Real-Time Virtual Support (RTVS)

RTVS expansion

RTVS Call Volumes Grow and Coverage Expands

In 2025, RTVS supported more than 36,000 calls and helped prevent over 5,856 hours of rural emergency department closures, allowing patients to receive care closer to home while keeping local sites open and staffed. Today, RTVS serves 133 rural and First Nations communities, including 63% of BC’s medically isolated communities, with providers responding to more than 3,000 calls each month.

Patients save money

Patients save money because of RTVS

In July 2025, the UBC Digital Emergency Medicine Team published a five-year report. The report included a study that estimated that across all RTVS pathways, including First Nations Health Authority and HealthLink BC (811) pathways, RTVS averted $34-million in travel costs for patients and families, allowing them to stay close to home.  

Increasing access to healthcare closer to home decreases stress for patients and increases confidence in the health system.  

Planning for the future

Strategic plan helps ensure RTVS is future-proof 

The RTVS team worked together to create a new strategic plan that will guide the program for the next five years. Consultation was a vital step in the plan’s creation, with the structure of the plan built around feedback collected from two surveys. An internal survey went to all RTVS staff, all RTVS providers and RCCbc leadership. A partner survey was then sent to Ministry of Health and health authority partners. Among the themes that emerged from the consultation was the desire to maintain the RTVS culture of “how can I help?” The creation of this strategic plan will ensure that all team members are aligned on priorities. This focus will allow RTVS to support the Ministry of Health and other partners in achieving organizational improvements and system design efforts that build capacity. 

Faculty development learning journey

RTVS providers gather for learning journeys 

Faculty development offerings within RTVS ensures virtual providers are progressing on their cultural safety and humility journey, notably through regular sessions with Cultural Safety and Humility Consultant Harley Eagle. The sessions also aim to ensure providers are sharing knowledge and best practices to best support First Nations, rural and remote communities. In 2025, a total of six faculty development sessions were hosted, including two that focused on cultural safety and humility, two that focused on transport, a best practices in virtual care session, as well as a fall virtual retreat that included both clinical education and cultural safety and humility.     

Real-world results for prenatal project

MaBAL chart reviews improve patient care and management

An RTVS Maternity and Babies Advice Line (MaBAL) project has been building trust with two remote First Nations communities by co-creating a service to better support Indigenous lifegivers and care providers. An evaluation about the project was released in 2025. The project saw MaBAL providers carrying out chart reviews with family physicians, nurse practitioners and RNs to increase comfort with and knowledge about caring for pregnant patients. Since the chart reviews began in Kwadacha and Tsay Keh Dene, community providers (FP, NP and RNs) have observed improvements in preventative care and management of maternity patients. An evaluation participant shared that early identification of pregnant patients has enabled tests to be ordered near the beginning of pregnancy and, as relevant, to initiate early conversations about mental, emotional, and spiritual health and wellness.  

Ensuring maternity care access

Maternity care when no other support exists

In addition to supporting routine and high-complexity prenatal care, RTVS MaBAL serves as a vital safety net for many communities without maternity care providers or birthing facilities. The high acuity events include precipitous and preterm deliveries, facilitating the timely assessment and medevac of preterm laboring patients from remote communities, and providing guidance for local births when patients choose not to relocate to a site with birthing facilities or when one is not accessible. MaBAL supports FNHA’s Indigenous Birth Reclamation work and is directly referenced in the recent “Answering the Call: Calls to Action from First Nations Community Members to Improve the Rural and Remote Birthing Journey” report.

Huge support for RTVS

Rural providers show huge support for CHARLiE and MaBAL service

The RTVS MaBAL and CHARLiE (Child Health Advice in ReaL-time Electronically) teams elevated the need for a sustainable and equitable funding model for all of RTVS. In fall 2025, when changes to the model did not happen, both services were reduced to 12-hour overnight coverage. Rural support for MaBAL and CHARLiE was profound:

“CHARLiE and MaBAL are not luxuries — they are lifelines.” – The Primary Care teams from Haida Gwaii Hospital – Xaayda Gawky Ngaaysdll Naay (Daajing Giids) and Northern Haida Gwaii Hospital & Health Centre (Masset)

“If the CHARLiE or MaBAL services were to no longer exist, I would seriously doubt my interest in continuing to work in Rural Communities as knowing that I have these two invaluable services supporting me was one of the key reasons I started my career in [X community].” – Rural family physician

Getting the word out

CHARLiE Shares Pediatric Real-Time Virtual Support Model Provincially and Nationally 

In 2025, CHARLiE spoke nationally at the Canadian Pediatric Society’s Annual Conference and the Canadian Medical Association’s Canadian Conference on Physician Health.  Provincially, CHARLiE spoke at the Joint Collaborative Committee Conference, the Joint Standing Committee on Rural Issues, the Provincial Virtual Health Collaborative, the UBC Department of Pediatrics Faculty Meeting and the Pediatric Residency Education Retreat.  Through these platforms, CHARLiE spread the innovative model of RTVS, how it supports patient outcomes, reduces patient and system costs, and supports recruitment and retention both of rural generalists and specialists.

