Real-Time Virtual Support as an Emergency Department Strategy for Rural, Remote, and Indigenous Communities in British Columbia: Descriptive Case Study

• DOI: 10.2196/45451
• Publication Date: 2023-08-16T04:24:55Z
• Authors: Helen Novak Lauscher; Brydon Blacklaws; Erika Pritchard; Elsie Jiaxi Wang; Kurtis Stewart; Jeff Beselt; Kendall Ho; John Pawlovich
• Keywords: Peer Support; Rural Health; Telehealth

Background British Columbia has over 200 rural, remote, and Indigenous communities that have limited health care resources due to physician isolation, sparsity in clinical resources, the lack of collegial support, provider burnout. Real-time virtual support (RTVS) peer-to-peer pathways provide patients providers. Amid COVID-19 pandemic exacerbating existing disparities equitable access timely care, RTVS presents a portable additional opportunity be deployed hospital or patient home setting rural communities. We highlight story Rural Urgent Doctor in-aid (RUDi) pathway within successfully supported Dawson Creek District Hospital (DCDH) emergency department (ED) 2021. Objective This study aims describe rapid implementation process identify facilitators barriers successful implementation. Methods case is grounded Quadruple Aim Social Accountability frameworks for systems learning. The entire period was approximately 6 months. After 1 week implementation, we interviewed RUDi physicians, DCDH staff, authority leadership, staff gather their experiences. Content analysis used themes emerged from interviews. Results physicians covered 39 overnight shifts were most responsible providers (MRPs) 245 who presented ED. A total 17 interviews with key informants revealed important related leadership relationships as coverage’s success, experience remote providing “safety net,” finding new ways interprofessional collaboration, need extensive IT throughout. Quality improvement findings identified demonstrated tangible recommendations how this model can improved future cases. Conclusions By acting MRP during ED shifts, prevented closure diversion another hospital. Rapid codevelopment digital solutions leveraged partnerships mutual trust between EDs ease pressures shortage, particularly COVID-19. establishing modified workflows, provides safety net challenged by learnings implemented serve crisis.