Specific Populations

In May 2019, The CARE Course team and faculty celebrated the delivery of the 100th course in Nanaimo, ahead of the BC Rural Health Conference

The CARE Course enjoyed another successful season in BC. The interprofessional faculty team – comprised of rural physicians, nurses and prehospital providers – travel from all across BC to teach the course together. Of the 16 courses delivered in 2019-20, most occurred in rural communities in BC, for interprofessional teams of local healthcare providers. Several courses were offered in rural Alberta, and as always, several were specifically aimed at UBC Family Practice residents (The CARE-R Course), including the fun-filled ‘venti’-sized course, which runs once a year and brings together 48 family practice residents for the two day event.  

Two faculty development events were hosted – one in November 2019 and one in February 2020 to support the growth of 10 new faculty-in-training.  

The CARE Course coordination corecomprised of co-directors, Drs. Jel Coward and Rebecca Lindley, along with new Program Coordinator, Charlene Carver and RCCbc Specified Projects Manager, Elisa Chow, deepened relationships with several organizations that it has collaborated with in the past, including the Rural Health Professionals Action Plan (RhPAP) in Alberta, the Ontario College of Family Physicians (OCFP), and the Saskatchewan Medical Association (SMA). The collaboration resulting from these relationships continues to grow, with The CARE Course offering support to these organizations as they explore how they might best offer the course to rural healthcare teams in their provinces.  

During this year, The CARE Course team reviewed and made significant updates to its website and online materials for participants and faculty. It also updated other course documentation used for administering the course. Another significant milestone involved Drs. Coward and Lindley presenting to the Joint Standing Committee on Rural Issues (JSC) and receiving an additional three years of funding, securing the future of The CARE Course in British Columbia as a pivotal “by rural, for rural” in-community resource for years to come.  

There were 398 participants enrolled in The CARE Course this year, bringing the total number of rural healthcare professionals trained to 2,629. Approximately 1,100 of these participants are physicians.

Feedback from a course participant:

“This course has probably kept me working in an urgent care setting, rather than leaving, as I was considering. My confidence, that I am providing good care, is much improved.”

As the lead for BC’s Enhanced Surgical Skills network, Dr. Nancy Humber is busy engaging with professional and government leaders to explore ways to strengthen and sustain rural surgery in the province.  

Her work in 2019-20 has included learning about measurement and monitoring frameworks that incorporate holistic safety and quality improvement as part of their structure and considering applying these frameworks to rural surgical services in general. Dr. Humber is also working with the Ministry of Health to develop an assessment for Enhanced Skills in anesthesia, Caesarian section, and/or low-risk intrapartum skills. This framework would be used to provide international medical graduates (IMGs) enrolled in the Practice Ready Assessment BC (PRA-BC) program a pathway for assessment that would allow them to incorporate their skills into their Canadian practices. This proposal is being developed for consideration by the Joint Standing Committee on Rural Issues (JSC) and would be the first of its kind in Canada if successful.    

Dr. Humber is collaborating with Dr. Nicole Robbins on a project that seeks to learn more about small surgical site procedural specialist needs. Both physicians are looking for opportunities to network and link family physicians with an acute care focus and training in Enhanced Skills, such as surgery, Caesarian section, critical care, anaesthesia. These skills are a vital backbone to supporting small acute care hospitals in rural communities. Drs. Humber and Robbins hope to link all of these programs together to allow them to collectively support each other during the Covid-19 pandemic and beyond.  

During February 2020, Drs. Humber and Josh Greggain, presented to attendees at the Quality Forum 2020 to discuss how the Community Paramedicine Team (CPT) from BC Emergency Health Services successfully piloted a virtual outreach service for its rural and remote patients. The CMP Virtual Care program enables community paramedics to visit and connect in with their elderly and vulnerable rural patients using phone, Zoom or FaceTime to reduce holistic risks to both patient and provider incurred when travelling. This new approach was well accepted by patients, and – with the arrival of Covid-19 in BC – was rapidly deployed across the province to improve the safety and accessibility of medical check-ins.  

Nationally, Dr. Humber is working through her connections with the Society of Rural Physicians of Canada (SRPC) to strengthen relationships with and connections with RCCbc’s collaborators on Enhanced Surgical Skills: the Society of Obstetricians and Gynecologists of Canada (SOGC) and the Canadian Association of General Surgeons (CAGS). Dr. Humber was slated to co-present a session with these three groups at the 2020 SRPC Rural and Remote Medical Course but the event was cancelled due to the pandemic. The collaboration between the three groups will continue to build in the coming months.  

