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REAL-TIME VIRTUAL SUPPORT Toolkit for Healthcare Providers

August 2020

Real-Time Virtual Support Pathways rccbc.ca/rtvs

In This Toolkit

About Real-Time Virtual Support ........................................................................................................... 1

Flow Chart ............................................................................................................................................. 3

How to Access RTVS ............................................................................................................................. 4

Frequently Asked Questions ................................................................................................................. 6

Zoom Instructions ................................................................................................................................. 8

Zoom FAQs ...........................................................................................................................................11

Physician Profiles ................................................................................................................................. 13

RUDi Team ..................................................................................................................................... 14

ROSe Team ..................................................................................................................................... 21

CHARLiE Team ................................................................................................................................ 23

MaBAL Team ................................................................................................................................. 28

Dermatology Team ....................................................................................................................... 30

Posters ................................................................................................................................................. 31


About Real-Time Virtual Support In April 2020, Real-Time Virtual Support (RTVS) Pathways launched in BC. There are several pathways for rural healthcare providers, First Nations citizens, and rural and remote citizens to access virtual healthcare. Real-time virtual support enables on-demand consultation to support patient care and rural healthcare collaboration. RTVS helps you deliver timely emergency, urgent, and non-urgent patient-centred care for your patients by connecting you to a group of physicians with experience in emergency medicine, critical care, pediatrics, maternity and newborn, and dermatology as well as experience in rural communities. This toolkit is designed for physicians, nurses, and nurse practitioners in rural, remote, and First Nations communities. It describes the pathways that can be accessed by these healthcare providers, how they can be accessed, and which pathway is most relevant at any given time. Healthcare providers can use the following pathways:

1. RUDi – Emergency

2. ROSe – Critical Care

3. CHARLiE – Pediatrics

4. MaBAL – Maternity and Newborn

5. UBC Dermatology Rural and Remote Service RUDi (Rural Urgent Doctor in-aid) Physicians with emergency medicine and rural experience are available 24/7 through Zoom and by phone to support rural healthcare providers looking for support with a patient or preparatory simulation, including providing a second opinion about a patient, reviewing a case, running through simulation scenarios, helping to navigate the healthcare system, providing collaborative support in critical times, and other situations as needed by rural providers. ROSe (Rural Outreach Support) Intensivist/critical care specialists are available 24/7 through Zoom, the ROSe app, and by phone to support rural healthcare providers looking for a consultation, second opinion, or ongoing virtual support for patients. ROSe physicians have expertise in complex, acutely ill patients, and those who are deteriorating; although, they are open to support rural care providers for any patient whom they are concerned about.

CHARLiE (Child Health Advice in Real Time Electronically) Pediatricians, pediatric emergency physicians, and pediatric intensivists are available 24/7 by Zoom to provide urgent specialized pediatric support to rural healthcare providers who are presented with urgent problems in children and youth. Support includes providing a second opinion, reviewing a case, helping to navigate the healthcare system, and providing collaborative support.


MaBAL (Maternity and Babies Advice Line) Family physicians with expertise in maternal and newborn care and an understanding of the rural and cultural contexts are available 24/7 through Zoom and by phone to provide guidance on urgent and non-urgent pre-conception, prenatal, antenatal, intrapartum, and postpartum presentations, for both moms and newborns. Family physicians can also provide assistance in assessment and problem-solving and can rapidly facilitate access to specialist expertise from regional care centre obstetricians or provincial pediatricians. UBC Dermatology Rural and Remote Service UBC Dermatology is operating a service for physicians and nurse practitioners in rural and remote settings (including First Nations Virtual Doctor of the Day) by phone, text, photo, teleconference, and a combination of these. The first contact is usually with a senior dermatology resident who can orient new users. Residents will use submitted information to reach a working diagnosis and plan, which is reviewed with dermatology staff and the referring practitioner. Follow-up plans are made, and a written note is faxed. If you have a patient that you’re worried about, you can access RTVS 24 hours a day, seven days a week to connect with a physician for a second opinion or support. Don’t hesitate—RTVS pathways are here for you.

All RTVS physicians on-call are friendly, understand the rural practice context, and are ready to support your needs. RTVS supports established care pathways in regional health authorities by enhancing capacity and strengthening connections between regional and rural BC. We are exploring opportunities to collaborate with health authorities to fully integrate and embed real-time virtual support into clinical programs. This will enable health authorities to provide additional support to rural communities and bridge pathways across health authorities. We look forward to collaborating with you. For up-to-date information, visit rccbc.ca/rtvs.

Real-Time Virtual Support is an initiative of the Virtual Health and Wellness Collaborative for Rural and First Nations BC. RTVS is made possible through the incredible work and collaboration of Rural Coordination Centre of BC (supported by the Joint Standing Committee on Rural Issues), First Nations Health Authority, Provincial Health Services Authority, Providence Health Care, BC Emergency Medicine Network, and UBC Department of Emergency Medicine.

http://www.rccbc.ca/rtvs


Flow Chart This flow chart shows the RTVS pathways and resources available for rural healthcare providers, as well as First Nations citizens and residents in rural and remote communities across BC. As new pathways are added, please refer to rccbc.ca/rtvs for the most updated version of the diagram.

https://rccbc.ca/rtvs/


How to Access RTVS

Pathway Description Access Information

RUDi – Emergency (Rural Urgent Doctor in-aid)

A physician with emergency medicine and rural experience is available to provide support with a patient or preparatory simulation, including:

• providing a second opinion about a patient

• reviewing a case

• running through simulation scenarios

• helping to navigate the healthcare system

• providing collaborative support in critical times

• other situations as needed by rural providers

Available 24/7 Zoom: [email protected]

ROSe – Critical Care (Rural Outreach Support)

An intensivist/critical care specialist with expertise in complex, acutely ill, and deteriorating patients is available to provide support for a consultation, second opinion, or ongoing virtual support for patients. Physicians can also support rural care providers for any patient whom they are concerned about.

