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

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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Saranas Inc. is testing its technology that can detect and track internal bleeding complications. Getty Images

Houston medical device company heads to clinical trials following recent $2.8 million raise

HEalth tech

A Houston-based medical device startup is on a twofold mission to reduce healthcare costs and improve the safety of complex medical procedures involving blood vessels.

Saranas Inc. currently is testing its Early Bird Bleed Monitoring System, which is designed to detect and track bleeding complications related to endovascular procedures. These medical procedures treat problems, such as aneurysms, that affect blood vessels.

"What attracted me to Saranas is that our solution has the potential to meaningfully reduce serious bleeding complications that worsen clinical outcomes and drive up healthcare costs," says Zaffer Syed, president and CEO of Saranas. "In addition, our device may support access of important minimally invasive cardiac procedures by allowing them to be performed more safely."

Dr. Mehdi Razavi, a cardiologist with the Texas Heart Institute at Houston's Texas Medical Center, invented the device. It's being tested by the institute and other medical facilities in the U.S. As many as 100 patients will participate in the clinical trial, which is expected to last several months.

If all goes well, the U.S. Food and Drug Administration will approve Early Bird in 2019, Syed says. Then, the device would be made widely available to medical facilities across the country.

In May, Saranas said it received $2.8 million in funding from investors to enable testing of Early Bird. In all, the startup has collected $12 million from investors. A month after the funding announcement, Saranas was one of 50 startups chosen for the MedTech Innovator program, which nurtures medical technology companies.

As explained by the Texas Heart Institute, the Early Bird employs a sheath — a plastic tube that helps keep arteries and vessels open — embedded with sensors that measure the electrical resistance across a blood vessel. When the Early Bird senses a change in the electrical resistance, medical professionals get audible and visual notifications about potential internal bleeding. If detected early, this bleeding can be halted or prevented.

"There is a risk of bleeding that occurs when some of these coronary interventions are performed through the femoral artery, which is in the upper thigh," Syed says.

In a release, Texas Heart Institute cardiologist Dr. Joggy George says internal bleeding "remains the Achilles' heel" of advances in noninvasive endovascular procedures.

Syed says there's an underappreciation for how often bleeding occurs during nonsurgical procedures that provide access to a patient's blood vessels. Each year, doctors perform these procedures on more than 20 million patients in the U.S.; of those, about 1 million experience severe complications from bleeding. Those complications can lead to longer, more expensive hospital stays along with a higher risk of death.

Initially, Saranas is targeting high-risk endovascular procedures done with large sheaths, rather than endovascular procedures performed with sheaths of all sizes, Syed says.

Syed took the helm of Saranas in February 2017. He's spent nearly 20 years in the medical device industry, including four years at Bellaire-based OrthoAccel Technologies Inc.

For the time being, Syed is one of just a handful of employees at Saranas, which was founded in 2013 and has benefited from its affiliation with the Texas Medical Center Innovation Institute. Syed expects to grow the Saranas team in 2019 once the Early Bird gains clearance from the FDA.

During his tenure in the medical device sector, Syed has been "keenly interested" in bringing impactful innovations to the market, such as the Early Bird device.

"It is especially important to me that such innovation not only improves health outcomes but also aims to drive down healthcare costs," he says. "We are in a healthcare environment where if you don't have a health economic benefit coupled with a clinical outcome, it is very challenging to get adoption of new technology."

Efficient referrals from doctor to doctor could save a life, so this Houston company is setting out to create a network of medical professionals all accessible in an app. Getty Images

Houston-based company is connecting the dots on patient referrals

Diagnosing doctors

When your doctor recommends that you visit another practitioner, it's only natural that you trust the suggestion. But it's one case in which your physician isn't always an expert. Married doctors Justin Bird, an orthopedic surgeon, and Terri-Ann Samuels, a specialist in female pelvic medicine and reconstructive surgery, have long noted that patients are often referred incorrectly.

No big deal, right? Just go to another doctor. But not everyone has that luxury. Bird and Samuels never intended to start their own company. But when Bird lost a patient due to faulty referrals, they knew something had to be done.

"He believes that if she hadn't been bounced around from doctor to doctor, they could have saved her life," says Chris E. Staffel, chief operating officer of Patients We Share, the app that the couple created to fix the broken aspect of the health care system.

In 2015, Bird and Samuels began their company when they were shocked to realize that such an app didn't already exist.

"They started working with physicians around the country who said, 'We really, really need this,' and they also invested in it," recounts Staffel. From those friends, they built a physician advisory board of 15 investors.

Prescribing growth
The project was accepted into Johnson & Johnson's incubator, JLABS in 2016, then TMCx's digital startup program in the spring of 2018.

"They started realizing it was gaining momentum and realized they needed to have business people on board," says Staffel.

They hired Michael Antonoff, a Rice University M.B.A., as CEO. He invited former classmate Staffel to join as COO. Having come from a background in oil and gas, Staffel jumped at the chance to try her hand in a different industry.