 

Dr. Kirk McCarroll, lead of RCCbc’s Family Practice Anesthetists (FPA) Network, was busy coordinating several initiatives during 2019-20. He – along with UBC CPD Conference Services – organized another successful gathering of FPAs from across the province for the annual Refresher Course for Family Practice Anesthetists conference in November 2019. This two day event offered both didactic learning sessions and hands-on workshops, and allowed FPA colleagues to network and strengthen relationships as well. 

During the past year, Dr. McCarroll focused on coordinating opportunities for FPA Network members to engage in the Coaching and Mentoring Program (CAMP) with UBC Rural Continuing Professional Development (UBC RCPD). He connected with anesthesiologists at Surrey Memorial Hospital (Dr. Alex Veselyand BC Women and Children’s Hospital (Dr. Anton Chow) to create coaching opportunities for FPAs at these two sites. Although in-person coaching is currently suspended due to the Covid-19 restrictions on non-essential travel, Dr. McCarroll is confident that coaching and mentorship engagement opportunities will continue once restrictions on such interactions are lifted. 

Following up on a healthcare human resourcing survey conducted last year by Drs. Stu Iglesias, Kirk McCarroll, John McAlpine, and RCCbc Project Manager Adrienne Peltonen, Dr. McCarroll, the Ministry of Health, and Dr. McAlpine are currently in discussions to increase the number of seats in the UBC Family Medicine Enhanced Skills Program for Family Practice Anesthesia. It is anticipated that the addition of these program seats will help the province meet the demand for rural anesthesia in-community support.   

Although several of the FPA Network’s projects were disrupted by the Covid-19 pandemic at the end of March 2020, the group pivoted quickly, leveraging their relationships with specialists in VancouverRCCbc’s Rural Surgical and Obstetrics Networks (RSON – see below) projectand UBC Rural CPD to begin offering a Covid-19 webinar series for FPAs. Sessions are well attended (60-70 people per webinar) and are being recorded and distributed for members via the FPA Network listserve.  

Dr. Terri Aldred, Indigenous Physician Network Lead, continues her work to build and support an Indigenous Physician Network in British Columbia, and to advise on RCCbc’s integration of the Truth and Reconciliation Commission’s Calls to Action into its work through the TRC Calls to Action Working GroupThis year, she also collaborated with UBC Continuing Professional Development (CPD) to create an Indigenous patient-led project to address cultural safety and humility with BC’s rural physicians.  

Indigenous Medical Education Gathering (IMEG) 

The Indigenous Medical Education Gathering brought together Indigenous medical learners, physicians, and elders to learn, share, and dream Photo: Melody Charlie

Building on the success of the 2019 Indigenous Mentorship and Leadership Symposium, Dr. Aldred and Program Coordinator Kassia Skolski hosted the 2020 indigenous Medical Education Gathering in early March in Esquimalt, BC at the Wellness Centre of the Songhees Nation of the Lək̓ʷəŋən PeopleOver 55 Indigenous and non-Indigenous students, residents, physicians, health allies attended this event, which blended learning with traditional activities such as ceremony, sharing circles, native plant medicine teachings, and Metis Jigging Workshops. Traditional foods were served to participants. 

Keynote speakers shared stories and teachings on important topics such as:  

  • Indigenous Leadership in Indigenous Medical Education  
  • First Nations Health, Wellness and Functional Medicine 
  • Addictions and Homelessness 
  • Harm Reduction and Land Based Healing 

This event was hosted by the Indigenous Physicians Network with supports from RCCbc, Rural Education Action Plan (REAP), UBC Indigenous Family Medicine Program (based in Victoria, BC), and UBC Faculty of Medicine. 

Overall, IMEG participants appreciated the space created for them to freely engage, the strength demonstrated in the gathered community, and the genuine support from the group. One participant noted that it was “very helpful and powerful to hear stories of practicing [Indigenous] physicians” and that they enjoyed the “’front line, experience-based’ vs. ‘academia’” accounts.   

Indigenous patient-led rural CPD project 

RCCbc supported Dr. Aldred’s in the scoping and development of a project to address cultural safety and humility with rural doctors around BC using an Indigenous patient-led approach. During the initial stages of this project, Dr. Aldred hosted several meetings to build relationships and develop a framework for this project. She also commissioned a literature review to examine other models in order to inform the work of this project. In September 2019, the project was approved for one-time funding from the Joint Standing Committee on Rural Issues and transitioned to UBC Rural Continuing Professional Development (RCPD) for implementation.  