Available 24/7 Zoom: [email protected] Phone: 1-888-918-0626 ROSe mobile app (Download the app from rosetelehealth.com)

CHARLiE – Pediatrics (Child Health Advice in Real Time Electronically)

Pediatricians, pediatric emergency physicians, and pediatric intensivists are available 24/7 by Zoom to provide urgent specialized pediatric support to rural healthcare providers who are presented with urgent problems in children and youth. Support includes providing a second opinion, reviewing a case, helping to navigate the healthcare system, and providing collaborative support. Referrals will continue through current regional referral pathways utilizing the partnerships developed by Child Health BC, with the Tiers of Service guiding referrals and discussion of transfers.


http://www.rosetelehealth.com/


Pathway Description Access Information

CHARLiE physicians will partner with CompassBC, a program that provides virtual support to providers managing children and youth living with mental health and substance use concerns. CHARLiE physicians will work with the current Neonatal and Pediatric Critical Care Transport program to support rural healthcare providers.

MaBAL – Maternity and Newborn (Maternity and Babies Advice Line)

Family physicians with expertise in maternal and newborn care and an understanding of the rural and cultural contexts are available 24/7 through Zoom and by phone to provide guidance on urgent and non-urgent pre-conception, prenatal, antenatal, intrapartum, and postpartum presentations, for both moms and newborns. The FPs can also provide assistance in assessment and problem-solving and can rapidly facilitate access to specialist expertise from regional care centre obstetricians or provincial pediatricians.


UBC Dermatology Rural and Remote Service

UBC Dermatology is operating a service for physicians and nurse practitioners in rural and remote settings (including First Nations Virtual Doctor of the Day) by phone, text, photo, teleconference, and a combination of these. The first contact is usually with a senior dermatology resident who can orient new users. Residents will use submitted information to reach a working diagnosis and plan, which is reviewed with dermatology staff and the referring practitioner. Follow-up plans are made, and a written note is faxed.

Monday to Friday (except holidays) 9 am to 5 pm Phone: 1-778-771-DERM (3376) Once contact has been established by phone, texts and photos can be sent through WelTel (the dermatology team will set you up on WelTel), or through Zoom at [email protected] (Rural Derm).


Frequently Asked Questions Who can call an RTVS specialist (RUDi, ROSe, etc.)? For ROSe, any physician or nurse practitioner with an active licence in Canada (except in Quebec). A nurse or a medical student who is being directly supervised by an actively licensed physician can call as well. For all other pathways, any member of the healthcare team in rural or remote communities in BC. What can I call an RTVS specialist about? Any patient issue that you need support with, or any patient whom you’re concerned about. Think of RTVS as “phoning a friend.” RTVS specialists can:

• provide a second opinion about a patient;

• review a case;

• help navigate the healthcare system;

• provide collaborative support in critical times; and

• provide ongoing virtual support for all patients, including complex, acutely ill, deteriorating, and

stable patients.

When can I call an RTVS specialist? All pathways except Dermatology are available any time, 24/7. Dermatology is available Mondays to Fridays (except holidays) from 9 am to 5 pm. Do I have to pay for a Zoom account to access RTVS? Not at this time. The Joint Standing Committee on Rural Issues is offering rural healthcare providers in BC the option to have access to a Zoom for Healthcare license. To request a Zoom account, fill out the form at bit.ly/rccbc-zoom. Please see the Zoom Instructions section in this toolkit for more information. How do I make a Zoom call? First, you’ll need a Zoom account. Please see the Zoom Instructions section below for more information. Do I have to pay for the ROSe mobile app? No, the app is free. Physicians and nurse practitioners can visit rosetelehealth.com to download the app and request an access code. Once you have the access code, you can open the app and create an account. How do I make a call on the ROSe mobile app? Watch the video at bit.ly/ROSeApp to learn how to make a call with the app.

http://bit.ly/rccbc-zoom

http://www.rosetelehealth.com/

http://bit.ly/ROSeApp


Do I get a transcript of the consult? Transcripts are not available for consults done through Zoom, but we’re working on having a summary of the consult available through Medical Office Information System (MOIS), a cloud-based EMR. If you use the ROSe app, after your call is done, you’ll have a consult dictated to you directly in the ROSe app. You can view the consult and respond to it via text or phone call right away. You can also print this consult or upload it to your EMR via secure email. For Dermatology, you’ll get patient recommendations immediately over the phone and a written letter faxed to you within several days. What information do I need to provide to make a call? For ROSe, please have the following information ready before you make a call:

• patient’s name

• patient’s date of birth

• patient’s valid Provincial Health Number

• the community where the patient is from

• physician/nurse Practitioner’s valid billing number For the other pathways, you may call before the patient arrives. Can I call back about the same patient again on the same day? tomorrow? Yes! The team is here for as many times as you need them, any time. Are we still using the Patient Transfer Network? If you think the patient is going to need a transfer, please call PTN as soon as you can, even if you’re using RTVS. We can even call PTN for you—just let us know. What if the issue is very complex and I need extra help? Will you be frustrated with me or upset or not want to talk to me? Absolutely NOT! We understand that patient care is challenging. We’re your colleagues—we’re not here to judge. If it means that we’re on video chat with you for awhile, that’s okay. Remember, if you have a patient that you’re worried about, you can access the RTVS pathways 24 hours a day, seven days a week to connect with a physician for a second opinion or support. Don’t hesitate—RTVS pathways are here for you. All RTVS physicians on-call are friendly, understand the rural practice context, and are ready to support your needs. What if I’m having issues with my Zoom account or have other general questions? Contact the Rural Coordination Centre of BC at [email protected]. An RCCbc team member is available Monday to Friday (except holidays) from 8:30 am to 4:30 pm.


Zoom Instructions If you already have a health authority Zoom account, go straight to Step 4.

