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 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.