Nonprofit pivots to telemedical treatments and therapies amid pandemic

telehealth

Planned Parenthood has made several of its services — including gender-affirming hormone therapy — available virtually. Getty Images

Naomi West has been homebound since COVID-19 became a threat in February. Sitting in front of her computer screen, much of her time is spent pursuing her graduate degree in physics from Rice University and teaching courses through Zoom. Most of her virtual meetings are the same except for one recurring appointment. Every 90 days, West logs on her computer to sit with a Planned Parenthood Gulf Coast (PPGC) nurse practitioner and check-in on her gender-affirming hormone therapy.

West, a Houston trans woman, made her first appointment to receive hormone therapy in October, prior to the pandemic. As she embarked on her transition, she saw an immediate change within herself.

"There was absolutely no going back...it was a night and day difference within 24 hours," she explains.

West has been receiving treatment for ten months at Planned Parenthood. After being hospitalized for depression and drowning in hundred-hour work weeks, West was feeling hopeless. Inspired by her best friend's journey with hormone therapy at Planned Parenthood, West felt motivated to change her life.

"The difference [trans care] makes is immeasurable to say the least," she says, "I couldn't imagine having it any other way. I couldn't imagine being without it."

Trans care is offered at two Houston-area Planned Parenthood locations—Prevention Park and Northville. Since the coronavirus, Planned Parenthood's services have gone virtual, allowing Texans outside of Houston to experience the service.

"COVID-19 has really changed the way we approach patient care," says Dr. Bhavik Kumar, medical director of Primary and Trans Care at PPGC.

The centers first rolled out virtual appointments on April 1, allowing them to safely serve 5,539 patients in four months.

"We've moved a lot of our care towards telehealth, which has allowed people to access care in a way that is safer for them and also protects our frontline workers," explains Dr. Kumar.

The healthcare provider has six centers in the Houston area, as well as two in Louisiana, that are providing virtual appointments with experts as well as access to curbside birth control. Trans care first became available at Planned Parenthood in 2019, and includes gender-affirming hormone therapy for patients over 18.

"We went into providing trans care knowing that a lot of folks have bad experiences accessing healthcare and perhaps bad experiences with providers," says Dr. Kumar. "There's a lot of fear and anxiety in accessing care for trans communities, whether it's being misgendered, having their dead name used, or having a number of different things that can lead to traumatic experiences," he explains.

To a transgender person, access to health isn't just a hot button political issue but a lifeline. Like West, many transgender Americans struggle with depression and feelings of hopelessness.

In a 2019 survey from The Trevor Project, 29 percent of trans and non-binary youth reported that they'd attempted suicide while 54 percent considered it. The striking statistics are a glimpse into the struggles trans and nonbinary people face daily as they experience discrimination, violence, and cohersion due to their gender identity.

West, like many in the trans community, shared the same fears prior to her first appointment.

"I've always come down with what I say is white coat syndrome, but within 10 minutes I realized it was all completely unfounded," she explains.

PPGC follows an informed consent treatment model, meaning patients are not required to receive an approval letter from a therapist to begin treatment. After speaking with a patient to explain the risks and benefits of hormone therapy, patients can make the decision to move forward.

"It was just a conversation," explained West, "I felt no judgement. It was just support for my decision to begin hormone therapy and suggestions for how to go about it, when to go about it—they were nothing if not accommodating.

Telehealth lends itself as a suitable substitution for in person care, according to West. Many of the appointments are spent discussing her psychological state and feelings regarding the treatment, and she goes for a blood test every 90 days. West, who has been very careful to prevent exposure to COVID-19, has felt at ease meeting virtually with her nurse practitioner.

Thanks to the ability telehealth has to connect us with people regardless of distance, transgender Texans have access to care at any distance. One of the core benefits of trans telehealth is that "folks who are further away from our health centers, perhaps in rural communities, don't have to make the several hour drive to the health center and then back," says Dr. Kumar.

The convenience has allowed PPGC to accommodate 240 gender-affirming hormone therapy appointments and serve 176 transgender patients.

More than cut travel time, the emergence of telemedicine also welcomes comfort. "They get to be in the safety and the comfort of their home or wherever they do feel safe," explains Dr. Kumar, "They can have other folks around them if they want, whether it's family or friends."