1. Request an RCCbc Zoom account If you are a BC healthcare provider and don’t have a Zoom healthcare account yet, please request an account by completing the online form at bit.ly/rccbc-zoom. If you have trouble accessing the form, please send an email to [email protected] with the following information:

• full name

• email address (preferably not a health authority email address)

• phone number

• community you support

• community you live in

• MSP number

• whether you’re a GP, nurse practitioner, or specialist (and what specialty)

• whether RCCbc can send you updates (yes/no)

2. Install Zoom Install the Zoom app on your iPhone, android, or desktop computer.

3. Activate your RCCbc Zoom account Within 48 hours of requesting an account, you’ll receive an email (check your junk mail!) with an activation link for your license. Click on the blue “Activate Your Zoom Account” button. This will take you to the next window, where you can decide how to log in. Please use the “Sign Up with a Password” link at the bottom. This will take you to the section where you can set your password and brand your account with what attendees will see (e.g. if your title is Dr., preface your first name with “Dr.”).

http://bit.ly/rccbc-zoom

mailto:[email protected]

https://itunes.apple.com/us/app/id546505307

https://play.google.com/store/apps/details?id=us.zoom.videomeetings

https://zoom.us/download


4. Log in to Zoom Use your Zoom account to log in to the app on your phone or computer. Click on Contacts at the bottom.

If you have an RCCbc Zoom account, the RTVS groups will automatically be in your Contacts.

If you have a health authority Zoom account, you’ll need to add RTVS contacts to your account:

• Click the + icon and “Add a Contact.”

• In the Search box, type the RTVS email

addresses, select the matched contact, and

click Add:

o [email protected]

o [email protected]

▪ backup accounts:

[email protected]

[email protected]

[email protected]

o [email protected]

o [email protected]

o [email protected]

• Note: It may take up to 24 hours for your

contact request to be accepted, so contacts

will show as “pending” until then.

If you need help adding contacts, watch the video at bit.ly/RTVSContacts or email [email protected].

XXX-XXX-XXXX {Name of physician on call}

{Name}

XXX-XXX-XXXX

Name - XXX-XXX-XXXX

https://bit.ly/RTVSContacts

mailto:[email protected]


5. Request a consult Use your Zoom account to log in to the app on your phone or computer. Go to Contacts, and click on the RTVS contact group to see the list of contacts in the dropdown menu. Availability is indicated by the symbol next to each contact:

Offline

Online and available (desktop)

Online and available (mobile)

Away, not immediately available

On a video call

Click on the desired contact with the green symbol, then click the Meet button to start a video call.

Note: If there is no answer right away:

• Call the backup cell number listed for that contact (this will

change based on who is on call).

• For ROSe, call 1-888-918-0626 or use the ROSe mobile app.

6. Training and Resources For Zoom training sessions offered by RCCbc and additional resources, visit rccbc.ca/rtvs/zoom.

XXX-XXX-XXXX

XXX-XXX-XXXX

XXX-XX…

XXX-XXX-XXXX

XXX-XXX-XXXX

http://www.rccbc.ca/rtvs/zoom


Zoom FAQs Why did you select Zoom as the platform for RTVS? Understanding that no technological tool is perfect, we selected Zoom as the best option at this time mainly because of the platform’s stability and ease of use. Zoom allows for connectivity within patient’s homes, clinics, health centres, and hospitals. It can bridge multiple health providers to collaborate on patient care and support one another. Having a technological solution that harmonizes with our provincial partners is optimal, and using Zoom is an important step in this direction. Recent media stories have reported that Zoom meetings don’t support end-to-end encryption. Should I be concerned? In an article posted on April 1, 2020, Zoom explained that in a meeting where all of the participants are using a Zoom client (a laptop, computer, or smartphone running the Zoom app or a Zoom Room), and the meeting is not being recorded, Zoom encrypts all video, audio, screen sharing, and chat content at the sending client, and does not decrypt it at any point before it reaches the receiving clients. In addition, RCCbc has purchased Zoom for Healthcare licenses which comply with Canada’s Personal Information Protection and Electronic Documents Act (PIPEDA), by offering the following features:

• RCCbc Zoom accounts have all recording disabled, so there is nothing stored anywhere to access. • RCCbc Zoom accounts automatically lock and encrypt all sessions to outside access, preventing

somone from jumping into an active session. • Access to RCCbc Zoom sessions can be accomplished only if the host admits the participant to the

room. • RCCbc Zoom accounts are located in a contained Canadian space that resides only on Zoom servers

in Vancouver and Toronto. Should I be worried about “Zoombombing”? Zoombombing refers to uninvited participants joining an active Zoom session. Zoom has a number of protective features that can help prevent this, such as waiting rooms, passwords, muting controls, and limiting screen sharing. RCCbc Zoom licenses automatically direct all participants into the waiting room by default, preventing anyone from accessing the Zoom clinical session. Patients and other providers must be manually admitted to the waiting room by the clinician. A good rule to follow is to not admit anyone into a session that you are not expecting. Also, if there is more than one patient in the waiting room, there is no way for any of them to see or communicate with each other, or even know someone else is present. The Zoom for Healthcare license prevents accidental exposure of the provider’s waiting room.

https://blog.zoom.us/wordpress/2020/04/01/a-message-to-our-users/

https://zoom.us/docs/doc/PIPEDA_PHIPA%20Canadian%20Public%20Information%20Compliance%20Guide.pdf

https://www.priv.gc.ca/en/privacy-topics/privacy-laws-in-canada/the-personal-information-protection-and-electronic-documents-act-pipeda

https://www.priv.gc.ca/en/privacy-topics/privacy-laws-in-canada/the-personal-information-protection-and-electronic-documents-act-pipeda


What protections does RCCbc have in place for healthcare providers using Zoom? RCCbc Zoom for Healthcare licenses have the following protections:

• RCCbc Zoom accounts have all audio and chat recording disabled, so there is nothing stored anywhere to access.

• RCCbc Zoom accounts automatically lock and encrypt all sessions to outside access, preventing somone from jumping into an active session (“Zoombombing”).

• Access to RCCbc Zoom sessions can only be accomplished if the host admits the participant into the session.

• RCCbc Zoom accounts do not allow users to sign in with Facebook. Doctors of BC, First Nations Health Authority, Interior Health, and Northern Health are issuing Zoom healthcare grade licenses to their providers and communities. These accounts have similar protections to the RCCbc Zoom licenses. Does the Ministry of Health endorse the use of Zoom for Healthcare licenses? Yes, Zoom for Healthcare is endorsed by the Ministry of Health and Provincial Health Services Authority and is compliant with PIPEDA. In response to recent media attention and concerns about Zoom security, the Ministry of Health released the following statement:

The Digital Health COVID-19 Response Team is aware of and following recent media attention focused on privacy and security concerns with the virtual care tool Zoom. Zoom and Zoom for Healthcare (being deployed in Health Authorities) is rapidly deploying across the health sector. Zoom (the company) has been responsive in rapidly addressing privacy/security issues, and we are assessing the security and privacy risks of using Zoom for patient care. At this time, we are not recommending discontinuation of Zoom.