Partnership supports critical care team

Partnership with Northern Emergency Response Team 

ROCCi and RUDi began a partnership with the Northern Emergency Response Team (NERT) that was formally launched in March 2025. The NERT team is a high-acuity transport team based at the University Hospital of Northern BC in Prince George. NERT provides advanced monitoring and care during inter-facility transfers for critically ill or injured patients within a two-hour ground transport radius of Prince George. The team supports rural Northern Interior EDs by stabilizing high-acuity patients awaiting Critical Care Team transport. Along with RUDi support during hours when ROCCi isn’t available, ROCCi support has been instrumental in NERT getting off the ground. The RTVS team provided physician oversight in 36% of the 81 transfers that NERT were involved with in 2025.  

Rural providers have peace of mind with ROCCi

ROCCi helps give rural providers peace of mind 

The Rural Outreach in Critical Care and Internal Medicine (ROCCi) pathway celebrated one year of operation in October 2025. During this period, ROCCi has had an outsized impact on patients and rural care providers, connecting them with expert critical care and internal medicine support when they need it most. “It’s like having a caregiver in your back pocket that can make you feel like you’re providing good care locally, and preventing you from being scared of the case,” said one rural family physician.  

VERRa makes care more sustainable

Case study: VERRa has big impact on small, rural Emergency Departments 

RTVS Virtual Emergency Room Rural assistance (VERRa) is able to help make care in small rural hospitals more sustainable. A 2025 VERRA shift gives an example of the support provided. The shift was in an isolated community and was busy all night. There were multiple complex patients, including a liver transplant and metastatic cancer patient around midnight. Along with RTVS ROCCi support, this case took a fair bit of time and kept the virtual doctors and on-site nursing team busy until 3:00 a.m. when a patient presented with a history of seizures and in need of stabilization. All this care happened without the need to call the local doctor in.  The team was grateful the local doctor had a good night’s sleep and was well rested for a major pediatric resuscitation case that came in just before shift change in the morning. The resuscitation case was heartbreaking for everyone involved, and it would have been only worse had that local doctor been awake the entire night beforehand.  

VERRA lead Dr. Brydon Blacklaws said: “For our small part, I was proud of the VERRA team for its contributions to this small community ER that night. VERRA helped provide the best care possible when it mattered most.” 

Thousands of calls from nursing stations

RUDi provides critical support for nursing stations 

RUDi answered 13,481 calls from nursing stations in 2025. Nurses have reported that their jobs would not be manageable without RTVS. Nurses like Katie LeRone, a Registered Nurse with Remote Certification (RNC) who works unsupported by a physician in the remote Nemaiah Valley regularly calls RUDi and the other RTVS pathways. “I use RTVS for anything that’s outside of my scope of practice as an RNC. I have to consult with a physician, and so RTVS makes my world go round,” she says. “Honestly, I wouldn’t be here if I didn’t have RTVS. I don’t think I would feel safe. I don’t know how I would do my job at all now.” 

Reducing wait times for specialist care

Consultation to Conversation prevents patient travel and offers reduced wait times for specialist care 

Consultation to Conversation 2.0 was officially launched on January 15, 2025, with 230 C2C consults having taken place between rural patients, primary care providers, and C2C specialists to date. Specialties that are now available include cardiology, internal medicine, pediatrics, psychiatry, rheumatology, sci-nav (physiatry & allied health), and infectious disease. The C2C program is seeing growing use in northern communities where barriers are greater. Survey data collected as part of the program shows that C2C is helping improve referral coordination and get patients connected to specialists sooner while reducing the need for patients to travel outside of their communities to access care.   

Recent examples: 

Psychiatry – ADHD Assessment 

A patient in a rural BC community required a non-urgent Adult ADHD Assessment through the C2C program. The consultation was coordinated and completed within 12 days from referral to appointment. In comparison, publicly reported provincial wait times for the non urgent Adult ADHD Assessments average approximately 24 months for private clinics and 1 – 2 years through the publicly funded system demonstrating how C2C can significantly reduce time to specialist access for rural patients. 

New learners exposed to collaborative care

Resident involvement through C2C consults expose new learners to collaborative care approaches  

Specialists and primary care providers taking part in C2C consults were encouraged to invite medical students, residents, and/or fellows to join C2C consults. Following these consults, 8/8 learners rated their experience in this learning environment as “Excellent”, as one learner further elaborated:  

“[The] virtual platform enabling real-time discussion and collaboration was most helpful for my learning. The video format was particularly helpful.” – Medical Student 

To date, 8/8 learners shared that they would recommend this learning experience to other medical students or residents in the future.  

Three new Quick Reply pathways

Three new Quick Reply Pathways launched 

A total of three new Quick Reply pathways were launched in 2025: Pharmacists, Spinal Cord Injury Navigation and Orthopaedics. The Pharmacists pathway includes practitioners from the UBC Pharmacists Clinic who are committed to providing culturally safe care for rural and remote communities. The Spinal Cord Injury Navigation service provides clinical support from a physiatrist or other expert peer to assist in their interactions with persons living with SCI. This may take the form of advice, training, or participation in three-way consultations with their patients. Providers can call the RTVS Orthopaedics pathway for any musculoskeletal pathology. There are now 11 Quick Reply pathways serving rural providers across BC.