Although this group had plans to engage with rural providers face-to-face, the Covid-19 pandemic and subsequent halt on non-essential travel resulted in the RCPD group pivoting to alternate methods of engagement. The group produced a two page document for rural providers, along with two videos to help start the conversation about cultural humility and safety in the rural healthcare setting. Dr. Aldred, UBC RCPD and Elders and other supports will continue to examine how to best engage with rural healthcare providers during the pandemic over the next few months.  

RCCbc’s Truth and Reconciliation Working Group 

This group, led by Dr. Aldred and supported by Program Coordinator Kassia Skolski, is working to develop a framework for RCCbc to enable embedding of the Truth and Reconciliation Commitssion’s (TRC) Calls to Action within its various projects and programs. The group is developing two Conceptual diagrams (spoke and matrix) as internal and external tools of measurement and accountability through a social justice lens. The group also intends to develop an RCCbc “report card” to relay how the organization is addressing the TRC Calls to Action, and how it might continue to carry out this work.  

As part of its work, and as an exploration of how the TRC Working Group might support RCCbc projects and programs, members of the working group consulted with the Rural Site Visits Project to assess and improve the cultural safety of the project’s communication and engagement processes. This involved providing feedback on Rural Site Visit interview questions, and supporting Rural Site Visitors in framing questions for an Indigenous cultural context. The success of this process with the Rural Site Visits Project has opened the possibility for the TRC Working Group to evolve into a Resource Working Group that actively advises other RCCbx projects and programs in the integration of select TRC Calls to Action.

In 2019-20, the UBC Department of Family Practice (DFP) obtained approval for Obstetrical Surgical Skills (OSS) to be offered  as a Category 1 Enhanced Skills Program. This six month program – offered at Surrey Memorial Hospital – is intended to skill rural BC family physicians to perform Caesarian section deliveries in community operating rooms. Each cohort will provide two openings per year, with the first successful candidates slated to start in January 2021.  

With the approval of the OSS program, UBC put out a call for interested applicants for this new R3 Enhanced Skills offering

Over the years, RCCbc has advocated for the OSS program to be formally accredited and offered to BC’s rural family physicians as one of several strategies aimed at retaining rural maternity healthcare closer-to-home and/or in-communityDr. Nicole Ebert is RCCbc’s representative on the OSS program working group, and brings a rural perspective to this table. She reports that the working group will be seeking additional family physician representation in the near future to ensure the program content is relevant going forward. 

Category 1 Enhanced Skill Programs are required to create a formal curriculum and offer CPD opportunities to past participants. Creating both of these items can be challenging with the small number of OSS graduates in British Columbia, so the OSS program opted to develop an online curriculum and offer an annual skills/boot camp to support ongoing CME/CPD education.  

The online curriculum will consist of web-based modules featuring topics that might not be covered during the six month residency at Surrey Memorial Hospital. These modules will be collected into a single repository that will serve as a resource both during and after completion of the program. The Working Group has hired two curriculum consultants to coordinate collection and curation of content for the online modules, and to explore how and where the content might be housed.  

The Surgical Management of Obstetrical Complications Skills camp was scheduled to be held March 24 and 25 at the BC Children and Women’s Hospital simulation lab in Vancouver. However, due to the Covid-19 pandemic, the camp will be rescheduled for a later when non-essential travel across Canada is permitted. The camp intends to provide participants the opportunity to learn and/or practice less common procedures and address the challenges that may attend such surgeries in rural settings. Participants will have an opportunity to network with their colleagues from across the country within the camp setting as well.  

In Fall 2019, RCCbc launched its Rural Obstetrics and Maternity Sustainability Program (ROAM-SP) which works to enable the delivery of sustainable rural maternity services in BC by identifying, developing, and supporting peer, facility, and regional networks and relationships. This program aims to contribute towards creating connections and enhancing team approaches for maternity care providers in rural communities across BC. ROAM-SP initiatives are co-created with communities to allow local providers to design and customize resources, local initiatives, and coaching programs to best meet their community’s maternity needs. For more information about the rural 1a and 1b communities being supported by ROAM-SP, please consult the rccbc.ca web site

The ROAM-SP initiative is led by an interprofessional team of rural maternity care providers: Drs. Jeanette Boyd, Dietrich FurstenbergHeather Gottlieb; Lee Yeates (RM); Andrea McKenzie (RN); and, RCCbc Project Manager Adrienne Peltonen. (The team was previously supported by Project Coordinator Tatiana Ticona from October 2019 – May 2020.) The team spent its early months designing and distributing promotional materials, actively engaging communities to launch the program, assessing provider need and capacity to participate, and meeting with physicians and midwives both virtually and in-person. The development of team tools and network resources, including the mapping of patient and provider perinatal referral pathways across BC, the creation of team and community learning needs assessments, as well as care planning and case review templates is underway.