I am a physician, and it looks like I can obtain a Zoom license from either my health authority or from RCCbc. Is there a difference? RCCbc and all health authorities in BC are providing the same healthcare licenses. Some default settings may be different, but all these healthcare accounts provide the same level of security and privacy. One difference is that the accounts provided by RCCbc are pre-configured to provide direct access to Real-Time Virtual Support pathways for rural physicians. If you have a Zoom account provided by a health authority, you can still access the RTVS pathways, but you’ll need to add them to your contacts (see Zoom Instructions).

https://zoom.us/docs/doc/PIPEDA_PHIPA%20Canadian%20Public%20Information%20Compliance%20Guide.pdf


Physician Profiles We’ve put this section together to help you get to know the teams who will be providing you with support when you call Real-Time Virtual Support. This section is current as of August 1, 2020. Future updates will be made at rccbc.ca/rtvs, so we encourage you to visit the website on a regular basis.



RUDi Team (Emergency)

Click on each name to view their photo and bio.

Frank Ackermann ........................................................................................................................... 15

Bret Bachelor ................................................................................................................................. 15

Jeff Beselt ...................................................................................................................................... 15

Brydon Blacklaws ........................................................................................................................... 15

Wayne Choi .................................................................................................................................... 16

Jel Coward ...................................................................................................................................... 16

Meredith Davidson ......................................................................................................................... 16

Sean Ebert ...................................................................................................................................... 16

Jeffrey Eppler ................................................................................................................................. 17

James Heilman ............................................................................................................................... 17

Nancy Humber ............................................................................................................................... 17

Gord McInnes ................................................................................................................................. 17

Stefanie Falz Mclellan .................................................................................................................... 18

Anthon Meyer ................................................................................................................................ 18

Lisa Moddemann............................................................................................................................ 18

John Pawlovich .............................................................................................................................. 18

Matt Petrie ..................................................................................................................................... 19

Ian Ricketson .................................................................................................................................. 19

Pieter Van Zyl ................................................................................................................................. 19

Adam Watchorn ............................................................................................................................. 19

David Whittaker ............................................................................................................................ 20

Tandi Wilkinson ............................................................................................................................. 20

Jen Williams .................................................................................................................................. 20


Frank Ackermann Frank has been a full-time emergency room physician at East Kootenay Regional Hospital in Cranbrook since 2003. He is also ARDMS certified in ultrasound, has been involved in teaching bedside ultrasound for more than 12 years, and is the CME coordinator for the Emergency Department. Frank is Chair of the Regional Medical Advisory Committee for the East Kootenays and was previously Transport Advisor for Interior Health. He has worked as a full-scope family doctor in rural settings in BC and the Yukon. Frank is a husband and father of three, and he is also the full-time head coach for the Kimberley Nordic Racers, which is his passion.

Bret Batchelor

Bret is a rural GP with Enhanced Surgical Skills in Revelstoke. He was born and raised in BC and has spent his entire career in rural BC, first in Vanderhoof and now in Revelstoke. Bret divides his time between the emergency room, clinic, inpatient, endoscopy suite, obstetrical suite, and operating room. He loves rural medicine and is very excited about RUDi and what it means for new medical graduates and anyone who needs a friendly face and help in the ER.

Jeff Beselt

Jeff is a family and emergency physician. He lives on a small farm in Campbell River and has worked in emergency in Campbell River since 2005. Jeff is driven by his passion for cultural humility and belief in culture change through compassion and inclusion. He has spent much of his time as a family physician working in partnership with First Nations communities and provides care as a member of the health and wellness teams in Kwadacha and Tsay Keh Dene. Jeff has also joined RCCbc as Medical Co-Director of RUDi.

Brydon Blacklaws

Brydon is an emergency physician who has worked coast to coast, from the busy urban centres of Halifax and Regina to the small community hospitals of Terrace and Port Alberni. He spent the last three years doing emergency and trauma team leader work in Prince George, where he also headed the SIM Program for UNBC and helped create UBC’s first SIM curriculum. Brydon currently works in Powell River, while maintaining teaching roles with UNBC, Island POCUS, the Nanaimo Emergency Education Program, and the Powell River SIM Program. Brydon is very excited to join RCCbc as the Medical Co-Director of RUDi. Brydon enjoys boating, fishing, and gardening with his family on the Sunshine Coast.


Wayne Choi Wayne is a full-time emergency physician at Royal Columbian Hospital (tertiary care trauma centre) and Eagle Ridge Hospital (community hospital). He has an interest in technology and innovation, as well as POCUS, simulation, and education. Outside of medicine, Wayne plays ultimate in the summer and skis and snowboards in the winter. Wayne hopes to be of service to rural care providers who need to bounce off ideas, assistance, or even for sims!

Jel Coward

Jel has been a rural physician for 25 years, working in family practice and emergency. After spending 15 years in Pemberton, he now works as a rural locum. Jel has an interest in pre-hospital care and wilderness medicine and has worked with Pemberton Search and Rescue and Whistler-Blackcomb ski patrol for many years. He is Co-Director of The CARE Course and was previously Medical Director at Wilderness Emergency Medical Services Institute - International. Jel enjoys hiking, mountain biking, Celtic music—all of which he tries to do with his partner and two teenagers.

Meredith Davidson Meredith is an emergency room physician at Kelowna General Hospital. She completed her training at Queen's University in Ontario and moved out west to enjoy the lifestyle of the Okanagan. When not at work, Meredith can be found being active somewhere in the great outdoors or travelling the world.

Sean Ebert Sean and his wife Nicole lived and worked in Vanderhoof for 22 years where they raised their three kids. They relocated to Coldstream near Vernon where they continue to support rural medicine through provincial programs such as RUDi. Sean and Nicole enjoy an active, outdoor lifestyle and plan to explore our beautiful province while seeking greater harmony during this transitional stage of their lives.