With new business clout behind PWS, the company is growing quickly. Currently, PWS is entering its next seed round of $2.5 million that will allow the company to pay salaries of new team members and bring some tech development in-house. Until now, the making of the app itself has been outsourced to Mobisoft Infotech, a company based in Houston and India, which has worked on many projects at the Texas Medical Center. Local Black + Grey Studio is responsible for the design.

PWS has been working with both those teams in recent months to get a prototype app ready for launch. Currently, 100 physicians around the country are part of an invite-only pilot program. Soon, Staffel hopes to allow early adopter doctors who haven't been invited to enroll in the program for free. It will likely be in 2020 that patients will start joining the community, too.

How it works
An index of all the providers on the app allows doctors to easily find practitioners in a particular specialty. But there's more to it. Detailed profiles contribute to machine learning that assures the optimal match every time. Patient reviews will also play a role.

Though referrals were the impetus for the creation of PWS, it may be even more important as a communication tool between doctors, fellow clinicians (anyone from nurse practitioners to physical therapists may be invited to join), and patients. Staffel says participants in the pilot program are already using the messaging system to compare notes on cases, even sending photos from surgery to consult on patient issues.

The app's encryption means that it's HIPAA-compliant. Patients provide permission to discuss their cases via the app. And they can be confident of the quality of care they'll receive. Likely, the app will remain largely invite-only, and everyone who joins will share their National Provider Identifier licenses to be vetted against the federal database.

Doctors will communicate directly with patients through the app, but will also share resources digitally. Instead of making copy after copy of information about post-surgical care, for instance, the physician need only press a button to share a link.

Eventually, the goal is for PWS to be used not just nationally, but internationally, not just by individuals, but by whole hospital systems. A world in which doctors can compare notes around globe could be a little safer for us all.

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New Houston venture studio emerges to target early-stage hardtech, energy transition startups

funding the future

The way Doug Lee looks at it, there are two areas within the energy transition attracting capital. With his new venture studio, he hopes to target an often overlooked area that's critical for driving forward net-zero goals.

Lee describes investment activity taking place in the digital and software world — early stage technology that's looking to make the industry smarter. But, on the other end of the spectrum, investment activity can be found on massive infrastructure projects.

While both areas need funding, Lee has started his new venture studio, Flathead Forge, to target early-stage hardtech technologies.

“We are really getting at the early stage companies that are trying to develop technologies at the intersection of legacy industries that we believe can become more sustainable and the energy transition — where we are going. It’s not an ‘if’ or ‘or’ — we believe these things intersect,” he tells EnergyCapital.

Specifically, Lee's expertise is within the water and industrial gas space. For around 15 years, he's made investments in this area, which he describes as crucial to the energy transition.

“Almost every energy transition technology that you can point to has some critical dependency on water or gas,” he says. “We believe that if we don’t solve for those things, the other projects won’t survive.”

Lee, and his brother, Dave, are evolving their family office to adopt a venture studio model. They also sold off Azoto Energy, a Canadian oilfield nitrogen cryogenic services business, in December.

“We ourselves are going through a transition like our energy is going through a transition,” he says. “We are transitioning into a single family office into a venture studio. By doing so, we want to focus all of our access and resources into this focus.”

At this point, Flathead Forge has seven portfolio companies and around 15 corporations they are working with to identify their needs and potential opportunities. Lee says he's gearing up to secure a $100 million fund.

Flathead also has 40 advisers and mentors, which Lee calls sherpas — a nod to the Flathead Valley region in Montana, which inspired the firm's name.

“We’re going to help you carry up, we’re going to tie ourselves to the same rope as you, and if you fall off the mountain, we’re falling off with you,” Lee says of his hands-on approach, which he says sets Flathead apart from other studios.

Another thing that's differentiating Flathead Forge from its competition — it's dedication to giving back.

“We’ve set aside a quarter of our carried interest for scholarships and grants,” Lee says.

The funds will go to scholarships for future engineers interested in the energy transition, as well as grants for researchers studying high-potential technologies.

“We’re putting our own money where our mouth is,” Lee says of his thesis for Flathead Forge.

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This article originally ran on EnergyCapital.

Houston-based lunar mission's rocky landing and what it means for America's return to the moon

houston, we have a problem

A private U.S. lunar lander tipped over at touchdown and ended up on its side near the moon’s south pole, hampering communications, company officials said Friday.

Intuitive Machines initially believed its six-footed lander, Odysseus, was upright after Thursday's touchdown. But CEO Steve Altemus said Friday the craft “caught a foot in the surface," falling onto its side and, quite possibly, leaning against a rock. He said it was coming in too fast and may have snapped a leg.

“So far, we have quite a bit of operational capability even though we’re tipped over," he told reporters.

But some antennas were pointed toward the surface, limiting flight controllers' ability to get data down, Altemus said. The antennas were stationed high on the 14-foot (4.3-meter) lander to facilitate communications at the hilly, cratered and shadowed south polar region.

