When a woman going into cardiac arrest presented to a rural health centre with a massive overdose of beta blockers, the attending physician immediately contacted ROSe, a Real-Time Virtual Support (RTVS) pathway for critical care. For the next hour, the ROSe virtual physician provided advice to help the attending physician manage the cardiac arrest—a collaboration that saved the patient’s life and prevented neurological damage.
RTVS pathways, like ROSe, provide physicians, nurse practitioners and nurses in rural, remote and First Nations communities with access to just-in-time advice from clinical specialists to support patient care. Currently, there are four acute and four non-acute RTVS pathways that rural practitioners can easily access using Zoom and/or telephone. Additional pathways, including one for hematology, will come on board in 2021.
Consultations provided by RTVS teams are different than those commonly experienced by rural healthcare providers. RTVS virtual physicians understand rural and cultural contexts and provide culturally safe and compassionate support.
“The spirit behind RTVS is really like calling a friend,” says Dr. John Pawlovich, RTVS lead for the Rural Coordination Centre of BC (RCCbc). “The virtual physicians on the other end of the Zoom or telephone line are friendly, non-judgmental, have dedicated time for your call, and are willing to jump in and help wherever needed.”
Some examples of support provided by RTVS teams include:
- providing a patient consult, second opinion, or ongoing patient support
- reviewing a patient case
- running through patient simulation scenarios
- navigating the healthcare system
- providing collaborative support in critical times
Rural practitioners who have used RTVS pathways have been highly positive about their experience.
“RTVS significantly decreases the stress and anxiety and the frustration in getting help,” one rural physician explains. “That changes your whole way of practicing, your quality of life as a person, and just being able to share the responsibility, as well. You feel like sharing the decision-making process with somebody who knows it a little better than you.”
Getting started with RTVS pathways is easy. Rural practitioners can download the RTVS toolkit, which provides a step-by-step guide to setting up and using a Zoom account, bios and photos of the friendly RTVS teams, and posters. Additional information about RTVS platforms, including descriptions of the various RTVS pathways, is also available on the RCCbc website.
What’s the best advice that one physician can give to other healthcare providers about RTVS pathways?
“There should be no barriers to reaching out for support,” says Dr. Pawlovich. “Don’t be nervous about getting set up and using Zoom. Don’t worry about reaching out and asking for help. Everything we do as healthcare providers is in the best interest of our patients, so use the RTVS platforms whenever you need to.”
Real-Time Virtual Support is an initiative of the Virtual Health and Wellness Collaborative for Rural and First Nations BC and is made possible through the work and collaboration of RCCbc (funded by the Joint Standing Committee on Rural Issues), First Nations Health Authority, Provincial Health Services Authority, Providence Health Care, BC Emergency Medicine Network and the UBC Department of Emergency Medicine.