Jeffrey Eppler

Jeffrey has been practicing emergency medicine in Kelowna for 25 years and has been involved in providing CME at many rural EM conferences as well as at CAEP. He worked as a GP in rural and remote parts of BC prior to doing his emergency medicine fellowship, so he understands some of the challenges faced by healthcare providers outside the “big city” and is happy to be involved with the RUDi program. When he’s not working, he loves outdoor activities, especially those with the word “mountain” in them!

James Heilman

James has been an emergency physician in Cranbrook for more than 10 years. Prior to that, he worked across BC, either as an attending or resident, including Port McNeill, Vernon, Penticton, and Salmon Arm as well as up in the Yukon and NWT. James has been extensively involved in the transport system, from being an EPOS physician to a HART medical director. As such, he gained a solid understanding of both the complexity of the province’s geography and the difficulty healthcare providers occasionally face as they take care of their patients.

Nancy Humber

Nancy has been a rural generalist physician at Lillooet District Hospital for 23 years and works as a GP with Enhanced Surgical Skills and also supports maternity care. She has been involved in supporting and mentoring new to practice physicians and graduates of the Practice Ready assessment program as well as family practice residents. Nancy has worked collaboratively with Indigenous communities in the western Interior, both virtually and in outreach models. She is passionate about team-based care in rural settings and advocating for equity in access to high quality care in BC. Nancy is the mother of six children, always striving to find the best balance between work and medicine.

Gord McInnes

Gord is one of three Co-Presidents of the Section of Emergency Medicine. He has been a full-time emergency physician at Kelowna General Hospital for the last 18 years. Gord works as a trauma team leader, has been a transport advisor, and has been involved with undergraduate medical education for many years.


Stefanie Falz Mclellan

Stefanie lives in Invermere, where she works as a family and emergency physician. She has an interest in wilderness and low resource medicine, as well as point of care ultrasound. She is an instructor for Wilderness Medical Associates and a member of Columbia Valley Search and Rescue. Stefanie has also done missions with Médecins Sans Frontières in South Sudan, Iraq, and Syria. In her spare time, she enjoys skiing, climbing, mountain biking, gardening, and spending time with her husband.

Anthon Meyer

Anthon is a dedicated family physician with extensive clinical experience in primary and emergency care. He is Medical Director of Fort St. James Medical Clinic, a family physician with Stuart Lake General Hospital, and Co-Chair of the General Practice Services Committee. His previous leadership roles include: President, BC College of Family Physicians; Chair, Board of Directors, Northern Interior Division of Family Practice; Chair, Health Data Coalition; and Associate Professor with UBC, UNBC, and Northern Ontario School of Medicine. Anthon’s core belief of equal opportunities for rural and Indigenous communities has significantly influenced his career, and his leadership and teaching work have been recognized provincially and nationally.

Lisa Moddemann

Lisa is an emergency physician in Kelowna and Penticton. She completed her FRCPC Emergency Medicine training at the University of Manitoba. In her spare time, she enjoys biking, hiking, skiing, and anything the Okanagan outdoors has to offer.

John Pawlovich John Pawlovich has worked in rural and remote communities across Canada for more than 25 years. He holds multiple leadership roles, including: Director, Rural Education Action Plan; Medical Director, Carrier Sekani Family Services; Telehealth Sector Lead, RCCbc; Clinical Professor, UBC Department of Family Practice. John’s interest in Indigenous health has evolved over the years with a focus of bringing innovative primary care and specialty services on reserve to reach the people most in need. John is co-founder and co-lead of the BC Virtual Health Grand Rounds and the e-Health theme lead for the UBC Faculty of Medicine. He speaks both nationally and internationally on virtual healthcare solutions and systems.


Matt Petrie Matt’s practice includes full-time emergency medicine and trauma at Kelowna General Hospital, in addition to resident and undergraduate medical education. He is a facilitator for the Interior Health Rural Simulation program that brings simulation and education to ERs within the region, and an EDE1 and EDE2 instructor, he is also interested in POCUS. Matt’s interest in medical education, experience working and educating in smaller centres, combined with an open communication style dovetails well into the role of RUDi physician. Matt is honoured to be a part of this meaningful and important service supporting rural colleagues and patient care.

Ian Ricketson

After completing his residency in Vancouver, Ian has worked full-time in emergency medicine in Powell River for the last five years. He also works as an EPOS physician and has spent time working in rural areas in northwestern BC. Ian enjoys fly fishing, photography, music, and hockey.

Pieter Van Zyl

Pieter is a family and emergency physician in Fort St. James, serving his community for seven years. He is from South Africa, where he graduated from medical school. Prior to moving to Canada, he was an emergency physician in a tertiary-sized hospital. Pieter is dedicated to helping his peers feel more comfortable in the same “scary” emergency cases that he’s familiar with himself. He sees the virtual platform as a great way to help colleagues and build relationships. Pieter enjoys spending time with his wife, two children, and energetic dog as well as skiing, waterskiing, and running with their dog.

Adam Watchorn

Originally from Chetwynd, Adam lives and works in Golden. He received his CCFP(EM) from Calgary and has worked in emergency departments around BC, in both rural and urban areas. Adam is an instructor for the HOUSE EM course, teaches local simulations, and is currently involved in rural transport research.


David Whittaker

David has worked and lived in rural communities for the last 10 years, which has gifted him a fantastic work and personal life. He has an interest in rural emergency and feels simulation is important for rural teams. For the past two years, David has been the physician lead for the Rural and Remote Division of Family Practice, which has given him additional insight into the challenges as well as the strengths of healthcare providers in rural communities. David feels RUDi is yet another example of rural innovation!

Tandi Wilkinson

Tandi is a rural emergency medicine physician based in Nelson, working in BC and in Yellowknife, NWT. She has a special interest in point of care ultrasound and is the medical director of the UBC CPD HOUSE program. Tandi was a recent UBC Department of Family Practice Rural Scholar and conducted research on physician peer support. This interest in physician wellness led her to create and run workshops on this subject, called Transforming Our Work.