"We are constantly analyzing the way we provide care, but even more so in a different way during the pandemic," shares Dr. Kumar. Telehealth services include birth control consultation, emergency contraception, long-acting birth control implant consultations, PrEP follow-ups, primary care, STI treatment, and other healful visits to address problems like pelvic pain or bleeding.

Of the many services that are now remote, Depo birth control shots and oral contraceptives, are available curbside.

"Patients don't have to get out of the car; they don't have to worry about touching the door handle or anything else they have anxiety around," explains Dr. Kumar, "They're able to access the care they need without having to deal with potential exposure."

Will telehealth at PPGC become a permanent staple? Only time will tell, but Dr. Kumar has found that patients have found the service to be helpful during the COVID-19 pandemic.

"We always strive to provide as many options for our patients so that they can get the healthcare that's best for them," shares Dr. Kumar.

With some help from there humans, Houston pets can get virtual care through a Texas startup. Image courtesy of TeleVet

This Texas startup is helping Houston pets get virtual care during coronavirus

fur-tual care

A Texas-based, digitally optimized company focused on veterinary care is helping pet owners connect with medical professionals from the comfort of their homes, offsetting the impact of the social distancing measures to reduce the spread of COVID-19.

TeleVet Inc., which is based in Austin but is used by local veterinarians, recently announced that they will be providing their animal telemedicine platform free for one month to provide essential animal healthcare, connecting animal patients to veterinarians all over the country. TeleVet is used across 1,000 clinics and is accessible on phone, tablet, or computer.

The free month will be provided to cities that have been hard-hit by the virus such as New York City, Atlanta, New Orleans, San Francisco, Seattle, Miami, Las Vegas, and Chicago.

"In some cases, clinics in impacted cities are having to suddenly shut down or doing drop off visits," Steven Carter, co-founder, and CEO of TeleVet, tells InnovationMap. "We see that telemedicine is a huge component to keeping their staff and their client base during a time when social distancing is critical to flattening the curve of coronavirus cases."

Houston-area vet Amy Garrou and the other vets in her practice have been using TeleVet for several months before the outbreak of the virus. Before the platform, animal patients and their owners had to come into the office for post-surgery check-ups or other outpatient procedures. Garrou says her practice has been increasing the number of patients who use the platform since before the social distancing measures, making it a part of their daily workflow.

"We can check for infections such as ear infections or drainage from either a still picture or a video, or even a live video conference with the owner," says Garrou. "The platform has been useful because we can do any of those consultations and get the information we need to manage the case without the pet owner having to come into the clinic."

In January, TeleVet closed a $2 million seed round with investments from Houston-based Mercury Fund and Nebraska-based Dundee Venture Capital. (Amy Garrou is the wife of Mercury Fund Managing Director Blair Garrou.) According to the company's LinkedIn page, TeleVet is hiring.

Since being founded in 2015, the company has become a U.S. market leader in animal telemedicine. Over the last few years, telemedicine has been quickly expanding, and during the coronavirus outbreak, there has been a greater rush to move towards providing telemedicine for humans as well as pets.

"We realized that a lot of stuff can be solved remotely, keeping the client and the pet at home so that the staff does not have to physically interact with the client which offers convenience to both the client and the vet," says Carter.

Vets like Garrou say TeleVet helps them streamline the process by syncing with their medical records software seamlessly. This cuts costs and saves time from administrative duties. This also allows pet-owners to have access to medical notes regarding the health of their pet.

Her office is thinking of offering a curbside pick up service where they use TeleVet to communicate with pet owners to provide a contactless vet visit. A medical professional with personal protection equipment meets them in the parking lot and escorts the pet inside the vet's office where they use live video feed during the consultation so the owner can continue to be part of the process.

"It's proved to be really vital, especially in those cities where there's a complete shutdown," says Garrou. "The number of people that are realizing they've got to do something in this environment to keep their businesses afloat is rising."

As reliance on telemedicine increases due to the crisis, Garrou says it will eventually become part of the options available for pet owners, and especially vets who work long hours and tend to suffer from high levels of stress and burnout.

"We're really focused on helping, not only just to keep vets' businesses afloat right now," says Carter. "We can't stress enough that we care about the individuals in those practices. We want to help vets with work-life balance and reduce the burnout rate."