Left to right: Project Coordinators Krystal Wong and Tatiana Ticona attending the Healthy Mothers, Healthy Babies conference in Vancouver

Strengthening relationships between maternity care stakeholders and health system partners and working to cultivate synergy among provincial programs and initiatives is an identified aim of ROAM-SP. The ROAM-SP team has been meeting and building relationships with representatives from Vancouver Coastal Health, the First Nations Health Authority, Northern Health, Island Health and Interior Health, as well as UBC Continuing Professional Development and the Mobile Maternity project team. As an important step toward ensuring coordination with and between existing programs and resources, ROAM-SP has partnered with the General Practitioners Service Committee’s (GPSC) Maternity Care Working Group to create a provincial resource database. An exhibit and break-out presentation at PSBC’s Healthy Mothers Healthy Babies conference in February 2020 gave ROAM-SP team members the opportunity to network in-person with health care providers and leaders from across BC.

To date, ROAM-SP introduction and onboarding calls have been held with the communities of Squamish, Sechelt, Powell River, North Vancouver Island, Haida Gwaii, Williams Lake, Salmon Arm, Fernie, Invermere, and Golden. After a face-to-face visit with the ROAM-SP team, Salt Spring Island was the first community to accept the invitation to participate in ROAM-SP. To date, Salt Spring’s healthcare providers have used their program funding to host regular perinatal team meetings, enhance role-fluidity within the maternity care team, provide mentorship for local nurses, and support the team’s pandemic planning efforts. On March 2, the first in a series of six ROAM-SP introductory webinars engaged 15 participants and stimulated new requests for program information.

Through its first six months of operation, community-level implementation of ROAM-SP has been slower than initially anticipated due the complexity of partnership and relationship development, as well as ensuring coordination with existing programs. The team’s foundational work focused on creating internal administrative and strategic processes as well as community tools and resources to successfully implement and deliver ROAM-SP. More recently, adapting to the reality of COVID has delayed community-level uptake and the ROAM-SP team has pivoted strategically and functionally to address and meet emergent sustainability and stability needs.

The Rural Surgical and Obstetric Networks (RSON) initiative – co-led by Dr. Nancy Humber and Networks Director Kim Williams – continues to progress strongly within the selected Interior Health communities of Revelstoke, Golden, Fernie and Creston. Smithers and Hazelton joined as RSON supported communities this year and are  focusing on building their local working groups. During 2019-20, the RSON team continued to work with the steering committees within both Interior and Northern Health to oversee the work of the project. When Project CoordinatorPaul Kendal, took parental leave during the winter, we were fortunate to have Tom Skinner join the RSON team as Paul’s leave replacement. Paul returned to RCCbc in March 2020 and is now supporting the Rural Health Learning Collaborative as its Networks Coordinator while Tom remains in the Project Coordinator for RSON. The invaluable support of both Paul and Tom has become the backbone of the network. 

Feedback from providers and health authority administrators engaged in the pillars of RSON work (continuous quality improvement (CQI), evaluation, clinical coaching, Remote Presence Technology) has been very positiveA presentation to the JSC including an inspirational video from Dr. Ron Clarke in Fernie outlined some of the success and local impacts achieved to date. [LINK TO: video] 

The RSON team welcomed new staff member, Karen Osiowy, to RCCbc’s Interior Node as its Coordinator, Quality Improvement and Knowledge Translation. Karen is supporting Dr. Sean EbertCQI Pillar Lead, in the integration of CQI training and tools into each of the RSON communities. This work advanced greatly during this past year, with the RSON team traveling to Cranbrook to engage with the teams from Golden, Fernie, and Creston to learn about the MORE-EX quality improvement framework and to formalize the relationships between participating communities as a networkThe onboarding of the local clinical quality nurses has also contributed to a greater sense of shared learning. The CQI team is now focusing on collecting patient reported outcomes and experiences through telephone surveys and looks forward to disseminating this information to healthcare teamsto inform local CQI initiatives. 

