A Telehealth Project in Cleveland Combines Hair Care and Healthcare

An innovative project in Ohio is using barbershops, hair salons and telehealth to screen people for hypertension.

Three Cleveland-area barbershops in urban neighborhoods are currently working with the Cleveland Clinc to screen patrons with mHealth-enabled blood pressure cuffs. Once the readings are taken and entered into a connected health platform developed by VSee, those patrons can then work with care providers to manage their blood pressure.

For some, the experience was life-saving.

“Ninety percent or more (of our) customers discover the first time they’re screen they have high blood pressure,” Waverley Willis, owner of the Urban Kutz barbershop, said in a story prepared by the Benton Institute for Broadband & Society. “Several customers’ blood pressure was so high they went straight to the ER, and a good number were well on their way to a stroke or a heart attack.”

The program is the brainchild of Craig Settles, a telehealth and broadband business planner, who wanted to find some way to improve care management for the African-American community - 40 percent of which are living with hypertension.

And his inspiration came from a TV show.

“I’d been struggling over the summer with how to help people understand the need for proactively uniting telehealth and community-owned high-speed Internet networks, and their combined benefits,” he says. “I was watching a TV show, New Amsterdam, about the hospital’s medical director convincing barbers to screen customers for hypertension in their shop.”

“In the director’s dramatic soliloquy at the end, he says there’s no reason healthcare has to be delivered in a hospital,” Settles says. “In fact, it’s better delivered in an environment patients are comfortable with and by those people they trust. Watching those barbers on TV interacting with their customers using traditional blood pressure cuffs, it hit me: Telehealth would take this service to a higher level.”

Settles targeted barbershops and hair salons, he says, because they “have influence in these communities.”

It’s a familiar refrain for any telehealth or mHealth project targeting population health and dealing with low adoption or engagement. Many such programs struggle to identify a proper entry point, or a means by which to get people interested in using digital health tools and platforms to improve their health and lifestyles.

“It really doesn’t take very long, maybe five or 10 minutes, to take and record someone’s blood pressure,” Settles says. “But it’s enough to time to become a little ritual that folds in with everything happening in the shop. It adds a lot to the camaraderie.”

“It’s also interesting to notice the number of owners who want to make their shops more than places where folks get their hair done,” he adds. “They want their shops to become book exchanges, informal encounter groups, comic book clubs, maybe even a smoothies bar.”

By using telehealth, Settles’ project has the potential to go beyond a simple blood pressure check-up. It can lead to collaboration with a care provider, the development of a chronic care management plan, even monitoring and treatment for other health issues. In underserved neighborhoods, a program like this can have quite an impact on healthcare efficiency.

“I’m pursuing three things,” says Settles. “One, demonstrating how the effective use of telehealth in barbershops and hair salons can increase the number of customers screened and moved into treatment. Two, explore other telehealth solutions that can be implemented from barbershops and salons. And three, determine how I can leverage barbershops and salons as launch points for community broadband buildouts that in turn drives residential telehealth into surrounding neighborhoods.”

Settles is still working out the details of this project, which involves Cleveland and barbershops in three other cities. He plans to expand the program to other cities.

“At least since 2005 there have been articles about relying on barbershops and hair salons in African-American communities to screen for hypertension, and several shops are pursuing the strategy using traditional blood pressure cuffs,” he says. “These pilots will probably be the first uses of telehealth for hypertension screening.”

“Everyone is very excited about the possibilities,” Settles adds. “They understand how much of a threat hypertension is and this program gives them an opportunity to affect change in their communities. Many hair dressers and barbers see their customers every other week or so, and shops and salons are tight communities. It’s noticeable when someone disappears and you find out later that the person is disabled by a stroke, or has died from a heart attack.”