service, called Amazon Now, first launched in India last June. Amazon says 30-minute deliveries now are also available in urban areas of the United States, Brazil, Mexico, Japan, the United Arab Emirates, the United Kingdom.

The mini-warehouses devoted to Amazon Now are about the size of a CVS drugstore. They stock about 3,500 products for expedited delivery, including beer, diapers, pet food, meat, nonprescription medications, playing cards and cellphone charging cables.

“We know that customers love speed and always have,” Beryl Tomay, Amazon’s head of transportation, told The Associated Press on Monday. “What we see customers doing, when we offer faster speeds, are they purchase more from Amazon. And Amazon becomes more top of mind for that or other types of items as well.”

In the U.S., the company first tested Amazon Now in Seattle, the home of its headquarters, and in Philadelphia. Most residents of the Dallas-Fort Worth area and Atlanta now have access as well. The service is also live in Dallas-Fort Worth, Denver, Minneapolis, Phoenix, Oklahoma City, Orlando, and dozens of other cities, Amazon said, with New York City and others expected by year-end.

The service charges for Amazon Now start at $3.99 for Prime members, who pay an annual fee of $139, and $13.99 for non-members. A $1.99 small basket fee applies to orders under $15, Amazon said.

The company's bet on a need for speed also comes as some consumers are rebelling against rushed deliveries as they weigh the potential impact on the environment and the workers tasked with preparing orders at a rapid rate.

Amazon’s approach
A relentless focus on speed helped Amazon build a logistics and e-commerce empire. After it made two days the new delivery time normal, Amazon moved into one-day and same-day deliveries for its Prime members. This spring, the company began making 90,000 products available in one hour or three hours at an extra cost.

The scaled down and sped up microhubs that are designed to handle 30-minute orders represent another step in Amazon's pursuit.

Only a handful of people prepare orders from aisles of shelves in the 5,000- to 10,000-square-foot facilities, unlike the sprawling fulfillment centers storing millions of items where Amazon employs a mix of human workers and robotics to pick and pack orders.

Amazon tailors the product inventory to each location and uses artificial intelligence and other technology to analyze what customers buy, as well as when and how often. The most popular U.S. purchases so far include soap, toothpaste, mouthwash, toilet plungers, bananas, limes and wireless earbuds, Amazon said.

The competition
Amazon’s attempt to up the instant gratification ante provides direct competition to on-demand food delivery platforms like Instacart, Uber Eats, DoorDash and Grubhub, which don't have the scale of the e-commerce titan, according to independent retail analyst Bruce Winder.

“What Amazon brings is their prowess in supply chain,” Winder said.

These smaller companies said they don't see Amazon as a threat, though, citing the hundreds of thousands of items they are able to deliver to users' doorsteps by partnering with various merchants and restaurants.

“DoorDash has a mission to empower grocers and retailers and augment their existing footprint, not to replace them,” DoorDash spokesperson Ali Musa said in an emailed statement. “We win only when they win, which is how we can offer over half a million grocery and retail items in under an hour across the country.”

Amazon also is in a race with Walmart to become the retailer that reliably gets orders to online shoppers in under an hour.

For an additional $10 on top of standard delivery charges, shoppers can place Walmart Express Delivery orders from among more than 100,000 products that are guaranteed to arrive in an hour. Many customers, however, are receiving the items under 30 minutes, Walmart CEO John Furner told analysts in February.

Domino's cautionary tale
Companies have promised deliveries in 30 minutes or less before, but the landscape also is littered with failed attempts to break the speed barrier.

The COVID-19 pandemic produced a flurry of companies that promised 10- to 15-minute grocery deliveries from microwarehouses in dense neighborhoods, according to Sucharita Kodali, an analyst at market research firm Forrester Research.

But soaring operating costs, low customer loyalty and the drying up of investor money ultimately caused most to fail before the pandemic was over, analysts said.

Domino’s in 1984 pushed a guarantee that customers would receive their pizzas for free if they weren't delivered in under a half-hour. The company amended the “30 minutes or it’s free” policy after two years, providing only a $3 discount for late deliveries.

The promotion helped Domino’s win market share, but it ended up tarnishing the company's reputation. It dropped the guarantee in December 1993 after a string of crashes and lawsuits involving drivers racing to meet the deadline.

Brad Jashinsky, a retail analyst at information technology research and consulting firm Gartner, said he thinks Amazon should take the pizza chain's experience as a cautionary tale.

“You get in trouble when you start overpromising something like that,” he said.

Amazon won't be making any time guarantees and instead plans to keep customers who chose the 30-minute delivery option updated on the progress of their orders, Tomay said.

“There's no rushing either in our building workers or the gig workers,” she said.

Taking it slow
Kodali thinks Amazon will need a lot of people placing orders around the same time from the same or adjacent apartment buildings for the 30-minute service to be cost-effective.

Consumers may appreciate rapid receipt of products like toilet paper and batteries, but retailers and logistics experts said they also see some online shoppers, especially members of Generation Z, choosing no-rush shipping for products they don't need in a hurry.

Amazon for several years has invited customers to skip one- or two-day delivery and to receive their orders on the same day in as few parcels as possible. Consolidating orders into fewer packages by electing to have them delivered at the same time cuts down on boxes, shipping envelopes and fuel use, analysts said.

“The millennials who came to age in an era that was on fast delivery came to expect it de facto, whereas ... Gen Z is more accepting of a slower speed than previous generations before them,” said Darby Meegan, a general manager at Flexport, a supply chain and logistics company that fulfills orders for thousands of online merchants.

Still, Amazon executives have cited positive early results for Amazon Now in India, where they said Prime members tripled their requests for 30-minute deliveries once they started using the service.

Amazon Now also is attracting more repeat American customers, Tomay said.

“It’s in early days and time will tell,” she said. “I think that it will be interesting to see how it evolves.”