While the virtual delivery of health services expanded rapidly during the COVID-19 pandemic, many regions have decreased use of these services in recent years. In B.C., however, a unique pan-provincial partnership led by the Rural Coordination Centre of British Columbia (RCCbc), the First Nations Health Authority, the B.C. Ministry of Health, and the University of British Columbia (UBC) Digital Emergency Medicine Unit has worked together to build and grow a network of virtual services to support patients, physicians, and health care providers in rural communities.
Initiated in March 2020, the RTVS network is publicly funded and designed to support existing health services, rather than replace them. The network aims to enhance access to health care and equity for underserved communities through a patient- and community-centred approach.
"Our goal with RTVS is to break down barriers and increase health care access and support for people in partnership with health care providers in rural, remote, and First Nations communities. It's about meeting people where they are and offering a virtual safety net grounded in kindness, compassion, cultural safety, and responsiveness," said Dr. Kendall Ho, a professor of emergency medicine at the UBC Faculty of Medicine.
The RTVS program includes peer-to-peer services that connect rural clinicians and nurses with physicians specializing in specific areas; First Nations team-based services delivered with principles of cultural safety, humility, and trauma-informed care; and an 8-1-1 virtual physician telephone and video service to help people determine if they need to get in-person help or can manage their health concern at home.
"RTVS helps providers feel more comfortable and supported in taking on rural work, which means rural patients receive more equitable access to health care," said Dr. John Pawlovich, the Rural Doctors' UBC chair in Rural Health and RCCbc's Virtual Health lead.
Use of services across the program has increased yearly, with evidence showing a range of benefits for people in British Columbia, including improved access to primary, emergency, and specialized care, and the retention and support of rural practitioners. Since its founding, RTVS has had more than
- 20,000 encounters with peer-to-peer services in 129 communities
- 12,000 appointments annually with First Nations primary and specialist services
- 176,000 patient calls to the 8-1-1 virtual physician service
"Long-standing relationships built on trust have enabled these collaborative efforts to be successful," said Dr. Ray Markham, RCCbc's executive director.
As virtual care services continue to expand and evolve, the authors note the importance of ensuring programs are inclusive and accessible, including for those with limited digital skills. They also highlight that virtual care cannot replace in-person care but should be complementary to offer optimal patient experience and equity of access through hybrid care.
"Just as banks offer both online and in-person banking options to ensure clients get optimal services, virtual care is not meant to replace in-person care but should be offered in conjunction to optimize the hybrid care experience for patient-centred care," said Dr. Ho.
"Real-Time Virtual Support: a network of virtual care for rural, remote, Indigenous, and pan-provincial communities in British Columbia" is published July 28, 2025.