Lance Black says the COVID-19 outbreak has led to some interesting opportunities for Houston startups and health tech as a whole. Photo courtesy of TMCx

COVID-19 provides huge opportunity for telehealth, says Houston health tech leader

HOUSTON INNOVATORS PODCAST EPISODE 24

The Texas Medical Center's accelerator program has one foot in the health care system of today — operating in collaboration with the TMC's wide network of member institutions — as well as representing the future of health care as it cultivates new technologies those medical institutions need.

This unique setting makes Lance Black, associate director of TMCx, an interesting perspective on the COVID-19 outbreak, and something he says he's excited to see rise to the occasion — and, in this case, crisis — is telehealth.

"One of the things we focus on at TMCx is the ability to remotely monitor and care for patients outside the four walls," Black says on this week's episode of the Houston Innovators Podcast, "and this particular crisis really lends to that."

For better or for worse, the outbreak has forced a turning point in health care, and it's also put telehealth and other health tech companies to the test.

"This is going to force the health care system to take a hard look at what these platforms are capable of doing," Black says. "And it's going to stress the capabilities of these companies. To be honest, if there's a silver lining, that is one of them in my mind, that this will prove out the technology [in telehealth.]"

In the episode, Black provides some tips for startups going through the crisis, as well as praises the collaborative effort within the tech community in Houston. And in a way, something felt familiar to Black, a medical doctor who previously served in the United States Air Force.

"In the military, we joked about how there's a 'hurry up and wait' attitude. You hurry up to get things ready, and then you're just sitting there waiting for the right time to respond," Black says. "I feel like that's what our startups are doing now."

Black says he has seen startups taking inventory of their resources, accommodating their products for different uses, assessing their personnel, and waiting to see where they fit in to help.

Meanwhile, there's plenty Black can do to help serve TMCx's startups. This year marked the first cohort of TMCx's revamped program, and last month the TMC Innovation Institute welcomed in 19 startups for a bootcamp. While that went off without a hitch, Black says, the next phase — due to start in May — could be pushed back.

"Out of respect for our hospitals and member institutions, we want to delay the physical presence of the companies in Houston," Black says. "But that doesn't mean we're not able to call or virtually meet with the companies. There's a lot of pre-work we can do in order to prep the companies appropriately so that when they do have meetings face to face, they can put their best foot forward."

Black discusses the coronavirus' effects and offers his advice to startups on the podcast. Listen to the full episode below — or wherever you get your podcasts — and subscribe for weekly episodes.


EverlyWell's online results will be available within 48 hours. EverlyWell/Facebook

Texas company first to launch at-home test for COVID-19

COVID-19 WATCH

As reports keep indicating a shortage of supply for COVID-19 tests around the country, a Texas startup has rolled out a new at-home test for consumers beginning today, March 23.

Everywell, which already offers an array of at-home lab tests, says 30,000 COVID-19 tests will be available in the initial batch. Free telehealth consultations will be provided for people who test positive for COVID-19, or the coronavirus.

As TIME first reported, this is the first U.S. company to offer at-home COVID-19 test kits directly to consumers.

"The extreme shortage of tests for COVID-19 puts millions of Americans at risk," Julia Cheek, founder and CEO of Everlywell, said in a March 18 release. "Everlywell is committed to helping stop the spread of COVID-19 in the U.S. by making this test widely available. As the national leader in at-home lab testing, we want to use our resources and expertise to help as many people as we can. We are committed to this fight, and we're here to help."

Working with a number of diagnostic labs, Everlywell plans to create testing and diagnosis capacity for 250,000 people per week.

Everlywell recently launched a $1 million program aimed at encouraging labs to fast-track development of an at-home COVID-19 diagnostic test. Many labs stepped up to the task, enabling Everlywell to create a COVID-19 testing and diagnosis infrastructure in a matter of days.

"Our team has been working around the clock with top scientists and laboratories in the nation to develop a test that we will make available at the lowest price possible while covering our costs, at no profit to the company," Cheek says. "We have also reached out to government and public health officials to explore possibilities to provide it for free."

Each test costs $135, and is covered by participating providers of health savings accounts and flexible spending accounts.

The test can be requested online by consumers experiencing COVID-19 symptoms. Samples can be collected at home, preventing further exposure for consumers and the public. All of Everlywell's lab partners conducting COVID-19 tests comply with the U.S. Food and Drug Administration's emergency rules for COVID-19 testing.

"Given the high demand for testing, the company will work rapidly to make more tests available as the global supply shortage for COVID-19 diagnostic kits is addressed," the company says.

