Real-Time Virtual Support (RTVS)

Real-Time Virtual Support (RTVS) peer pathways are for physicians, residents, nurse practitioners, nurses, midwives—and, in some cases, first responders—in rural, remote, and First Nations communities in BC. Calling RTVS is like calling a friend. It is there for rural providers when they need free and friendly clinical support at the click of a button.

“RTVS is a game-changer for me in the rural ER. It fills so many roles: from a quick hallway consult about an unique case to a trusted expert to lean on in an "all hands on deck" emergency. Rural practice can be very isolating and RTVS helps me feel less like I am out there on my own. The support is consistently friendly and sensitive to what it means to provide care in lower resource environments. Without exception, the RTVS providers truly "get it". Looking back on my practice before RTVS, I don't know how I ever functioned without it. ”

Dr. Zeke Steve, Rural Locum

Achievements

Provincial support

RTVS peer pathways have supported 151 communities, representing 76% of the rural, remote and Indigenous communities identified in the Rural Subsidiary Agreement (RSA).  RTVS peer providers answered over 13,000 calls and messages from rural providers in these communities looking for clinical support. Some of the most frequent callers to the service are providers in Lax Kwa’laams, Anihim Lake, Kitkatla, Atlin and Kwadacha. 

Grants expand and improve work

RTVS peer pathways received funding from the Learning Health System (LHS) team at UBC Digital Emergency Medicine to expand and improve our work. A CHARLiE project, led by Dr. Arthur Cogswell, and supported by medical students, aims to create a database of pediatric resources at frequent calling sites that will be accessible to RTVS providers supporting these communities. Dr. Adrian Yee, hematologist on the RTVS Quick Reply specialist team, is leading a project to develop best practices in virtual team-based care. Another project, the UBC CPD RTVS Simulation Residency Site Project, aimed to deliver RTVS Simulation to UBC Family Medicine residency sites. In 2023, the project made it to all rural residency sites. One of the goals of the project was to ensure that every resident who intends to practice rurally in the future will be aware of and know how to connect with RTVS. Another goal was to collect data on the experience. The MaBAL pathway also received funding for a project to partner with a remote community in support of the delivery of maternity services. 

Expanded maternity support

As part of the MaBAL Learning Health System Grant project, the project team had an opportunity to visit their chosen community of Kwadacha to hear from community members, Elders, parents, health care providers, and administrators about their experiences with maternity care. From these discussions, the team was able to collaboratively identify and discuss how MaBAL could virtually support maternity care in Kwadacha. Since the visit, the project team has created a report, which included a visual representation of the patient journey, summary of opportunities through MaBAL, as well as community-led opportunities. The goal will be to pilot expanded virtual maternity services for Kwadacha.  

Preventing diversion and burnout

The RTVS team provided over 1800 hours of Most Responsible Provider (MRP) coverage in 2023 to small rural emergency departments (EDs) experiencing human resources challenges. This work has prevented hospital ED closure and diversion of patients to other communities. The support is a collaboration between RTVS, the local health authority, and the on-the-ground clinical team. During a RUDi MRP shift, a virtual RUDi doctor works with the local nursing team to oversee the ED overnight. The virtual support allows on-the-ground physicians to get some rest in support of retention. In communities where RTVS has provided this support, the work has been temporary until staffing levels can be stabilized. 

Award-winning documentary

In partnership with the Ed Tech team at UBC’s Faculty of Medicine, RCCbc launched The Edge of Care, a 22-minute documentary about the RTVS program and its impact on rural providers and the communities they serve. The film follows the story of community leaders, elders, artists, knowledge keepers, and physicians as they work together to deliver equitable health care to the most remote communities—those on the “edge”. The film was a two-time 2022-23 International Gold Muse Award winner. The film also won a 2022-23 International Hermes Creative Award for Video/Social Media. In 2023, more than 6,000 people saw the film on YouTube. It was also screened in front of a global audience at the October 2023 Towards Unity for Health (TUFH) conference in Sharjah, United Arab Emirates.

Excellence in virtual care

The RTVS Fire Department, which provides faculty development for RTVS providers and outreach to rural communities, hosted five faculty development events, an in-person retreat and a virtual retreat. All faculty development sessions have been created in order to raise the bar and ensure RTVS is at the leading edge of virtual health. The virtual faculty development events ranged from tips and tricks sessions to help team members improve their virtual provider skills, to cultural safety and humility events, along with Celebrations, Successes and Insight (CSI) rounds looking at RTVS case studies. Participants have given the sessions high praise, with the average rating for the events 4.4 out of 5 stars.  

Staying connected with rural

The RTVS Fire Department also engages in outreach to communities/teams that either use RTVS or may choose to use RTVS. In 2023, outreach trips were organized to Sun Peaks, Chase, Sorrento, Clearwater, Kwadacha, Port McNeill, Port Hardy, Alert Bay, Port Alice, Sointula, Grandforks, Midway, Rockcreek, Greenwood, Texada Island, Hornby Island, Bella Coola and Anihim Lake. The trips resulted in an increased understanding of the needs in these communities, which will inform improvements to our service.

Explore the numbers

13,000 Calls & messages

RTVS answered over 13,000 calls and messages from rural providers

1800 Hours

RUDi provided over 1800 hours of Most Responsible Provider (MRP) coverage

18 Site visits

Members of the RTVS team visited 18 different sites across the province in 2023 for outreach

4 Awards

RTVS was honoured with four awards in 2023. RTVS won a 2023 Quality Award from Health Quality BC, and our documentary The Edge of Care won a Hermes award and two MUSE awards

Making a Difference

RUDi expertise helps nursing teams save lives

Innovative support brings more stability to Northern Haida Gwaii hospital

MaBAL pathway gives rural providers just-in-time support for maternity cases

Card showing RTVS as a Quality Award winner.

RTVS named 2023 BC Quality Award winner

Plans for the Future

The MaBAL team have been working with community health care providers, administrators, and partners at the First Nations Health Authority to ensure pilot supports identified during the Kwadacha visit can be adopted. 
 

The RTVS Fire Department also launched a new end-user, encounter survey as well as a provider needs assessment survey. The information from these surveys will be used to inform our quality improvement and quality assurance initiatives.  