The Evaluation pillar of the RSON initiative – led by the Centre for Rural Health Research (CRHR) – also progressed significantly. An evaluation framework has been developed for the project and is comprised of four streams looking at facilities outcomes, population health outcomes, network structure and function, and cost-effectiveness. All four evaluation streams were developed using a Shared Measures Framework, which prioritizes the co-development of measures by key stakeholder groups including providers, patients and familiesThe Evaluation team engaged in site visits to the RSON supported communities in 2019-20 to collect data and conduct interviews with key stakeholders. They are also analyzing and sharing the group’s findings to date with patients and network members.  

Left to right: Drs. Kirk McCarroll (FPA), Vikki Haines (FPESS), Alex Farrugia (FPA) and Bret Batchelor (FPESS) Photo: submitted

The Remote Presence Technology pillar (RPT) continues to work with communities to explore the most appropriate technology for their needs. The rapidly changing landscape of virtual technology and Real-Time Virtual Support (see below) provides opportunities to shift the focus to more mobile and versatile modalities. The addition of RSON contribution to virtual support positions in some communities has increased the use of technology and enabled increased remote presurgical screening and patient interaction. This spring Dr. Bret Bachelor stepped down as the RPT clinical lead – wthank him greatly for his contributions to the project and to communities as we navigated the ever-changing technologies in this work.  

The Coaching pillar led by the team at UBC CPD continues to offer flexible and innovative ways to offer support to communities. Interdisciplinary coaching, team coaching and peertopeer coaching have all supported increased learning and team confidence. Several participating physicians and nurses have noted that although much of the learning and performance improvement activities are delivered to individuals, these providers frequently share their learnings with their teams, strengthening the relationships within these groups and fostering a culture of trust based on safe practices and quality improvement. We would like to especially acknowledge the following nurses: Andrea McKenzie from Nelson who did excellent work with  maternity nurses in Fernie and Creston; Martina Irvine from Prince George’s neonatal ICU unit, who offered neonatal education to teams in Smithers; and, midwife Celina Laurson from Haida Gwaii who provided coaching to the team in Hazelton. We would like to thank Drs. Vikki Haines, Kirstie Overhill, and Bob Bluman for their leadership and support in developing and expanding the clinical coaching as they step down from their roles as Coaching pillar leadsWe warmly welcome Dr. Bruce Hobson who is joining the RSON team as the new Coaching Pillar Lead.  

RSON ended 2019-20 with a full team meeting in Vancouver where all our leadership team, pillar leads, and local team coordinators gathered together to share ideas and learnings and to strategize how the group might continue to improve RSON at the local, regional and provincial levels. We look forward to continuing to support the local RSON teams going forward and are anticipating expanding our support to Vanderhoof and some teams within Vancouver Coastal Health and Vancouver Island over the next year. 

During 2019-20, Drs. Trina Larsen Soles, Jel Coward, and Nancy Humber made reasonable progress in the area of rural medical transport. The three rural physicians – through the Rural Patient Transfer and Transport Working Group – completed its mandate to consult with stakeholders throughout the province to address concerns and build collaborations with an eye towards improving rural patient transport supports. The group included health authorities, BC Emergency Health Services (EHS), Ministry of Health, and rural providers and, generated a report that was then submitted to the Standing Committee of Health Services and Population Health in July 2019. Work of this committee formed the basis of discussions at a public consultative workshop offered at the 2019 BC Rural Health Conference in Nanaimo. 

Winter travel conditions in many parts of BC combines slick roads, industrial transports, and passenger vehicles. In this case, an accident caused traffic in both directions to stop for several hours. Photo: Erika Belanger

During the fall of 2019, Drs. Larsen Soles, Coward, and Humber were invited to attend the Provincial Patient Transfer Service Advisory Committee (PPTSAC) hosted by BC Emergency Health Services (BC EHS) and chaired by Dr. Julie Gill. The formal membership of this group consists of representatives from each health authority including First Nations Health Authority along with emergency medicine physicians working within BC EHS. Drs. Larsen Soles and Coward accepted the invitation and brought a primary care perspective to this table which the PPTSAC members found beneficial.  

The conversations at this table primarily involved operational concerns. One of the more fruitful discussions centered around improving the process of repatriating rural patients back into and/or near their communities. As a result of these conversations, the committee was able to broker a Memorandum of Understanding between the health authorities that within 48 hours of agreeing to repatriate rural patients, bed planning must be completed to receive the returning rural patient.  