Jen Williams

Jen is an emergency physician at Kelowna General Hospital and Clinical Assistant Professor in the UBC Department of Emergency Medicine. Her special academic interests include resuscitation, resident education, and physician wellness. Jen is the proud mother of two boys, partner to an amazing man, and loves the outdoors, mountains, lakes, skiing, biking, and hiking.


ROSe Team (Critical Care)

Omar Ahmad Omar practices emergency and critical care medicine in Victoria and also works as an EPOS physician. He is the Department Head for Emergency and Critical Care Medicine at Island Health. Omar enjoys being an educator and is involved in various education initiatives. He has provided rural practitioner supports for the past number of years.

Ishtiaq Ahmed

Ishtiaq is an intensive care physician in Vancouver, practicing at Burnaby Hospital and Abbotsford Regional Hospital. He completed a residency in internal medicine at the University of Toronto and a fellowship in critical care medicine at UBC. Ishtiaq is currently the Chief of Critical Care at Burnaby Hospital and leads the hospital’s organ donation program. He has been a member of the ROSe program from its start.

Don Burke Don has been a critical care physician for 22 years. After completing medical school at the University of Toronto, he completed his internal medicine residency at Tuft’s University in Massachusetts, followed by a critical care fellowship in St Louis, Missouri. He then completed an Infectious Diseases fellowship at Case Western Reserve University in Cleveland, Ohio. Don started a pilot project, Critical Outreach & Diagnostic Intervention (CODI) in 2016 with a small group of intensivists, which had such strong acceptance amongst physicians in BC that they expanded the group into ROSe. ROSe is a fully redesigned version of the platform to support all frontline physicians in small, rural, and remote communities.

Mario Francispragasam Mario is the physician lead for ROSe. After finishing medical school at the University of Western Ontario, he moved to Vancouver for his residency. After part of his anesthesia residency and a trauma internship at the University of Cape Town, he transitioned into emergency medicine at UBC. He completed fellowships in adult intensive care medicine and point of care ultrasound as well as a Master’s in adult education. Mario practices emergency medicine at St. Paul’s Hospital and Vancouver General Hospital, works in intensive care for Fraser Health and Island Health, and is a pediatric critical care transport physician for BC Children’s Hospital.


Neilson McLean Neilson is dual trained in emergency and critical care medicine, with a subspecialty in hyperbaric medicine. He is the Regional Medical Director of Critical Care for Fraser Health and practices in ERs and ICUs in the Lower Mainland.

Marietjie (MJ) Slabbert

Marietjie (MJ) is a specialist physician in anesthesiology and critical care medicine. She worked in adult and pediatric trauma in Cape Town, trained in pre-hospital emergency medicine in the UK, and volunteered for the UK ambulance service as a critical care pre-hospital physician and on helicopter air ambulances. MJ lives and works in Prince George as an anesthesiologist, trauma team lead, and critical care specialist physician at UHNBC. She is Medical Director, ICU and Regional Medical Lead, Northern Health Critical Care Program. MJ has been part of the ROSe team since its inspection and is a passionate advocate for improving pre-hospital, rural, trauma, and critical care.

Adam Thomas Adam trained in Calgary for medical school, completed residency training in emergency medicine in Victoria, and recently finished a critical care fellowship in Vancouver. His interests are focused around point of care ultrasound, medical education, and innovation. Since his longitudinal clerkship in Yellowknife, Adam has had a passion for supporting rural health initiatives. He works and lives in Victoria with his wife (a GP) and two children.


CHARLiE Team (Pediatrics)

Click on each name to view their photo and bio.

Amanda Barclay ............................................................................................................................ 24

Allon Beck ..................................................................................................................................... 24

Jeff Bishop .................................................................................................................................... 24

Benetta Chin .................................................................................................................................. 24

Arthur Cogswell .............................................................................................................................25

Amie Dmytryshyn ...........................................................................................................................25

Meghan Gilley ................................................................................................................................25

Zaneta Lim......................................................................................................................................25

Alysha Mackenzie-Feder ............................................................................................................... 26

Tom McLaughlin............................................................................................................................ 26

Garth Meckler ............................................................................................................................... 26

Kirsten Miller ................................................................................................................................. 26

Mia Remington............................................................................................................................... 27

Jenny Retallack .............................................................................................................................. 27

Carmen Tait .................................................................................................................................... 27

David Wensley ................................................................................................................................ 27


Amanda Barclay Amanda is the Division Head of Pediatric Intensive Care at Victoria General Hospital, where she has worked for the last 17 years. After training in Ontario, she moved to Victoria and was hired as the first pediatric intensivist. When not caring for patients in the five-bed pediatric intensive care unit, Amanda enjoys teaching medical students and residents, leading simulation and PALS courses, and providing procedural sedation for pediatric outpatients throughout the hospital. Outside of work, she enjoys raising two sons, chickens, and bees as well as hiking and biking with her husband.

Allon Beck

Allon is a pediatric intensivist in Victoria and has worked there since finishing subspecialty training in 2013. He completed medical school and pediatric residency in the US and then a pediatric intensive care unit fellowship at McGill. Allon continued his clinical training in Australia before arriving in Victoria. He is eager to be involved with CHARLiE to collaborate with providers in lower-resource or lower-specialization settings and to help develop plans and alleviate stress in high-acuity situations. Allon spends much of his time outside the pediatric intensive care unit thinking about food and coffee, or making food and coffee. He’s an avid reader and hiker and is intent on passing those passions on to his two kids.

Jeff Bishop

Jeff completed medical school at UBC in 2004, followed by a residency in pediatrics and fellowship in pediatric emergency medicine. He worked for several years as a community pediatrician and part-time pediatric emergency physician before returning to complete an additional fellowship in critical care. Jeff is now an associate clinical professor with UBC's Island Medical Program in Victoria. His clinical work is based in the pediatric intensive care unit and with the pediatric sedation service. Academically, Jeff's interests include simulation-based education, procedural sedation, and pediatric trauma.

Benetta Chin

Benetta is a pediatric emergency medicine physician at BC Children’s Hospital. She completed her residency and fellowship training at UBC and has a special interest in quality improvement and patient safety. Outside of medicine, Benetta enjoys spending time with her partner and two young children. She looks forward to serving and supporting healthcare providers who care for children and youth across the province in this new and exciting way!


