COVID-19 May Challenge Rural Healthcare, but Clarkson Is Ahead of the Curve

Route 11

Route 11 is a two-lane blacktopped highway that runs parallel to a patchwork of farms and a busy train track hustling freight daily. As one of the major arteries of rural Northern New York, the corridor moves residents and visitors in and out of Potsdam, weaving past Clarkson's main entrance.

In March, traffic on Route 11 and other local roadways thinned out as #quarantinelife became a common thread and essential workers, particularly those on the frontlines in hospitals and COVID-19

Through a transformational gift from the Lewises, Clarkson is establishing the Earl R. and Barbara D. Lewis

COVID-19 May Challenge School of Health Rural Healthcare, but Clarkson Sciences to advance careers, Is Ahead of the Curve

By Kristen A. Schmitt

research and testing centers, became the sole commuters. The coronavirus tossed a new challenge on the nation’s already overwhelmed rural healthcare system — a system that has faced the closure of 120 rural hospitals over the past 10 years, according to the Chartis Center for Rural Health, and is designed for primary care and surgery (not pandemics).

Fortunately, Clarkson already had an action plan in progress even as the world began to tilt: the new Earl R. and Barbara D. Lewis School of Health Sciences.

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innovation that emphasizes meeting rural and distancechallenged healthcare needs.

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CLARKSON ON THE FRONTLINES

Long-time Clarkson donors Earl and Barbara Lewis provided the endowment to found the new Lewis School of Health Sciences. Students will have access to the highest quality education and hands-on experiences — including those that address a variety of rural-specific healthcare needs.

The Lewis School will provide three fully accredited graduate-level programs in physical therapy (PT), physician assistant studies (PA) and occupational therapy (OT) and give students a unique grounding in providing healthcare in a rural setting. The Lewises are longtime Clarkson donors; however, a personal family experience brought the unique challenges of rural healthcare to their attention, resulting in their engagement in Clarkson’s health sciences programs.

“We have seen firsthand the need for more rural healthcare options and know that the expansion of these programs at Clarkson can positively impact the quality of life for the many friends, neighbors and relatives we have in the North Country,” said Barbara Lewis.

“By ensuring resources in the health sciences for expanded educational offerings and practical research at the University, we can leverage Clarkson’s location and leadership in the North Country to continue producing health professionals whose education spans all boundaries,” said Earl Lewis ’66.

Students enrolled in the Lewis School will gain hands-on experience addressing a variety of rural-specific healthcare needs, like farming or industrial injuries, as well

as helping with other region-specific issues, such as treating competitive athletes who use Lake Placid’s Olympic facilities.

The School will also connect Clarkson’s expertise to distinct local communities within the Saint Regis Mohawk Tribe at nearby Akwesasne and the U.S. Army installation at Fort Drum.

“The Lewis School will help further our expertise in robotics, computer science and biomedical engineering,” says Provost Robyn Hannigan. “We’ll also be using our digital arts and sciences groups to develop new ways of providing telemedicine, as well as new ways of using the data and analyzing the types of data that you get through those systems, to determine what other healthcare support you can provide through telemedicine technologies.”

“Clarkson was already moving in this direction, but the recent pandemic provided an impetus to keep going and keep investing in the innovations we were already planning for,” says Hannigan.

“And, now, we have a much clearer understanding of where the challenges and opportunities are.”

With an anticipated rise in virtual physician visits as the pandemic continues, Clarkson’s focus on health sciences will prepare graduates for the future of telemedicine and the ever-evolving needs of rural healthcare.

The healthcare industry thrives on teamwork, such as bringing experts from a variety of fields together to find solutions that combat issues like pandemics and infectious diseases. Clarkson graduates are already on the frontlines locally at the Canton-Potsdam Hospital and regionally within New York state and the entire Northeast.

Teams within the campus community have also been hard at work.