Odysseus — the first U.S. lander in more than 50 years — is thought to be within a few miles (kilometers) of its intended landing site near the Malapert A crater, less than 200 miles (300 kilometers) from the south pole. NASA, the main customer, wanted to get as close as possible to the pole to scout out the area before astronauts show up later this decade.

NASA's Lunar Reconnaissance Orbiter will attempt to pinpoint the lander's location, as it flies overhead this weekend.

With Thursday’s touchdown, Intuitive Machines became the first private business to pull off a moon landing, a feat previously achieved by only five countries. Japan was the latest country to score a landing, but its lander also ended up on its side last month.

Odysseus' mission was sponsored in large part by NASA, whose experiments were on board. NASA paid $118 million for the delivery under a program meant to jump-start the lunar economy.

One of the NASA experiments was pressed into service when the lander's navigation system did not kick in. Intuitive Machines caught the problem in advance when it tried to use its lasers to improve the lander's orbit. Otherwise, flight controllers would not have discovered the failure until it was too late, just five minutes before touchdown.

“Serendipity is absolutely the right word,” mission director Tim Crain said.

It turns out that a switch was not flipped before flight, preventing the system's activation in space.

Launched last week from Florida, Odysseus took an extra lap around the moon Thursday to allow time for the last-minute switch to NASA's laser system, which saved the day, officials noted.

Another experiment, a cube with four cameras, was supposed to pop off 30 seconds before touchdown to capture pictures of Odysseus’ landing. But Embry-Riddle Aeronautical University’s EagleCam was deliberately powered off during the final descent because of the navigation switch and stayed attached to the lander.

Embry-Riddle's Troy Henderson said his team will try to release EagleCam in the coming days, so it can photograph the lander from roughly 26 feet (8 meters) away.

"Getting that final picture of the lander on the surface is still an incredibly important task for us,” Henderson told The Associated Press.

Intuitive Machines anticipates just another week of operations on the moon for the solar-powered lander — nine or 10 days at most — before lunar nightfall hits.

The company was the second business to aim for the moon under NASA's commercial lunar services program. Last month, Pittsburgh's Astrobotic Technology gave it a shot, but a fuel leak on the lander cut the mission short and the craft ended up crashing back to Earth.

Until Thursday, the U.S. had not landed on the moon since Apollo 17's Gene Cernan and Harrison Schmitt closed out NASA's famed moon-landing program in December 1972. NASA's new effort to return astronauts to the moon is named Artemis after Apollo's mythological twin sister. The first Artemis crew landing is planned for 2026 at the earliest.

3 female Houston innovators to know this week

who's who

Editor's note: Welcome to another Monday edition of Innovators to Know. Today I'm introducing you to three Houstonians to read up about — three individuals behind recent innovation and startup news stories in Houston as reported by InnovationMap. Learn more about them and their recent news below by clicking on each article.

Emma Konet, co-founder and CTO of Tierra Climate

Emma Konet, co-founder and CTO of Tierra Climate, joins the Houston Innovators Podcast. Photo via LinkedIn

If the energy transition is going to be successful, the energy storage space needs to be equipped to support both the increased volume of energy needed and new energies. And Emma Konet and her software company, Tierra Climate, are targeting one part of the equation: the market.

"To me, it's very clear that we need to build a lot of energy storage in order to transition the grid," Konet says on the Houston Innovators Podcast. "The problems that I saw were really on the market side of things." Read more.

Cindy Taff, CEO of Sage Geosystems

Houston-based Sage Geosystems announced the first close of $17 million round led by Chesapeake Energy Corp. Photo courtesy of Sage

A Houston geothermal startup has announced the close of its series A round of funding.

Houston-based Sage Geosystems announced the first close of $17 million round led by Chesapeake Energy Corp. The proceeds aim to fund its first commercial geopressured geothermal system facility, which will be built in Texas in Q4 of 2024. According to the company, the facility will be the first of its kind.

“The first close of our Series A funding and our commercial facility are significant milestones in our mission to make geopressured geothermal system technologies a reality,” Cindy Taff, CEO of Sage Geosystems, says. Read more.

Clemmie Martin, chief of staff at The Cannon

With seven locations across the Houston area, The Cannon's digital technology allows its members a streamlined connection. Photo courtesy of The Cannon

After collaborating over the years, The Cannon has acquired a Houston startup's digital platform technology to become a "physical-digital hybrid" community.

Village Insights, a Houston startup, worked with The Cannon to create and launch its digital community platform Cannon Connect. Now, The Cannon has officially acquired the business. The terms of the deal were not disclosed.

“The integration of a world-class onsite member experience and Cannon Connect’s superior virtual resource network creates a seamless, streamlined environment for member organizations,” Clemmie Martin, The Cannon’s newly appointed chief of staff, says in the release. “Cannon Connect and this acquisition have paved new pathways to access and success for all.” Read more.