2023 Northern BC Research and Quality Conference - Concurrent Session Information

Conference Poster

Concurrent Session L 

Date: November 9

Time: 10:45am - 11:45am 

Location: University of Northern BC, 6-305 (19 people max) 

Oral Presenters: 

Sean Duke, Dr. Jenna Treissman

Title:  Evaluation of the Real-Time Virtual Support (RTVS) Pathway Child Health Advice in Real-Time Electronically (CHARLiE) in Northwestern BC 

Background: To improve access to pediatric care for children living in rural, remote and Indigenous communities, the RccBC developed CHARLiE, a 24/7 real-time virtual support pathway providing pediatric consultation via videoconference.  Recently, CHARLiE covered 25% of the pediatric call burden in Terrace, the regional referral center for Northwestern BC.   
Objectives:  To evaluate the integration of CHARLiE into the pediatric call rotation and thereby improve upon CHARLiE’s implementation.  

Methods: This study used the SQUIRE 2.0 Quality Improvement framework (surveys and focus groups) to gather the experiences of rural providers using CHARLiE.

Tom Skinner 

Title: Simple tools and accessible help ensures Real-Time Virtual Support can wrap care around rural patients

Objective: To introduce the benefits of the use of low-barrier technologies to help establish and embed accessible healthcare for all. Participants will hear from two individuals who were instrumental in ensuring that rural healthcare providers were equipped with the technology to access Real-Time Virtual Support. 

Methods: Matching community familiarity of technology and capacity for training with the technology deployed. Using existing software and systems in a new and novel way to meet capacity. Development of tools to track data for tracking, trending, and reporting.

Person/Family/Community Partner Engagement: The Rural Coordination Centre of BC worked with a myriad of partners to ensure the success of RTVS, including the Ministry of Health, The BC Emergency Medicine Network, UBC Digital Emergency Medicine, the First Nations Health Authority, Northern Health, and others. This engagement ensured that there was a united approach to the virtual services and the technology used. 

Results: Throughout the Covid-19 pandemic, RCCbc intentionally sought to provide support through a people-centred, rather than technology-centred approach.  To serve rural frontline healthcare providers and the communities they support, the virtual technology needed to be simple to use, accessible and uncomplicated.  The team also knew that the accessibility of not just the technology but also the people on the other end would determine if RTVS would be a success. The Zoom platform was chosen because it was user-friendly, could be implemented on numerous operating systems, and was relatively inexpensive. Providers could even access the support through their own smartphone device. 

Lessons Learned: While the technology is not perfect, with challenges related to multiple provincial instances of Zoom and data capture , RTVS has been successful because it kept things simple. Rural providers and patients who live in rural areas get the best support from RTVS not because of the technology, but because they have easy access to the providers through a device at the bedside or even in their pockets. Alongside making the system as low-barrier as possible, the team built relationships and trust through ongoing support, training, and feedback from rural sites.  That   approach has served communities well.  

Dr. James Liu

Title: A Novel Approach to Using Handheld Ultrasound for Cardiac Care in Rural Communities Across British Columbia, Canada

Objective: The Rural Echocardiography Project is a collaborative program which aims to train rural physicians to acquire a limited set of cardiac images using handheld ultrasounds for interpretation by an offsite echocardiography expert, to facilitate triaging patients in remote settings and promote timely access to advanced cardiac care. A research evaluation study has been embedded to examine the training process and implementation of the project.   

Methods: Rural providers were trained to conduct non-urgent Cardiac Focused Handheld Ultrasound (CF-HHUS) studies that are uploaded to a cloud-based picture archiving and communication system (PACS) for interpretation by an off-site echocardiographer.  A total of 12 rural physicians were trained in-person. Using community engaged research principles, a mixed methods approach was used to capture the experience and perceptions of the training from the trainees, trainers and leadership team.  
Results: To date 51 studies have been successfully uploaded with clinical reports issued, including descriptions of the quality of the cardiac study, diagnoses, and clinical recommendations.