William Jemison, dean of the Wallace H. Coulter School of Engineering, Tony Collins Professor of Innovative Engineering Culture and an electrical engineer, took the lead on modifying positive air pressure respirators (PAPRs) to operate from batteries that are more readily available than their original specialized batteries. A PAPR is an important personal protective equipment (PPE) device that helps protect healthcare providers from COVID-19 while interacting with patients. With the modification, St. Lawrence Health System (SLHS) can better utilize their PAPR supply.

Once Jemison obtained a physical PAPR, he was able to create a modified prototype within three days. Then, he worked with Jacob Weller, Clarkson’s supervisor of Technical Support Services and the engineering shop, to demonstrate the working prototype to Kylie Broughal MS’18, a physician assistant at SLHS with expertise in infectious disease. Broughal showed the Clarkson team how to test the units for proper airflow, and the modified prototype passed a 13-hour test to ensure that the flow rate could be maintained over a full 12-hour shift.

“A lot of hospitals are using similar respirators with dead or unhealthy batteries,” says Jemison. “We’re trying to get the word out that we have a solution for three different models of respirators and, to the extent that somebody comes to us and wants a solution, we can help them.”

Since that initial prototype, Jemison has turned around an additional five PAPR units for SLHS. “We’ve also made six for Elizabethtown Community Hospital,” says Jemison, “four for Adirondack Health in Saranac Lake and six for Samaritan Medical Center in Watertown.”

And there are other PPE solutions in the works.

“We have manufactured plexiglass boxes to protect doctors in the unlikely or unpleasant event they have to perform an endotracheal intubation,” says Jemison, referring to the procedure in which someone must be intubated to use a ventilator. Because the virus can be transmitted through coughing, doctors must be protected in this type of situation.

“We’ve built two boxes where they can put the box over the patient’s head and torso,” explains Jemison. “The doctors can put their arms through holes in the box and do the procedure behind the protective cover of this plexiglass box.”

For this particular project, Jemison worked with Dr. Julie Vieth ’02, head of emergency medicine at SLHS. Based on information provided by Dr. Vieth, who had materials detailing research that was done in China using this box, Weller and Mark Hebel, engineering machinist, created Clarkson’s working prototype.

Jemison is also assisting Douglas Bohl, an associate professor in the Department of Mechanical & Aeronautical Engineering, in determining how to reuse N95 masks without degrading the material and masks, which happens when UV light is used to clean them.

“Doug is working on building a frame that goes around the outside of the mask

with a secondary set of bands, kind of like a suspender system, to hold the mask on,” says Jemison. “He took the lead on that by making a clay model around a mask that’s one of the brands the hospital is widely using.”

Once the clay model was finalized, Jemison worked with Alex Kupin ’21 in the Dorf Makerspace to complete a 3D scan, followed by a 3D print. Bohl and Colin Stutz ’16, MS'20 finalized the geometry based on the prototype. Because the prototype is now in demand and large quantities are needed, they partnered with Clarkson’s Shipley Center for Innovation to have Evolution Prototypes, one of its incubator tenants, do the manufacturing.

Using protocol from the University of Nebraska, Bohl is also working on a system to sterilize the masks with UV light for the local emergency ambulance squad. “I’ve helped Doug modify some UV detector circuits. As an EMT who works with the squad, Doug has an amazing passion for the project,” says Jemison.

While faculty have been primarily involved with these initial projects that will help solve coronavirus-related issues, Jemison is hopeful that community involvement and support will continue as the pandemic continues and after it ends.

“People who have never collaborated are now working together. You can see how impactful it can be when we start to focus our university expertise on solving real-world problems,” says Jemison. “I’d love to see it continue. I’m sure there are other problems in the hospitals that aren’t related to COVID-19, and we could do a lot of good.”

Learn more on how Clarkson and the St. Lawrence Health System have been collaborating and innovating during the COVID-19 crisis.

Left: SLHS Physician Assistant Kylie Broughal MS’18 (left), Dean William Jemison (center) and Supervisor of Technical Support Services Jacob Weller (right) collaborating on the modified PAPR system while socially distancing.

Above: Broughal demonstrates the modified PAPR unit.

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