ABOUT REAL-TIME SUPPORT
Real-Time Clinical Support is a form of digital emergency medicine that enables you to network with other BC emergency practitioners and provide on-demand consultation to help you care for your patients. Digital medicine is a relatively new but rapidly growing field. With this in mind, our Real-Time Clinical Support Program is in development as we determine how best to provide optimal technology-supported models of peer-to-peer clinician support for direct patient care and how the BC Emergency Medicine Network and the personnel required to support it can be sustained into the future. The Network will ultimately use Digital Health and Telehealth tools to provide four main platforms that you can access: a Smart Directory of emergency practitioners across the province; secure social media and text messaging-based support; real-time telephone advice; and just-in-time, video-linked, critical care support.
THE ROBSON VALLEY PILOT
ABOUT THE PROJECT
Virtual medicine in the Robson Valley aims to test the opportunities provided by virtual medicine and technology to enhance and support patient care by connecting providers in rural communities. A pilot of real-time, on-demand, electronic connectivity via text messaging, mobile, and bedside video conferencing in the context of emergency care is currently underway.
A variety-of-use cases will occur over time, which will be assessed in three service delivery contexts: 1) within Robson Valley 2) the Robson Valley to Northern Health regional site; and 3) the Robson Valley to an urban community such as Vancouver.
An evaluation based on the Institute of Health Improvement’s Triple Aim Framework addressing user experience, health outcomes, and cost was co-developed with stakeholders. A mixed method approach during a six-month implementation includes surveys, interviews, and focus groups with providers and patients and the collection of administrative/technology usage data. Formative evaluation will assess physician relationships and the paths to adoption and normalization of virtual care communication approaches.
Preliminary data between Robson Valley sites and the Prince George Emergency Department was collected. Patients expressed confidence in the physicians and telemedicine, noting the major benefit of avoiding transfer from the community, thus saving the time and expense of travelling home from Prince George. Physicians highlighted timely access to advice and support and increased understanding of the practice context of rural colleagues. Challenges included technical issues such as clarity of communication over video and the need to “work out” work flow aspects of incorporating telemedicine.
The project team gratefully acknowledges support from the UBC Department of Emergency Medicine through the BC Emergency Medicine Network, the Northern Interior Division of Family Practice, the Rural Coordination Centre of BC, the Rural Education Action Plan, and the BC Strategy for Patient Oriented Research Support Unit.