Like Everlywell's other tests, the COVID-19 test will be shipped to customers with everything needed to collect a test sample at home and safely send that sample to a certified lab. Samples will be shipped to labs overnight, secure online results will be available within 48 hours of the lab receiving a sample, and a free telehealth consultation with an independent board-certified physician will provided to anyone who tests positive.

Anyone seeking a test will be asked to fill out an online screening questionnaire.

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This article originally ran on CultureMap.

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Houston lab explores how AI bots can help the elderly

AI for aging

The University of Houston’s Empathetic Lifespan AI & Robotics for Aging (ELARA) Lab is currently conducting research into how AI bots may be able to help the elderly live more social and independent lives through several ongoing initiatives.

The lab officially launched last month as part of the Gerald D. Hines College of Architecture & Design under the leadership of Assistant Professor Chorong Park. Part of the lab’s mission is tackling ongoing problems with aging, such as dealing with disabilities and social isolation. Researchers’ current work is focused on designing a new AI companion bot specifically tailored to the needs of older people.

“We need to take all the needs of older adults seriously,” Park said in a news release. “They won't use the robot if they don't feel at ease or if they feel they are being constantly watched.”

The field testing of new AI bots in this population hopes to overcome several traditional obstacles in technology use among the elderly. A study by Park shows that many older people have a fear of overt surveillance when using advanced AI. There is also ageism to consider. Most new technologies are designed with younger and employed buyers in mind, not retirees who may need help remembering daily tasks or accessing important information.

“The more older adults are excluded from technology development, the worse those technology gaps will become,” Park said. “AI and the majority of technologies are created for younger people, so my research method integrates older adults directly into the design process.”

ELARA recently collaborated with the Mamie George Community Center in Richmond, Texas, to track seniors’ response to desktop AI bots like Emo and Cupboo. Researchers also had participants use air-dry modeling clay to create their ideal robotic companion.

While the eventual AI bot may be able to help the elderly feel less isolated and more supported, there are concerns to consider. A study published in the Asian Journal of Psychology charted the development of delusional thinking in a 72-year-old woman who became convinced the empathic-response bot was in love with her. The rise of “AI psychosis” has the potential to exacerbate mental health problems, particularly in socially isolated people, which a quarter of Americans over the age of 65 are.

ELARA’s research is focused on creating “pet-like” AI models with enhanced trust cues. If it can overcome the dangers of socially isolated people relying on AI for companionship, it could be a big step forward for independent aging.

SpaceX IPO set to be biggest ever and could make Elon Musk a trillionaire

IPO News

SpaceX says it plans to raise up to $75 billion when it goes public this month, setting the stage for the largest-ever stock market debut and putting Elon Musk on course to becoming the world's first trillionaire.

The company, formally known as Space Exploration Technologies Corp., said Wednesday it will sell 555.6 million shares at $135 a piece in an initial public offering. The estimated proceeds would easily top the $26 billion raised by oil giant Saudi Aramco in 2019. The offering would also give SpaceX a market value of $1.77 trillion. Only six companies in the S&P 500 are currently worth more, with Nvidia tops at $5.2 trillion.

Besides the size of the offering and the expected proceeds, SpaceX's amended prospectus updates details about how much control of the company Musk will have. As SpaceX's CEO, chief technical officer and chairman, Musk's voting power will come primarily through his ownership of 5.22 billion Class B shares, which give the holder 10 votes for every share held. According to the filing, Musk would have 82.4% of the voting power in the company.

Forbes currently values Musk's net worth at $826 billion and his stake in SpaceX at $542 billion. The estimated value of his SpaceX holdings was based on an overall value for the company of $1.25 trillion. Based on those numbers, a $1.77 trillion valuation for SpaceX would boost Musk's net worth by $223 billion, making him a trillionaire. However, much of Musk's worth is in stock that he has yet to cash in.

Even as it makes a bid for a blockbuster market debut, SpaceX is currently losing billions of dollars a year. The filing shows that the company lost $2.6 billion from operations last year on $18.7 billion in revenue, and the losses kept piling up at the start of this year, too.

Fantastical plans

Time will tell how SpaceX fares on the market. Musk's plans for the company are as fantastical as the money he hopes raise in the sale.

