Access to health care has long been a challenge in rural, remote and Indigenous communities. The COVID-19 pandemic intensified the existing gaps, highlighting the urgent need for a more resilient system.
The Real-Time Virtual Support Network (RTVS) aims to enhance ongoing patient care and address inequities without replacing existing health services. The hybrid care model was launched in collaboration with the First Nations Health Authority, the BC Ministry of Health, UBC’s Digital Emergency Medicine Unit and the Rural Coordination Centre of British Columbia.
This program has been developed in collaboration with colleagues across the province. In an interview with The Ubyssey, Dr. Kendall Ho, an emergency medicine specialist, professor in the department of emergency medicine at UBC, and RTVS lead, explained that the network started with 3 core components: peer-to-peer support for health care professionals, a First Nations Health Authority Virtual Doctor of the Day line and a patient-facing 811 virtual physician service.
“The service is about supporting individuals where they are,” said Ho.
RTVS works by connecting remote communities with health professionals through a hybrid model of care. When a patient or local provider needs support, the RTVS network team can step in via secure video calls or other digital platforms to provide real-time guidance for urgent or complex health issues. The system integrates electronic health records to share information with the patient’s own health care providers or refer them to local or emergency services when needed.
Dr. John Pawlovich, Rural Doctors’ UBC Chair in Rural Health, clinical professor in the department of family practice and RTVS co-lead, said “The idea was, through a health equity lens … to bring on-demand, real-time support to any First Nations, rural or remote community in BC — to help provide care, but also professional support.”
Both Pawlovich and Ho shared that while RTVS uses technology, it is not a tech-first model. Its foundation is relationships, cultural safety and compassion. Providers are trained to approach each encounter with a simple guiding question: “How can I help?”
The digital divide is a key challenge for the RTVS, which can widen health care gaps. Communities with strong digital access and skills benefit most, while those without may be left behind. RTVS compliments in-person services without replacing them, and patients must remain connected to local providers to avoid fragmented care.
When discussing the role of health care providers in virtual settings, Pawlovich emphasized the importance of being present with and seeking understanding from remote communities.
“How do providers show up [virtually] to support a community? What needs to be considered in terms of understanding the uniqueness of remote First Nations communities? What does cultural safety mean?”
“We can be present for five minutes or five hours. It just depends on what the needs of communities are,” said Pawlovich.
Ho shared stories where RTVS have already delivered impactful results. In one rural community, the network’s Maternity and Babies Advice Line and Child Health Advice in Real-Time Electronically pathway virtually supported a safe childbirth — the first in more than twenty years to take place locally rather than requiring the mother to be flown out.
In another case, a young woman struggling with COVID-19 was quickly connected to Ho through 811, ensuring she received timely guidance. “I think that it was truly a privilege to be there and to support them and to say there is a solution.”
Pawlovich believes in incorporating direct experience with rural and Indigenous communities into medical education and practice to help providers, which will enable health care providers to better understand the realities of remote health care and importance of cultural competence.
"Part of the success I see in the future is having learners not only have the right tools for virtual health and hybrid care, but spend time in the communities they're actually supporting," he said.
Learning to deliver care through telehealth while prioritizing both patient and provider perspectives, according to Pawlovich, is central to preparing clinicians for a landscape where digital tools and relationship-based care intersect.
“I think technology builds a whole new dimension of different ways that we can all contribute to health care,” said Ho.
This article was updated at 3:05 p.m. on Oct. 8, 2025 to give credit to the Maternity and Babies Advice Line and Child Health Advice in Real-Time Electronically pathway for their work. A previous version incorrectly credited the Rural Urgent Doctor in-aid service.