In January 2020, Covid-19 cases began arriving in British Columbia resulting in a situational transformation of the PPTSAC committee. The group began meeting three times a week in March 2020 and added Ministry of Health representatives as well as Drs. Larsen Soles and Coward, becoming the Patient Transport Emergency Operations Centre (PTEOC) for Covid-19 during the pandemic. Meetings were held daily during the initial planning phase. The work of this group(including principles developed in the RPTT working group) along with the collaborative Covid Response Group of First Nations Health Authority and Northern Healthand the Rural Partnership Table from RCCbc contributed to the development of the Rural and Remote Covid Response Framework that was announced on April 20, 2020 by Premier Horgan. Embedded in that framework is a commitment to improve medical transportation options to larger centres, including flight and ambulance.”

Dr. Larsen Soles notes that RCCbc’s role in this work over the past five years has focused on advocacy – bringing the rural voice and data to the provincial patient transport conversations – and on collaboration – pushing for action through establishing relationships based on trust and mutual respect. Building dialogue and relationship with all stakeholders, and working through issues at tables such as the RPTTWG, PPTSAC, and PTEOC, has enabled a shift in culture and focus from rural docs demanding solutions from BC EHS to all stakeholders working together to be accountable for what needs to be done.  

Looking ahead, post-pandemic, Dr. Larsen Soles hopes that this work will allow all collaborators to form a functional network that will continue to address the needs of BC First Nations, rural and remote communities well into the future.  

Dr. Stefan Du Toit demonstrates how virtual care can be integrated into the rural emergency department. Using a portable device, Dr. Du Toit connects with an intensivist to get an opinion, and can angle the camera so that the intensivist can see what the rural physician sees. Photo: John Pawlovich, courtesy of BC Emergency Medicine Network

Dr. John Pawlovich is busy working on several projects and initiatives on behalf of RCCbc. For much of 2019-20, he focused on bringing together a funder, a dedicated group of intensivists (critical care specialists)rural generalists, dermatologists, addictions experts, and other providers to create a Real Time Virtual Support (RVTS) for rural healthcare providers. This work builds upon the successful outcomes of a pilot project that used an app to facilitate communication between rural and specialist colleagues, allowing rural providers to access 24/7 support for acute, chronic, emergent, and non-urgent care. This work was well received by frontline healthcare providers and continues to grow. 

Dr. Pawlovich and Networks Director Kim Williams – together with Megan Hunt and Fiona Dalton from First Nations Health Authority (FNHA), and Providence Health – launched the Collaborative Centre of Excellence for Virtual Health in January 2020. The Centre’s mandate is to examine best practices for incorporating virtual care into existing patient-provider longitudinal relationships to facilitate delivery of a broader range of services closer-to-home. Owing to the Covid-19 pandemic, the Centre has already mobilized quickly to roll out several virtual care supports for rural providers, including but not limited to: ROSe, RUDi, HEiDi, FNHA’s First Nations Virtual Doctor of the Day, Rural Dermatology Service, and Virtual Locum resources in association with Locums for Rural BC. More pathways for virtual care, including supports for rural obstetrics and paediatric care are currently in development and will be deployed over the coming weeks.   

The Centre’s focus on virtual care will benefit rural patients greatly by reducing the risks and costs associated with healthcare travel to larger centres. The work being currently carried out by the Centre complements the collaborative framework to support BC rural, remote, and Indigenous communities announced on April 20  by the BC Ministry of Health in response to the Covid-19 pandemic. 

To facilitate the outreach of the Collaborative Centre of Excellence for Virtual Health, Dr. Pawlovich worked with the Doctors of BC’s Doctors Technology Office (DTO) to develop a mentoring pathway for peer-to-peer support of GPs and specialists wanting to integrate virtual care into their health service provision. While much of this work focused on supporting physicians providing longitudinal care, Dr. Pawlovich also pushed for these technologies to be leveraged by all physicians as early as possible to allow for a rapid response to the Covid-19 threat. DTO pushed to produce seminars and manuals to enable BC physicians to pivot to virtual care, and played an important role in the rapid deployment of virtual care to the general public after the Provincial Health Officer’s order to physically/socially distance came into effect.  

As part of his ongoing work, Dr. Pawlovich continues to collaborate with multiple stakeholders to extend specialist services into rural and remote communities. His most recent project involves providing a virtual pathway for the provincial Acute Coronary Syndrome strategy – a “rapid response” intervention support for rural healthcare providers. This initiative was co-developed by RCCbc with partners: UBC Division of Cardiology and Cardiovascular Surgery, UBC Department of Family Practice, and the BC Emergency Medicine Network.