PRESIDIO — At last Thursday’s meeting, the Big Bend Regional Hospital District (BBRHD) toasted a successful first two weeks of Bravo Health Terlingua, the region’s new “microclinic.” Billed as an innovative project to transform rural healthcare, the small building — staffed in-person by local nurse Ashley Grover — blends a traditional office visit with cutting-edge telemedicine. 

Ashish Gupta, a Houston-based doctor who interacts with patients in Terlingua from behind a screen, gave a report from his first two weeks at the new location. So far, he’d seen 57 unique patients and had gotten mostly positive feedback from South Brewster County residents excited about the service. “We’re seeing a lot of cool stuff and having a lot of fun,” he said. 

The small clinic building, located on Rex Ivey Road, has two clinic rooms for patient privacy and comfort. Nurse Grover performs most of the functions of a normal checkup — the difference here is that Gupta, from a desk 650 miles away, can see through the specially-rigged scopes and ask Grover to perform additional exams on-demand. 

Of the 57 patients, there were a few high-stakes visits — one patient came in with a severe laceration, and two others were treated with dangerous complications from alcohol abuse. Another patient with blood in their urine was subjected to a screening that revealed a mass on their kidney. 

Part of Gupta’s survey included asking patients what would have happened if the clinic was not available. Five responded that they would have stayed home and two responded that they would have gone to the emergency room. All patients surveyed said that they weren’t phased by the telemedicine technology used at the clinic. 

The report also included a “net promoter score,” which measures general patient satisfaction. Gupta said that primary care practices typically receive scores in the 60s, but the fledgling Terlingua clinic was already boasting 93%. “We’re really happy with those numbers,” he said. 

Hamilton Health Box — the company that runs Bravo Health Terlingua — will soon have a presence in other communities. This week, they’ll take over the lease on O’Reilly Street in Presidio for a former Big Bend Regional Medical Center clinic that shuttered in February, in hopes of opening the clinic back up to the public in June. (The company plans to purchase some of the equipment from the clinic from the hospital, and hopes to keep the ultrasound machine provided by Texas Tech University in place if possible.) 

The company has also stepped in to revamp Marfa Country Clinic, which will keep its name but will operate officially under the Hamilton Health Box umbrella on May 5. A clinic in Pecos could be next, adding to Hamilton’s regional reach.

Attendees at the meeting raised a few concerns, namely access to Spanish-language translation services and securing TRICARE coverage for veterans and service members. (Interpretation services are available, and the company is working to ensure that providers can accept TRICARE insurance.) “We hit the ground running, and I think from Dr. Gupta’s results you can see that we are already making an impact,” said Chris King, chief development officer at Hamilton Health Box. “We hope to address the concerns that we’ve heard from the community here today — and we really can’t wait to become a part of the community.”