Search results for: Derrick Watkins

Authors: Nihar Ranjan, Derrick Watkins, Dev P. Arya

Abstract:

Current methods in the study of antibiotic activity of ribosome targeted antibiotics are dependent on cell based bacterial inhibition assays or various forms of ribosomal binding assays. These assays are typically independent of each other and little direct correlation between the ribosomal binding and bacterial inhibition is established with the complementary assay. We have developed novel high-throughput capable assays for ribosome targeted drug discovery. One such assay examines the compounds ability to bind to a model ribosomal RNA A-site. We have also coupled this assay to other functional orthogonal assays. Such analysis can provide valuable understanding of the relationships between two complementary drug screening methods and could be used as standard analysis to correlate the affinity of a compound for its target and the effect the compound has on a cell.

Keywords: bacterial resistance, aminoglycosides, screening, drugs

Procedia PDF Downloads 336

Authors: Jiahao Cui

Abstract:

In the past centuries, due to climate change and intense whaling, the global whale population has dramatically declined. Among the various whale species, the fin whale experienced the most drastic drop in number due to its popularity in whaling. Under this background, identifying fin whale calls could be immensely beneficial to the preservation of the species. This paper uses feature extraction to process the input audio signal, then a network based on AlexNet and three networks based on the ResNet model was constructed to classify fin whale calls. A mixture of the DOSITS database and the Watkins database was used during training. The results demonstrate that a modified ResNet network has the best performance considering precision and network complexity.

Keywords: convolutional neural network, ResNet, AlexNet, fin whale preservation, feature extraction

Procedia PDF Downloads 88

Authors: Cedric Herring, Loren Henderson, Hayward Derrick Horton, Melvin Thomas

Abstract:

This paper asks whether business startups benefit from having racially diverse founding ownership teams. Using nationally representative data from the Kauffman Firm Survey, the analysis examines the relationship between the racial diversity of the founding ownership teams of business startups and their net worth, revenue, debt, and profits. The analysis shows that, net of firm characteristics and human capital characteristics, startups with racially diverse founding teams have higher net worth, lower debt, and greater profits than their non-diverse counterparts. The racial diversity of ownership teams is not, however, related to startup firms’ revenues, net of other factors. The implications of these findings are explored.

Keywords: racial diversity, business startups, founding ownership teams, diversity and business performance

Procedia PDF Downloads 344

Authors: Walid S. Alfuhaid, Saud A. Alghamdi, John M. Watkins, M. Edwin Sawan

Abstract:

Designing a controller for stochastic decentralized interconnected large scale systems usually involves a high degree of complexity and computation ability. Noise, observability, and controllability of all system states, connectivity, and channel bandwidth are other constraints to design procedures for distributed large scale systems. The quasi-steady state model investigated in this paper is a reduced order model of the original system using singular perturbation techniques. This paper results in an optimal control synthesis to design an observer based feedback controller by standard stochastic control theory techniques using Linear Quadratic Gaussian (LQG) approach and Kalman filter design with less complexity and computation requirements. Numerical example is given at the end to demonstrate the efficiency of the proposed method.

Keywords: decentralized, optimal control, output, singular perturb

Procedia PDF Downloads 337

Authors: Derrick Boakye Boadu, Zahra Fakhri

Abstract:

Transformational leaders are the catalyst of change and focus more importantly on members or followers. Involvement of transformational leadership style in organizational structures can provide interesting nuances to the implementation and enhancement of citizen and customer participation mechanisms in an organization regardless of the time consuming, cost, and delaying process of analyzing the feedback of workers and citizens/customers which stifles good outcome of organization’s department performance. It posits that transformational leadership has a positive direct effect on organization-departmental performance and the intervening role of citizen and customer participation and internal communication. Using the NASP-IV 2007 data, the article finds support for the five hypotheses in a structural equation model, and the findings show that transformational leadership does have a direct impact on organizational-departmental performance a partial mediation effect of the relationship through the role of internal communication and citizen and customer participation.  

Keywords: transformational leaders, departmental performance, internal communication, citizen/customer participation

Procedia PDF Downloads 82

Authors: Fatima S. Mohammed, Derrick Crump

Abstract:

Harmattan, a dusty weather condition characterized by thick smog-like suspended particles and dust storm are the peculiar events that happen during ¾ of the year in the Sahelian regions including Damaturu Town, Nigeria), resulting in heavy dust deposits especially indoors. The inhabitants of the Damaturu community are always inflicted with different ailments; respiratory tract infections, asthma, gastrointestinal infections and different ailments associated with the dusty nature of the immediate environment. This brought the need to investigate the nature of the settled indoor dust. Vacuum cleaner bag dust was collected from indoor of some Nigerian and UK homes, as well as outdoors including during seasonal dusty weather event (Harmattan and Storm dust). The dust was sieved, and the (150 µm size) particles were examined using scanning electron microscope (SEM). The physical characterization of the settled dust samples has revealed the various shapes and sizes, and elemental composition of the dust samples is indicating that some of the dust fractions were the respirable fractions and also the dust contained PM10 to PM 2.5 fractions with possible health effects. The elemental compositions were indicative of the diverse nature of the dust particle sources, which showed dust as a complex matrix.

