Real-time Virtual Support (RTVS) pathways for pediatrics, maternity + babies now available

Photo: Lab2112

There are two new Real-Time Virtual Support (RTVS) pathways available for BC healthcare providers supporting rural, remote and Indigenous communities who are seeking just-in-time advice and compassionate support. 

 CHARLiE – pediatrics (Child Health Advice in Real Time Electronically) 

Through the Child Health Advice in Real Time Electronically (CHARLiE) pathway, rural physicians, nurse practitioners and nurses can reach out 24/7 to pediatricians and pediatric emergency physicians via Zoom to seek a second opinion, review a case, ask for help navigating the healthcare system, and seek collaborative support. CHARLiE can also be used by pediatricians for real time virtual peer-to-peer support and case discussions. 

The CHARLiE pathway is an additional resource for rural healthcare providers and does not replace the current regional referral pathways.  

CHARLiE is a culmination of a collaboration between pediatric stakeholders – including Child Health BC, the BC Pediatric Society, the UBC Department of Pediatrics, and BC Children’s Hospital – and the Virtual Health and Wellness Collaborative that supports the Real-Time Virtual Support pathways. The pediatricians providing support through the CHARLiE pathway are available for rural providers to have a virtual “hallway conversation,” and are integrating with the current Neonatal and/or Pediatric Critical Care Transport program to support rural healthcare providers in stabilizing young patients for any necessary trips out of community to receive care. In addition to addressing physical health issues, CHARLiE is able to support community providers during regular working hours with child and youth mental health and substance use concerns through a partnership with CompassBC.  

Community healthcare teams wishing to engage in accredited education and training for pediatric care and/or emergency response will be able to book appointments with CHARLiE pediatricians to run simulations. These exercises not only help keep local provider skills sharp and allow them to review cases that illustrate current best practices, they also forge and strengthen collegial relationships over the medium- and long-term which positively impacts rural provider comfort, recruitment and retention. 

MaBAL – maternity and babies (Mothers and Babies Advice Line)  

MaBAL is a new Real Time Virtual Support (RTVS) pathway that will increase rural, remote and Indigenous communities’ direct access to primary care maternity and newborn consultation and expertise. This pathway is available to community nurses, nurse practitioners, midwives, and rural physicians seeking advice (a virtual “hallway conversation with a colleague”) on a maternity and/or newborn patient. A clear priority of this service will be to provide access to culturally safe maternity and newborn care support for those providing care to families in indigenous communities.  

 MaBAL providers have expertise in maternal and newborn care and an understanding of BC’s rural and cultural contexts. They will be available 24/7 through Zoom and by phone, and are able to provide guidance on inquiries involving urgent or non-urgent questions about pre-conception, prenatal, antenatal, intrapartum, and postpartum concerns. MaBAL providers can also assist with assessment, problem-solving, and care strategies, and will can help facilitate access to specialist expertise from regional care centres obstetricians or provincial pediatricians, freeing you to spend time with your patient. 

When MaBAL launches on August 17, support will be provided initially by family physicians with a strong generalist approach to healthcare service. In the coming months, midwives and obstetricians will be added to the roster for this service. Like other RTVS pathways, MaBAL providers will be offering simulation training to rural, remote, and Indigenous communities. If you would like to request simulation training, please email for further details.  

While MaBAL is one of the latest resources for rural maternity and newborn healthcare providers in BC, it is only one of several tools available to support rural obstetrics. RCCbc also offers rural and remote community maternity healthcare team supports through its Rural Obstetric and Maternity Sustainability Program (ROAM-SP), and supports regional network development and provincial relationship-building and advocacy through the Rural Obstetrics Network.  

Although MaBAL is a new resource that is being rolled out as part of rural BC’s Covid-19 pandemic response, it has deep and early roots in Dr. Jeanette Boyd’s work with RCCbc’s Rural Obstetrics Network. In 2012, Dr. Boyd invited rural maternity care providers from across the province – family physicians, midwives, specialists, and others – to form the Rural OB Network with a vision of bolstering and strengthening rural maternity services in rural, remote and Indigenous communities. “Communities have been clear about wanting access to maternity care closer-to-home,” says Dr. Boyd. “We know from studies and surveys that rural patients have better health outcomes and are less economically burdened when they don’t have to travel long distances for care. Supporting maternal and newborn health closer-to-home when it’s safe and appropriate to do so is better for everyone.”  

Adding CHARLiE and MaBAL to your Zoom account contacts list 

If you signed up for a Zoom license through RCCbc, all RTVS pathway contacts – including CHARLiE and MaBAL – will automatically display in your Zoom contact list. If your Zoom account was provided by your health authority or if you signed up for your own account, you will need to add the contacts for CHARLiE ( and MaBAL manually and wait up to 24 hours to have your request to link with CHARLiE and/or MaBAL approved. To start a video consultation with a CHARLiE or MaBAL provider, to Contacts and select either CHARLiE or MaBAL. Then, click the “Meet” button. 

If you are a rural BC physician or nurse practitioner, and you do not have a healthcare grade Zoom account, you may request one from RCCbc. Click here to learn how to request an account.

For more on Real Time Virtual Support pathways, visit RCCbc’s web site at or download the RTVS Toolkit now.   

CHARLiE and MaBAL are supported by the Joint Standing Committee on Rural Issues working in collaboration to provide Real-Time Virtual Supports to rural BC healthcare providers. The Real Time Virtual Support pathways are a project of the Virtual Health and Wellness Collaborative. RTVS pathways offer multiple resources that enable rural healthcare providers to access just-in-time advice and compassionate support from a wide range of colleagues including rural generalists, emergency physicians, critical care specialists (“intensivists”), dermatologists, and now pediatric and rural maternity and newborn providers.