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
A virtual care pilot in Robson Valley, located in northern BC, evaluated the use of videoconferencing and text messaging for on-demand consultation between family physicians at rural sites and emergency physicians at a regional site.
Focusing on the target population of patients and healthcare providers in and around McBride/Valemount/Robson Valley, evaluation of this virtual medicine pilot project used a framework based on the Triple Aim. Over an 18-month period, the virtual care service was used and evaluated in 26 just-in-time consultations.
Virtual care provides timely access to high quality, comprehensive, coordinated team-based care. By receiving care closer to home, patients experienced personal cost savings. Benefits for rural providers included confidence in diagnoses; urban emergency physicians gained a deeper understanding of rural practice.
Patient Medical Home (PMH) Project, Expanding Virtual Care
The Digital Emergency Medicine team is engaged to carry out evaluation activities for a virtual care initiative currently underway with the Northern Interior Rural Division of Family Practice. This initiative aims to expand virtual connections for Patient Medical Homes (PMH) in communities across the Division and is building on the proven virtual medicine project recently completed in the Robson Valley.
Telehealth services provided during the project facilitated the development of collaborative relationships with the PMH team and with health authority emergency staff and Physicians in Prince George. Confidence in medical decision making and reduced feelings of isolation, anxiety, and stress often associated with small community medicine evolved as partnerships developed. Telehealth service delivery is a natural fit for the team-based care model and will be an asset to Physician recruitment and retention in smaller communities.
CODI - instant, direct access to acute and critical care support: Evaluation Underway
CODI is the thoughtful integration of technology and the “right people” to help support rural physicians during some of their most stressful and challenging times in the emergency room. It is an “on-demand”, “24/7” critical care strategy through a secure APP on a smartphone. Literally, it is an “intensivist in your pocket” that can be accessed no differently than a FaceTime call. There is no bridge, switchboard or middle agency between the rural physician and intensivist, and every interaction happens at a highly encrypted level.
As CODI is progressively rolled out, an evaluation is underway to assess short-term outcomes and to identify areas for quality improvement to inform expansion and scalability. The evaluation team will be conducting surveys and interviews with physicians in communities in the coming months. Findings from this evaluation will serve to iteratively improve delivery during implementation and will also be able to inform recommendations for future implementation.