Keywords: indoor dust, Harmattan dust, SEM, health effects

Procedia PDF Downloads 272

Authors: Fatemeh Yazdandoust, Derrick Mirrindi

Abstract:

The excessive use of non-renewable fossil fuels has led to a pressing energy crisis that demands urgent attention. While renewable sources like solar, wind, and water have gained significant attention as alternatives, we must explore additional avenues. This study takes an interdisciplinary approach, investigating the potential of waste streams from energy production and other untapped natural sources as sustainable energy solutions. Through a review of case studies, this study demonstrates how these alternative sources, including human power, animal body heat, and noise, can seamlessly integrate into architecture and urban planning. This article first discusses passive design strategies integrating alternative energy sources into vernacular architecture. Then, it reviews the waste stream (exergy) and potential energy sources, such as human power, animal body heat, and noise, in contemporary proposals and case studies. It demonstrates how an alternative energy design strategy may easily incorporate these many sources into our architecture and urban planning through passive and active design strategies to increase the energy efficiency of our built environment.

Keywords: alternative energy sources, energy exchange, human and animal power, potential energy sources, waste stream

Procedia PDF Downloads 20

Authors: Edwina Owusu Panin, Derrick Antwi

Abstract:

Autism and cerebral palsy are fraternal twins in the world of communication and social interaction challenges. Caring for autistic and cerebral palsied female teenagers in Ghana can be difficult and stressful for parents. We highlight the findings of dealing with stress, where female teenagers are more daunting than male teenagers, related to the demand for a lot of attention linked to the puberty transition. This brief examines the challenges that parents face in caring for teenagers with autism and cerebral palsy in Ghana and the stress that can develop from parental care. The article also highlights the importance of identifying and addressing mental health and self-care issues in parents of disabled female teenagers, as these issues can significantly affect the well-being of both parents and their children. Parents of teenagers with disabilities often face a variety of challenges, including managing their children's care and medical needs, navigating the educational system, and addressing social and emotional needs. These challenges can be even more disheartening in Ghana, where resources and support for families of children with disabilities are limited. In a nutshell, the challenges of caring for female teenagers with autism and cerebral palsy can be significant in Ghana. The article outlines methods that parents in Ghana can take to manage their stress and provide a brighter future for their female teenagers. Parents are better able to cope with the challenges of parenting and provide the best care possible for their female teenagers with disabilities.

Keywords: autism, cerebral palsy, female teenagers, parental care

Procedia PDF Downloads 48

Authors: Derrick Mirindi, Frederic Mirindi, Oluwakemi Oshineye

Abstract:

The ongoing high rate of construction project failures worldwide is often blamed on the difficulties of managing stakeholders. This highlights the crucial role of strategic management (SM) in achieving project success. This study investigates how integrating digital tools into the SM framework can effectively address stakeholder-related challenges. This work specifically focuses on the impact of evolving digital tools, such as Project Management Software (PMS) (e.g., Basecamp and Wrike), Building Information Modeling (BIM) (e.g., Tekla BIMsight and Autodesk Navisworks), Virtual and Augmented Reality (VR/AR) (e.g., Microsoft HoloLens), drones and remote monitoring, and social media and Web-Based platforms, in improving stakeholder engagement and project outcomes. Through existing literature with examples of failed projects, the study highlights how the evolution of digital tools will serve as facilitators within the strategic management process. These tools offer benefits such as real-time data access, enhanced visualization, and more efficient workflows to mitigate stakeholder challenges in construction projects. The findings indicate that integrating digital tools with SM principles effectively addresses stakeholder challenges, resulting in improved project outcomes and stakeholder satisfaction. The research advocates for a combined approach that embraces both strategic management and digital innovation to navigate the complex stakeholder landscape in construction projects.