Colorful, even frightening in parts, the IPO document strikes a contrast with the typically dry, technical prose in IPO documents, detailing plans to use proceeds from the sale to help put men on the moon again and perhaps even Mars. In one section, it talks of a need to build "a permanent human colony" on the red planet with "at least one million inhabitants" as existential threats loom that could consign man to "the same fate as the dinosaurs."

Musk has almost equally ambitious plans for his other publicly traded company, Tesla. His goal is to transform the maker of electric vehicles into a producer of robotaxis and humanoid robots. Dan Ives of Wedbush Securities wrote in a research note that he expects Tesla and SpaceX to merge next year.

AI plays a key role

Key to the success of both companies — and any merged entity — is artificial intelligence. In its IPO filing, SpaceX says it sees potential revenue from AI of up to $26.5 trillion. But that depends on another lofty Musk ambition — putting data centers in space, which is not technologically possible at the moment.

Transforming his space company into a primarily AI-focused company will be a challenge for Musk, who started xAI in 2023 with 11 other co-founders who have all since left. Some were recruited away by rivals.

Its main AI product, the chatbot Grok, is "less impressive than anything that we see from any other major player in the space, whether that's OpenAI, or Anthropic, or (Google's) Gemini," said IDC analyst Arnal Dayaratna.

Dayaratna said that doesn't mean SpaceX doesn't have potential as a major AI player, thanks in part to its computing partnership with Anthropic and Musk's recent deal that gave SpaceX the rights to buy AI coding tool Cursor for $60 billion later this year. Folding in Cursor's capabilities would give SpaceX access to the coveted business customers now using Anthropic's Claude or OpenAI's ChatGPT.

SpaceX plans to use the net proceeds from the IPO to fund the expansion of infrastructure for its AI and rocket businesses, and to beef up the constellation of satellites that power Starlink Mobile, among other investments.

The company plans to list on the Nasdaq under the symbol "SPCX" and could begin trading as soon as the end of next week.

And SpaceX isn't the only colossal market debut investors are now bracing for. Earlier this week, Anthropic submitted a confidential filing with the U.S. Securities and Exchange Commission to officially start its own IPO clock.

OpenAI has not yet reported filing the initial SEC paperwork, but an IPO from the ChatGPT maker is widely expected.

"This listing represents the first major test for public markets after years of muted IPO activity with SpaceX paving the way for AI giants Anthropic and OpenAI to follow soon after," Ives wrote.

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Associated Press Technology Writer Matt O'Brien contributed.

New UH survey reveals concerns over AI data center growth in Houston

data findings

A new report out of the University of Houston shows that area residents remain wary of the long-term effects of operating data centers.

The recent survey from the University of Houston’s latest SPACE City Panel, conducted by the Center for Public Policy at the Hobby School of Public Affairs, shows that while 85 percent of Houston-area residents use AI, nearly 63 percent oppose the construction of AI data centers within 1 mile of their homes.

Respondents’ concerns centered around data centers’ high energy demand and the area’s power grid reliability. According to the survey, 32 percent of residents who oppose local data center projects would be more likely to support the centers if they relied on renewable energy over fossil fuels.

“Respondents understand that AI can bring economic and educational benefits, but they are also concerned about the physical infrastructure needed to fuel AI, especially data centers,” Soran Mohtadi, post-doctoral fellow at the Hobby School and a researcher on the report, said in a news release. “This physical infrastructure demands more electricity and water, leading to environmental impacts.”

Experts estimate that 6.5 gigawatts of data center capacity will be added to the Texas grid by 2030. And Houston’s data center capacity is predicted to more than double by 2028.

The Electric Reliability Council of Texas also projects electricity demand could reach 218 gigawatts by 2031, which would be more than double the record peak set in August 2023. Data centers are expected to account for 86 gigawatts of that new demand.

Survey respondents also said they are concerned about the state's future water supply, given the large amounts of water that data centers need to stay cool.

In terms of who’s responsible for that issue, 57.6 percent of respondents said they put the onus on Texas lawmakers, while 31.5 percent say tech companies should be responsible.

Additionally, more than 75 percent of respondents believed that data center developers and technology companies—not residents—should bear the cost of infrastructure upgrades to support data centers.

“Every decision legislators make has implications on residents’ everyday lives and local infrastructure now and in the future,” Maria P. Perez Arguelles, lead researcher on the report and research assistant professor at the Hobby School, added in the news release. “This issue is going to become more important in years to come, so this is just the beginning.”

Read the full report here.

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