Happy fifth birthday, CHARLiE!
July 2025 marks the fifth anniversary of the CHARLiE—Child Health Advice in ReaL-time Electronically—pathway.
The CHARLiE pathway became the second 24/7 Real-Time Virtual Support (RTVS) pathway administered by RCCbc back in 2020, following RUDi.
Call volumes have grown steadily over five years and now CHARLiE is embedded into the workflows of rural providers across the province.
“The CHARLiE team has been so helpful every time I've called from [community] where we do not have peds, but have many complex patients. I so appreciative that we have this resource.”
Led by Dr. Arthur Cogswell and Dr. Melissa Paquette, the CHARLiE team continues to improve equity in pediatric care for rural children while supporting on-the-ground rural pediatricians.
A growing number of rural hospitals across the province are being instructed to call CHARLiE first when they need pediatric support. This includes most of northwestern BC and select sites on Vancouver Island. In communities with limited local pediatricians, this service alleviates the pressure of providing continuous coverage while also reducing the burden on call groups in larger regional centres, which have reported being unable to absorb additional calls.
The pathway, available via Zoom or telephone, launched in July 2020 with support from the Joint Standing Committee on Rural Issues (JSC). Pediatricians Drs. David Wensley and Arthur Cogswell joined up with RTVS leads Drs. John Pawlovich and Kendall Ho to submit a proposal for a 24/7 pathway that would bring pediatric care closer to home for rural communities and provide assistance and mentorship to rural health care providers caring for infants, children and youth in BC.
David recounted: “John and I had met to work on setting up a videoconference system for assisting with managing sick children in rural sites about six or seven years prior to this as part of a Virtual Pediatric Intensive Care Unit (PICU) project we were trying to push out around the province.”
Technological and data challenges meant this previous iteration of a virtual pediatric pathway did not fully take off.
Early in COVID, David attended a presentation that John had given about RTVS.
“We had a side discussion regarding setting up a pediatric group,” David recalls. “Arthur and I discussed this, as we recognized that the support through the Pediatric Transport Program would be significantly impacted by COVID. Following this, there were a number of meetings that included Kendall Ho with his clinical, technical and research experience. We also invited experienced Pediatricians from around the province, Pediatric ER docs and PICU colleagues at BCCH and Victoria to become involved.”
John said that the relationship-building that took place before COVID provided the foundation to launch CHARLiE in the summer of 2020. “Without the prior relationship and trust David and I nurtured in those explorative years, it is very unlikely we would have ever connected early in COVID to brainstorm a pediatric RTVS pathway,” said John.
David added that the ability for sites to use iPads with Zoom technology, rather than specialized videoconference devices and specialized software, was also a factor in the pathway’s success in 2020.
Five years later, CHARLiE is a lifeline for rural providers. The pathway receives regular positive feedback from rural providers, including this recent one: “The CHARLiE team has been so helpful every time I’ve called from [community] where we do not have peds, but have many complex patients. I so appreciative that we have this resource.”
Find out more about CHARLiE on our website.