Keywords: strategic management, digital tools, virtual and augmented reality, stakeholder management, building information modeling, project management software

Procedia PDF Downloads 26

Authors: Anish Shah, Steve A. Wakelin, Derrick Moot, Aurélie Laugraud, Hayley J. Ridgway

Abstract:

A mixed pasture system of ryegrass-clover is used in New Zealand, where clovers are generally inoculated with commercially available strains of rhizobia. The community of rhizobia living in the soil and the way in which they interact with the plant are affected by different biotic and abiotic factors. In general, bacterial richness and diversity in soil varies by soil pH. pH also affects cell physiology and acts as a master variable that controls the wider soil physiochemical conditions such as P availability, Al release and micronutrient availability. As such, pH can have both primary and secondary effects on soil biology and processes. The aim of this work was to investigate the effect of soil pH on the genetic diversity and metabolic profile of Rhizobium leguminosarum strains nodulating clover. Soils were collected from 12 farms across New Zealand which had a pH(water) range of between 4.9 and 7.5, with four acidic (pH 4.9 – 5.5), four ‘neutral’ (5.8 – 6.1) and four alkaline (6.5 – 7.5) soils. Bacteria were recovered from nodules of Trifolium repens (white clover) and T. subterraneum (subterranean clover) grown in the soils. The strains were cultured and screened against a range of pH-amended media to demonstrate whether they were adapted to pH levels similar to their native soils. The strains which showed high relative growth at a given pH (~20% of those isolated) were selected for metabolic and taxonomic profiling. The Omnilog (Biolog Inc., Hayward, CA) phenotype array was used to perform assays on carbon (C) utilisation for selected strains. DNA was extracted from the strains which had differing C utilisation profiles and PCR products for both forward and reverse primers were sequenced for the following genes: 16S rRNA, recA, nodC, nodD and nifH (symbiotic).

Keywords: bacterial diversity, clover, metabolic and taxonomic profiling, pH adaptation, rhizobia

Procedia PDF Downloads 224

Authors: A. Fernandez Zuvich, I. Gana Watkins, H. Zolotucho, H. Troiani, A. Caneiro, M. Prado, A. L. Soldati

Abstract:

The study of actinide nanoparticles (NPs) has attracted the attention of the scientific community not only because the lack of information about their ecotoxicological effects but also because the use of NPs could open a new way in the production of nuclear energy. Indeed, it was recently demonstrated that UO2 NPs sintered pellets exhibit closed porosity with improved fission gas retention and radiation-tolerance , ameliorated mechanical properties, and less detriment of the thermal conductivity upon use, making them an interesting option for new nuclear fuels. In this work, we used a combination of diffraction and microscopy tools to characterize the morphology, the crystalline structure and the composition of UO2 nanoparticles doped with 10%wt Gd2O3. The particles were synthesized by a modified sol-gel method at low temperatures. X-ray Diffraction (XRD) studies determined the presence of a unique phase with the cubic structure and Fm3m spatial group, supporting that Gd atoms substitute U atoms in the fluorite structure of UO2. In addition, Field Emission Gun Scanning (FEG-SEM) and Transmission (FEG-TEM) Electron Microscopy images revealed the presence of micrometric agglomerates of nanoparticles, with rounded morphology and an average crystallite size < 50 nm. Energy Dispersive Spectroscopy (EDS) coupled to TEM determined the presence of Gd in all the analyzed crystallites. Besides, FEG-SEM-EDS showed a homogeneous concentration distribution at the micrometer scale indicating that the small size of the crystallites compensates the variation in composition by averaging a large number of crystallites. These techniques, as combined tools resulted thus essential to find out details of morphology and composition distribution at the sub-micrometer scale, and set a standard for developing and analyzing nanoparticulated nuclear fuels.

Keywords: actinide nanoparticles, burnable poison, nuclear fuel, sol-gel

Procedia PDF Downloads 308

Authors: Scott A. Ochsner, Christopher M. Watkins, Apollo McOwiti, David L. Steffen Lauren B. Becnel, Neil J. McKenna

Abstract:

Understanding signaling by nuclear receptors (NRs) requires an appreciation of their cognate ligand- and tissue-specific transcriptomes. While target gene regulation data are abundant in this field, they reside in hundreds of discrete publications in formats refractory to routine query and analysis and, accordingly, their full value to the NR signaling community has not been realized. One of the mandates of the Nuclear Receptor Signaling Atlas (NURSA) is to facilitate access of the community to existing public datasets. Pursuant to this mandate we are developing a freely-accessible community web resource, Transcriptomine, to bring together the sum total of available expression array and RNA-Seq data points generated by the field in a single location. Transcriptomine currently contains over 25,000,000 gene fold change datapoints from over 1200 contrasts relevant to over 100 NRs, ligands and coregulators in over 200 tissues and cell lines. Transcriptomine is designed to accommodate a spectrum of end users ranging from the bench researcher to those with advanced bioinformatic training. Visualization tools allow users to build custom charts to compare and contrast patterns of gene regulation across different tissues and in response to different ligands. Our resource affords an entirely new paradigm for leveraging gene expression data in the NR signaling field, empowering users to query gene fold changes across diverse regulatory molecules, tissues and cell lines, target genes, biological functions and disease associations, and that would otherwise be prohibitive in terms of time and effort. Transcriptomine will be regularly updated with gene lists from future genome-wide expression array and expression-sequencing datasets in the NR signaling field.