Arthur Cogswell

Arthur is a pediatrician, additionally trained in critical care, and has worked at BC Children’s Hospital in the pediatric intensive care unit since 1994. He is also trained in transport/retrieval medicine and is currently well occupied trying to resuscitate BC’s transport system for pediatric patients, as there is a lot of room for improvement in that field. Arthur started his medical career as a family medicine trainee in Tasmania more than 40 years ago and switched to pediatrics after a rotation in a remote mining town proved to him that he needed to learn a lot more about children. Pursuit of training took Arthur all over Australia and New Zealand until he settled in British Columbia.

Amie Dmytryshyn Amie is a general pediatrician with a focus on neonatal care and medical education. She graduated residency in 2012 from UBC. Amie splits her clinical time between BC Children’s and BC Women’s Hospitals and Fairmont Pediatrics. She focuses inpatient care on newborn care and acute general pediatrics as an attending physician on the clinical training unit. As simulation lead, she is responsible for training pediatric residents and medical students on the concepts and skills of neonatal resuscitation. Outside of work, Amie loves skiing, cooking, and travelling as much as her family of six allows.

Meghan Gilley Meg is a full-time pediatric emergency medicine doctor at BC Children’s Hospital and also does the occasional rural, general pediatrics locum. She completed her medical degree and residency at BC Children’s and did a fellowship in pediatric emergency medicine at the Hospital for Sick Children in Toronto. Meg has interests in trauma, transport medicine, and rural pediatric medicine.

Zaneta Lim

Zaneta is a general pediatrician in Terrace. She attended medical school in Kingston, started her pediatric residency in Ottawa, and finished it in Vancouver at BC Children’s Hospital. A city person at heart, Zaneta never imagined she would be working in rural BC. After four years in Terrace, she is inspired by the amazing resilience and dedication of rural physicians and is grateful that she has the opportunity to support her rural colleagues through the RTVS program.


Alysha Mackenzie-Feder

Alysha Mackenzie-Feder is a general pediatrician working and living in Kelowna. She completed medical school at UBC and a pediatric residency at BC Children’s Hospital. Alysha enjoys acute care medicine and has a hospital-based practice. She is a clinical assistant professor with UBC and an active member of the Interior Health simulation team working to bring pediatric simulation to the region. Alysha has two young boys and, in her spare time, enjoys hiking, skiing, and all the Okanagan has to offer!

Tom McLaughlin

Tom is a pediatrician at BC Children’s Hospital, where he works primarily on the clinical teaching unit, for which he has been the medical director since 2019. Tom’s academic interests are in pediatric health systems, in particular to ensure that children have access to the healthcare they need, no matter where they live or who they are. In his spare time, Tom enjoys biking, hiking, and spending time with his two cats.

Garth Meckler Garth is a pediatric emergency physician and head of pediatric emergency medicine at BC Children’s Hospital. He worked with Child Health BC to develop the Tiers of Service framework to better understand the needs and resources of BC’s acute care facilities for pediatric emergencies. Garth is excited to connect with rural colleagues providing care to children throughout the province.

Kirsten Miller

Kirsten is a pediatrician in Prince George and Medical Lead for the Child and Youth Health Program at Northern Health. She provides care for patients in the pediatric ward and neonatal ICU at the University Hospital of Northern BC, and in her practice, she sees children and youth with complex medical, developmental, and mental health challenges. Kirsten is one of a small number of BC pediatricians working in child maltreatment and works at the Suspected Child Abuse and Neglect Clinic. Kirsten feels strongly about supporting healthcare providers in rural communities to ensure delivery of excellent care to pediatric patients around the province. She loves northern BC, where she lives with her physician husband and three sons.


Mia Remington

Mia a general pediatrician, primarily based at BC Children’s Hospital, and also works as a locum in rural and remote communities. As one of the program directors of the UBC pediatrics residency program, Mia is keen to continue building ties throughout BC in order to better prepare future pediatricians to practice in community settings. She has a strong interest in quality improvement and is developing a curriculum in patient safety for UBC’s postgraduate medical education program. Outside of work, you can find Mia chasing her 18-month-old son, Wheaton Terrier, and husband around Vancouver, or spending time relaxing at a family cabin in Saskatchewan.

Jenny Retallack

Jenny is a general pediatrician working at BC Children’s Hospital on the clinical teaching unit and the pediatric intensive care unit. She has also been involved in outreach to Smithers, Hazelton and Whitehorse. Jenny has spent many years taking transport calls and has enjoyed working with physicians to support pediatrics in many different situations.

Carmen Tait Carmen is a general pediatrician and pediatric emergency physician in Vancouver. She works as a general pediatrician at Lu’ma Medical Centre, providing culturally integrated pediatric care to Indigenous patients and practices within the Division of Emergency Medicine at BC Children’s Hospital. Carmen also works within an outreach group of pediatricians serving Hazelton and Smithers. She strives for cultural sensitivity within healthcare and is engaged in cultural humility and allyship education within UBC health disciplines. When not practicing medicine, Carmen spends time with her husband and two children.

David Wensley David recently retired from the pediatric intensive care unit at BC Children's Hospital but is still active in pediatric respiratory medicine. He has been involved with pediatric transport in BC for more than 30 years and supported practitioners in the management of sick children in many communities around the province. David also visited some smaller communities when he helped bring the PALS and APLS courses to BC and helped develop the TelePICU project that was supported by Child Health BC to provide various communities in BC with telehealth support for sick children.


MaBAL Team (Maternity and Newborn)

Jeanette Boyd

Jeanette is a family physician in Nelson, providing maternity care at Apple Tree Maternity—an interprofessional team-based care collaborative. She also provides support for neonatal, family physician, maternity, and inpatient call rotations at Kootenay Lake Hospital. In addition to being a passionate advocate for the value of comprehensive, longitudinal family medicine, Jeanette believes strongly in the role that team-based care plays in providing sustainable, high-quality, relationship-based, and culturally safe maternity care close to home. She and her husband are adjusting to an intermittently empty nest as their children fledge and explore their own passions.

