Real-Time Virtual Support (RTVS) Pathways

Real-Time Virtual Support (RTVS) pathways provide on-demand consultation to support patient care and rural healthcare collaboration. RTVS enables the delivery of timely emergency and urgent patient-centred care closer to home.

These pathways can be accessed by:

1. residents in rural and remote communities and BC First Nations citizens
2. rural healthcare providers

The flow chart shows how the pathways work and can help determine which pathway is most relevant for residents and healthcare providers at any given time. Descriptions of each pathway are below. Download the flow charts:

• for patients
• for providers

 

1. Support for residents in rural and remote communities and BC First Nations citizens

HEiDi (HealthLink BC Emergency iDoctor-in-assistance)

Virtual HEiDi physicians provide decision support to 8-1-1 nurses on calls with patients to determine how best to address the patients’ concerns, whether to go to emergency/urgent care centres (immediately or within 24 hours) or be safely followed up by the patients’ family physicians. 8-1-1 nurses can also transfer calls that meet specified clinical criteria to a medical office assistant, who will then arrange for a virtual visit or phone call with a HEiDi physician. HEiDi physicians will always encourage patients to follow up with their family physicians or, for those patients who do not have one, refer them to family physicians in their own communities for continuity of care.

First Nations Virtual Doctor of the Day

This pathway ensures that First Nations people and their family members can access primary healthcare closer to home. Members of BC First Nations with limited or no access to their own doctors can make virtual appointments by calling 1-855-344-3800 to book an appointment. Medical office assistants are available to help seven days a week from 8:30 am to 4:30 pm. For more information, visit fnha.ca/virtualdoctor.

2. Support for rural healthcare providers

Zoom Licenses

Zoom for Healthcare licenses are available to rural physicians and nurse practitioners. This tool will enable you to reach out virtually to patients and peers. Learn more.

Pathways

The following pathways are available to rural healthcare providers, giving them access to just-in-time advice and culturally safe, compassionate support:

• RUDi – Emergency
• ROSe – Critical Care
• CHARLiE – Pediatrics
• MaBAL – Maternity and Newborn
• UBC Dermatology Rural and Remote Service

 

They are accessible by Zoom and/or telephone as noted in the table below. If you need a Zoom account, please complete the online request form.

If you signed up for a Zoom license through RCCbc, all RTVS pathways will be added to your Zoom contacts automatically. If your Zoom account was provided by your health authority, you will need to add the RTVS contacts to your account.

Once your contacts are added, you can request a consult with the pathways. If you need help with Zoom, visit our Zoom Basics section.