Keywords: target gene database, informatics, gene expression, transcriptomics

Procedia PDF Downloads 249

Authors: David L. Olson, Stephen B. H. Bruder, Adam S. Watkins, Cleon E. Davis

Abstract:

In global navigation satellite systems (GNSS), denied settings such as indoor environments, autonomous mobile robots are often limited to dead-reckoning navigation techniques to determine their position, velocity, and attitude (PVA). Localization is typically accomplished by employing an inertial measurement unit (IMU), which, while precise in nature, accumulates errors rapidly and severely degrades the localization solution. Standard sensor fusion methods, such as Kalman filtering, aim to fuse precise IMU measurements with accurate aiding sensors to establish a precise and accurate solution. In indoor environments, where GNSS and no other a priori information is known about the environment, effective sensor fusion is difficult to achieve, as accurate aiding sensor choices are sparse. However, an opportunity arises by employing a depth camera in the indoor environment. A depth camera can capture point clouds of the surrounding floors and walls. Extracting attitude from these surfaces can serve as an accurate aiding source, which directly combats errors that arise due to gyroscope imperfections. This configuration for sensor fusion leads to a dramatic reduction of PVA error compared to traditional aiding sensor configurations. This paper provides the theoretical basis for the depth camera aiding sensor method, initial expectations of performance benefit via simulation, and hardware implementation, thus verifying its veracity. Hardware implementation is performed on the Quanser Qbot 2™ mobile robot, with a Vector-Nav VN-200™ IMU and Kinect™ camera from Microsoft.

Keywords: autonomous mobile robotics, dead reckoning, depth camera, inertial navigation, Kalman filtering, localization, sensor fusion

Procedia PDF Downloads 179

Authors: Bukunola K. Oguntade, Gareth M. Watkins

Abstract:

The synthesis and characterization of metal-organic frameworks (MOFs) is an area of coordination chemistry which has grown rapidly in recent years. Worldwide there has been growing concerns about future energy supplies, and its environmental impacts. A good number of MOFs have been tested for the adsorption of small molecules in the vapour phase. An important issue for potential applications of MOFs for gas adsorption and storage materials is the stability of their structure upon sorption. Therefore, study on the thermal stability of MOFs upon adsorption is important. The incorporation of two or more transition metals in a coordination polymer is a current challenge for designed synthesis. This work focused on the synthesis, characterization and small molecule adsorption properties of three microporous (one zinc monometal and two bimetallics) complexes involving Cu(II), Zn(II) and 1,2,4,5-benzenetetracarboxylic acid using the ambient precipitation and solvothermal method. The complexes were characterized by elemental analysis, Infrared spectroscopy, Scanning Electron microscopy, Thermogravimetry analysis and X-ray Powder diffraction. The N2-adsorption Isotherm showed the complexes to be of TYPE III in reference to IUPAC classification, with very small pores only capable for small molecule sorption. All the synthesized compounds were observed to contain water as guest. Investigations of their inclusion properties for small molecules in the vapour phase showed water and methanol as the only possible inclusion candidates with 10.25H2O in the monometal complex [Zn4(H2B4C)2.5(OH)3(H2O)]·10H2O but not reusable after a complete structural collapse. The ambient precipitation bimetallic; [(CuZnB4C(H2O)2]·5H2O, was found to be reusable and recoverable from structure collapse after adsorption of 5.75H2O. In addition, Solvo-[CuZnB4C(H2O)2.5]·2H2O obtained from solvothermal method show two cycles of rehydration with 1.75H2O and 0.75MeOH inclusion while structure remains unaltered upon dehydration and adsorption.