Dietrich Fürstenberg

Dietrich is a family physician currently working at UHNBC in Prince George. His special interests are emergency medicine, operative and non-operative obstetrics. Dietrich moved from South Africa to Quesnel in 2013, where he practiced as a full-service family physician prior to moving to Prince George. He has a passion for team-based obstetrical care and advancing rural obstetrical teams to function to the highest level of their scope and training.

Deborah Lisoway Deborah is a family physician practicing GP obstetrics in Comox, and she is an ALARM Instructor with SOGC. She has practiced in numerous rural communities in BC and the Yukon. Prior to moving to Comox, she had a busy shared maternity practice serving women from around the Yukon. Deborah enjoys growing food, cooking, and outdoor adventures with her husband and two young kids.

Ashnoor Nagji

Ashnoor was trained in Family and Aboriginal Medicine at UBC, and her practice focuses on youth, marginalized populations, residential care homes, and delivering babies. She is a clinical associate professor in the UBC Faculty of Medicine, an associate professor at the UBC School of Population and Public Health, and an instructor for many maternity courses locally and globally. Ashnoor’s passion for teaching and reducing poverty is evident through her community and volunteer work in 116 countries, including teaching in Nepal, Pakistan, and Uganda and being a volunteer physician in Afghanistan and Africa. After her field work in Guyana, she founded BELIEF (Becoming Educated Leaders Inspired by Exemplary Females)—a platform for women's empowerment.


Virginia Robinson

Virginia began her career working in the remote Cree community of Chisasibi, northern Quebec 25 years ago. She subsequently spent several years working in a high volume urban emergency room in Kitchener, Ontario. At one time, a keen mountaineer, she served as the physician for the Canadian Everest team in 2000. For the last 15 years, Virginia has practiced maternity and emergency medicine in Fernie and Cranbrook. She is an instructor for both the HOUSE EM and HOUSE OB courses and presently leads the Intelligent Network for POCUS project for RCCbc. Virginia enjoys mountain biking, skiing, and gardening.

Sara Sandwith

Sara is a family physician providing maternity and neonatal care at Comox Valley Hospital. She trained at McMaster University and completed residency in Newfoundland and Labrador before moving back to her beloved West Coast. When not at work, Sara is usually running in the forest somewhere.

Megan Taylor Megan is a family physician in Castlegar. Originally from rural Alberta, she has lived and worked in the Kootenays for the last 12 years. She is a passionate full scope family doctor with a special love for obstetrics and women’s health. When not working, Megan likes to spend time outside, read a good book, and hang with her teenagers. She is very excited for the opportunity to be the friendly voice on the end of the phone!

Visit rccbc.ca/rtvs/mabal as we add profiles for the following team members over the coming weeks:

• Suzanne Campbell

• Bre-el Davis

• Nicole Ebert

• Sunelle Fawell

• Ettienne Roux

• Lisa Sawyer

• Magda Steenkamp

• Jaco Strydom

• Dubravka Uckman

• Theresa Wilson

• George Youssef

https://rccbc.ca/rtvs/mabal


Dermatology Team

Neil Kitson Neil graduated in medicine from McMaster University, completed an internship in Toronto, six months of anesthesia in England, and a year of pediatrics in Australia. His experience transmuted into research, which subsequently turned into a change of direction towards dermatology. After another two years of general medicine in the UK, Neil trained in dermatology at UBC. He is an associate professor with the UBC Department of Dermatology and Skin Science and a dermatologist with Vancouver General Hospital. For 20 years, Neil has been interested in providing dermatology services to populations with difficult access, using telemedicine in part. His evolving career goals include using First Nations technology to create topical applications for the skin.

Nathan Teegee

Nathan is a member of the Takla Lake First Nation and was raised in Fort St. James. He earned his undergraduate degree at University of Toronto. He is an alumnus of the Northern Medical Program at UBC and is currently a senior resident within the UBC Dermatology postgraduate residency program. As resident lead of the UBC rural and remote dermatology service, Nathan is working closely with Dr. Neil Kitson to develop a dermatology care model that improves access to care. He is excited to be a part of this great work and looks forward to helping where he can. Nathan enjoys spending time with his wife Linda and their three-year-old daughter, Madeline.


Posters Print the following posters for your hospital, clinic, or office. The posters can also be downloaded at rccbc.ca/rtvs.


Real-Time Virtual Support (RTVS) Your RTVS specialist colleagues can support you with ANY issue, any time, 24/7.

• Urgent or non-urgent

• Critical or non-critical

• Acute or chronic issues

• Complex or deteriorating patients

• Second opinion, consult, or case review

• Ongoing support

Don’t hesitate to call! All RTVS physicians are friendly, understand the rural practice context, and are ready to support your needs.

Connect with RTVS any time you need support

RUDi – Emergency ROSe – Critical Care

Zoom: [email protected]


Phone: 1-888-918-0626

Backup Contacts [email protected] [email protected] [email protected]

Or download the ROSe mobile app from rosetelehealth.com

CHARLiE – Pediatrics MaBAL – Maternity & Newborn



Visit rccbc.ca/rtvs for updates, Zoom account information, or assistance.

Worried about a patient? Need support? Call us!

❶ UBC Dermatology is operating a service for physicians and nurse practitioners in rural

and remote settings (including FNHA Virtual Doctor of the Day).

❷ We use phone, text, photo, teleconference, and a combination of these.

❸ The first contact is usually with a senior dermatology resident who can orient new users.

❹ Residents will use submitted information to reach a working diagnosis and plan.

❺ The plan is reviewed with dermatology staff and the referring practitioner.

❻ Follow-up plans are made.

❼ A written note is faxed.

❽ Evaluation is a work in progress. We welcome comments and suggestions.

Monday to Friday: 9 am to 5 pm (except holidays)

Phone: 1-778-771-DERM (3376)

Once contact has been established by phone, texts and photos can be sent through WelTel (we’ll set you up) or

Zoom at [email protected] (Rural Derm).

Back Up Contacts: Office Phone (MOA Joanne): 604-266-5353 Office Fax: 604-879-7475. Dr. Neil Kitson Cell: 236-999-1658

For more information about the process, please contact 1-778-771-3376 or [email protected], or visit rccbc.ca/rtvs/dermatology.

Rural and Remote Dermatology Service