Pathway	Access Information
RUDi – Emergency (Rural Urgent Doctor in-aid) Physicians with emergency medicine and rural experience are available 24/7 by Zoom and phone to support rural healthcare providers looking for support with a patient or preparatory simulation, including: • providing a second opinion about a patient • reviewing a case • running through simulation scenarios • helping to navigate the healthcare system • providing collaborative support in critical times • other situations as needed by rural providers See additional resources	Available 24/7 Zoom Contact: rudi1@rccbc.ca Backup Accounts: rudi2@rccbc.ca rudi3@rccbc.ca rudi4@rccbc.ca
ROSe – Critical Care (Rural Outreach Support) Intensivist/critical care specialists are available 24/7 by Zoom, mobile app, and phone to support rural healthcare providers looking for a consultation, second opinion, or ongoing virtual support for patients. ROSe physicians have expertise in complex, acutely ill patients, and those who are deteriorating. However, they are open to support rural care providers for any patient whom they are concerned about. See additional resources	Available 24/7 Zoom Contact: rose1@rccbc.ca Phone: 1-888-918-0626 ROSe mobile app
CHARLiE – Pediatrics (Child Health Advice in Real Time Electronically) Pediatricians, pediatric emergency physicians, and pediatric intensivists are available 24/7 by Zoom to provide urgent specialized pediatric support to rural healthcare providers who are presented with urgent problems in children and youth. Support includes providing a second opinion, reviewing a case, helping to navigate the healthcare system, and providing collaborative support. Referrals will continue through current regional referral pathways utilizing the partnerships developed by Child Health BC, with the Tiers of Service guiding referrals and discussion of transfers. CHARLiE physicians will partner with CompassBC, a program that provides virtual support to providers managing children and youth living with mental health and substance use concerns. CHARLiE physicians will work with the current Neonatal and Pediatric Critical Care Transport program to support rural healthcare providers. See additional resources	Available 24/7 Zoom Contact: charlie1@rccbc.ca
MaBAL – Maternity and Newborn (Maternity and Babies Advice Line) Family physicians with expertise in maternal and newborn care and an understanding of the rural and cultural contexts are available 24/7 through Zoom and by phone to provide guidance on urgent and non-urgent pre-conception, prenatal, antenatal, intrapartum, and postpartum presentations, for both moms and newborns. Family physicians can also provide assistance in assessment and problem-solving and can rapidly facilitate access to specialist expertise from regional care centre obstetricians or provincial pediatricians. See additional resources	Available 24/7 Zoom Contact: mabal1@rccbc.ca
UBC Dermatology Rural and Remote Service UBC Dermatology is operating a service for physicians and nurse practitioners in rural and remote settings (including First Nations Virtual Doctor of the Day) by phone, text, photo, teleconference, and a combination of these. The first contact is usually with a senior dermatology resident who can orient new users. Residents will use submitted information to reach a working diagnosis and plan, which is reviewed with dermatology staff and the referring practitioner. Follow-up plans are made, and a written note is faxed. Note: Texting is through WelTel, a secure texting service based in Vancouver. See the Dermatology page for more information.	Monday to Friday (except holidays) 9 am to 5 pm Zoom Contact: rrderm@telus.net Phone: 1-778-771-DERM (3376) Once contact is established, texts/photos can be sent to 1-236-999-1658 or through Zoom
myoLIVE myoLIVE (Link Immediately to Virtual Expertise) support is now available through the RTVS non-acute pathways. This support service is for myoActivation practitioners and clinicians who are challenged by a myofascial pain presentation.	Seven days per week 8 am to 6 pm Zoom Contact: info@anatomicmedicine.org
RheumVision RheumVision assists rural family physicians and specialists in the Northern Health region and First Nations Health Authority to manage adult patients with inflammatory rheumatologic conditions, such as arthritis, connective tissue diseases, vasculitis, or other similar autoimmune diseases, who are unable to see a rheumatologist in a timely manner. The service provides longitudinal patient care until the patient can be seen by the nearest local rheumatologist.	Monday to Friday 9 am to 5 pm Zoom Contact: rheum.vmoa@rccbc.ca Zoom call will go to a medical office assistant who will schedule a virtual appointment.
Clinical Hematology Clinical Hematology provides consultations to all physicians regarding patients with benign or malignant hematological issues.	Monday to Friday 9 am to 5 pm Zoom Contact: hematology@rtvs-bc.ca Zoom call will be answered if provider is available. If not, virtual provider will call back shortly.
Thrombosis Medicine Thrombosis Medicine provides rapid support for patients with thromboembolic or arterial thrombosis disease, including deep vein thrombosis, pulmonary embolism, atrial fibrillation, warfarin bridging, and direct oral anticoagulation management.	Monday to Friday 9 am to 5 pm Zoom Contact: thrombosis-clinic@rccbc.ca Zoom call will be answered if provider is available. If not, virtual provider will call back shortly.

 

Download the toolkit and posters

The Real-Time Virtual Support Toolkit for Healthcare Providers is aimed at helping physicians, nurse practitioners, and nurses in rural, remote, and First Nations communities navigate through the RTVS pathways.

It includes the flow chart, details on how to access each pathway, Zoom instructions, frequently asked questions, bios and photos of the physicians in each RTVS team, and posters to put up in your hospital, clinic, or office.

If you just need the posters, download them separately:

RTVS Poster

Dermatology poster

 

Virtual Locum Service

Locums for Rural BC offers a more flexible approach to locum support, including linking locums with community. Temporary policy and administrative changes are now in place, addressing:

• essential locum assignments
• number of locum days
• support for ALL RSA communities from RGPLP, RGPALP, and RSLP
• locum assistance via Telehealth

 

Read more about these temporary changes. If you have any questions, email info@locumsruralbc.ca, or leave a message at 1-877-357-4757, and a locum officer will get back to you.

Acknowledgements

Real-Time Virtual Support is an initiative of the Virtual Health and Wellness Collaborative for Rural and First Nations BC. RTVS is made possible through the incredible work and collaboration of Rural Coordination Centre of BC (supported by the Joint Standing Committee on Rural Issues), First Nations Health Authority, Provincial Health Services Authority, Providence Health Care, BC Emergency Medicine Network, and UBC Department of Emergency Medicine.

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Thanks for serving your communities in the many ways that you do. Please let us know if you have ideas of other ways the RCCbc can help you at this time.