Keywords: adsorption, characterization, copper, metal -organic frameworks, zinc

Procedia PDF Downloads 107

Authors: Sergio V Davalos, Alison L. Watkins

Abstract:

User generated content (UGC) such as website post has data associated with it: time of the post, gender, location, type of device, and number of words. The text entered in user generated content (UGC) can provide a valuable dimension for analysis. In this research, each user post is treated as a collection of terms (words). In addition to the number of words per post, the frequency of each term is determined by post and by the sum of occurrences in all posts. This research focuses on one specific aspect of UGC: sentiment. Sentiment analysis (SA) was applied to the content (user posts) of two sets of political forums related to the US presidential elections for 2012 and 2016. Sentiment analysis results in deriving data from the text. This enables the subsequent application of data analytic methods. The SASA (SAIL/SAI Sentiment Analyzer) model was used for sentiment analysis. The application of SASA resulted with a sentiment score for each post. Based on the sentiment scores for the posts there are significant differences between the content and sentiment of the two sets for the 2012 and 2016 presidential election forums. In the 2012 forums, 38% of the forums started with positive sentiment and 16% with negative sentiment. In the 2016 forums, 29% started with positive sentiment and 15% with negative sentiment. There also were changes in sentiment over time. For both elections as the election got closer, the cumulative sentiment score became negative. The candidate who won each election was in the more posts than the losing candidates. In the case of Trump, there were more negative posts than Clinton’s highest number of posts which were positive. KNIME topic modeling was used to derive topics from the posts. There were also changes in topics and keyword emphasis over time. Initially, the political parties were the most referenced and as the election got closer the emphasis changed to the candidates. The performance of the SASA method proved to predict sentiment better than four other methods in Sentibench. The research resulted in deriving sentiment data from text. In combination with other data, the sentiment data provided insight and discovery about user sentiment in the US presidential elections for 2012 and 2016.

Keywords: sentiment analysis, text mining, user generated content, US presidential elections

Procedia PDF Downloads 158

Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

Abstract:

The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

Procedia PDF Downloads 48

Authors: Majed Al Otaibi, Melissa Lessard-Beaudoin, Amel Loudghi, Raphael Chouinard-Watkins, Melanie Plourde, Frederic Calon, C. Alexandre Castellano, Stephen Cunnane, Helene Payette, Pierrette Gaudreau, Denis Gris, Rona K. Graham

Abstract:

Introduction: Alzheimer disease (AD) is a chronic disorder that affects millions of individuals worldwide. Symptoms include memory dysfunction, and also alterations in attention, planning, language and overall cognitive function. Olfactory dysfunction is a common symptom of several neurological disorders including AD. Studying the mechanisms underlying the olfactory dysfunction may therefore lead to the discovery of potential biomarkers and/or treatments for neurodegenerative diseases. Objectives: To determine if olfactory dysfunction predicts future cognitive impairment in the aging population and to characterize the olfactory system in a murine model expressing a genetic factor of AD. Method: For the human study, quantitative olfactory tests (UPSIT and OMT) have been done on 93 subjects (aged 80 to 94 years) from the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge) cohort accepting to participate in the ORCA secondary study. The telephone Modified Mini Mental State examination (t-MMSE) was used to assess cognition levels, and an olfactory self-report was also collected. In a separate cohort, olfactory cortical volume was calculated using MRI results from healthy old adults (n=25) and patients with AD (n=18) using the AAL single-subject atlas and performed with the PNEURO tool (PMOD 3.7). For the murine study, we are using Western blotting, RT-PCR and immunohistochemistry. Result: Human Study: Based on the self-report, 81% of the participants claimed to not suffer from any problem with olfaction. However, based on the UPSIT, 94% of those subjects showed a poor olfactory performance and different forms of microsmia. Moreover, the results confirm that olfactory function declines with age. We also detected a significant decrease in olfactory cortical volume in AD individuals compared to controls. Murine study: Preliminary data demonstrate there is a significant decrease in expression levels of the proform of caspase-3 and the caspase substrate STK3, in the olfactory bulb of mice expressing human APOE4 compared with controls. In addition, there is a significant decrease in the expression level of the caspase-9 proform and caspase-8 active fragment. Analysis of the mature neuron marker, NeuN, shows decreased expression levels of both isoforms. The data also suggest that Iba-1 immunostaining is increased in the olfactory bulb of APOE4 mice compared to wild type mice. Conclusions: The activation of caspase-3 may be the cause of the decreased levels of STK3 through caspase cleavage and may play role in the inflammation observed. In the clinical study, our results suggest that seniors are unaware of their olfactory function status and therefore it is not sufficient to measure olfaction using the self-report in the elderly. Studying olfactory function and cognitive performance in the aging population will help to discover biomarkers in the early stage of the AD.

Keywords: Alzheimer's disease, APOE4, cognition, caspase, brain atrophy, neurodegenerative, olfactory dysfunction

Procedia PDF Downloads 232

Authors: Ashley L. Freeman, Jessica D. Watkins

Abstract:

TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

Procedia PDF Downloads 47