Real-Time Virtual Support as an Emergency Department Strategy for Rural, Remote, and Indigenous Communities in...

Area of Science:

• Digital Health
• Health Services Research
• Rural Health

Background:

• Rural and remote communities in British Columbia face significant healthcare challenges, including physician isolation and limited resources.
• The COVID-19 pandemic exacerbated existing healthcare disparities, highlighting the need for innovative solutions.
• Real-time virtual support (RTVS) offers a portable solution for healthcare delivery in rural settings.

Purpose of the Study:

• To describe the rapid implementation of the Rural Urgent Doctor in-aid (RUDi) pathway, a component of RTVS.
• To identify facilitators and barriers to the successful implementation of this virtual support model.

Main Methods:

• A case study approach was employed, utilizing the Quadruple Aim and Social Accountability frameworks.
• Interviews were conducted with physicians, hospital staff, and health authority leadership approximately one week after implementation.
• Content analysis was used to identify emergent themes from qualitative data.

Main Results:

• The RUDi pathway supported 39 overnight shifts, serving as the most responsible provider for 245 patients at Dawson Creek District Hospital's emergency department.
• Key facilitators included strong leadership, established relationships, and effective interprofessional collaboration.
• Barriers identified related to the need for extensive IT support and the experience of remote physician coverage.

Conclusions:

• The RUDi pathway successfully prevented emergency department closures and patient diversions, demonstrating the value of RTVS.
• Rapid implementation of digital health solutions, built on trust, can alleviate physician shortages and provider burnout in rural areas.
• This model provides a safety net for rural patients and providers, offering valuable learnings for future implementation in underserved communities.