Imagine a day where residents in Takla Landing, a rural and remote Aboriginal community of approximately 250 people, 300 km north of Prince George, have routine access to the same primary care physician. Now imagine that this family physician is able to examine patients with an ENT camera, lead consults, and work with the clinical nursing staff in Takla Landing from his office in Abbotsford, 1,072 km away. This is a reality thanks to Dr. John Pawlovich’s pioneering work with telehealth medicine in BC.Dr. Pawlovich works with Carrier Sekani Family Services to provide primary care services to five remote First Nations communities through a complement of both face to face and virtual visits. It works like this: Dr. Pawlovich travels to the communities once a month where he sees patients in person. He supplements this visit by connecting virtually with patients and local health care providers over the intervening weeks as necessary. In the past four years, Dr. Pawlovich has challenged the traditional model of primary care and, with a little innovation has redesigned the delivery of such services to fit community needs and the rural reality. Dr. Pawlovich’s strategy is simple – telehealth is used to complement face-to-face interactions. The combination of clinical and virtual care results in continuous physician-patient interaction, regardless of Dr. Pawlovich’s physical location, and creates a platform for longitudinal care and support for his rural patients.
When asked where research fits into this initiative, Dr. Pawlovich stressed that the most important research question that needs to be addressed concerns patient perspectives of telehealth. Next in line to be answered are the changes in accessibility of primary and specialist care with telehealth, evidence to support virtual interactions as an effective tool to complement the traditional physician-patient relationship, and inquiry of the impact of telehealth on First Nations populations.
Dr. Pawlovich now sees 75% of his patients virtually and says that, anecdotally, the telehealth initiative has achieved proof of concept in the rural communities he works in. Dr. Pawlovich has two recommendations when it comes to scaling up telehealth initiatives in BC. The rate determining step is to overcome preconceived biases that the only ‘right way’ to do physician-patient interactions is face to face. The second is the technological and administrative challenges implicit in implementing telehealth medicine. Once the policy framework is in place to support this activity training initiatives will be needed to overcome some of the logistical challenges.
The telehealth solution is simple: it builds on the video and audio technology we use every day in our lives. Dr. Pawlovich is one of the creative and passionate physicians who are thinking outside the box and trying new things to improve access to and the quality of health care in rural and remote BC communities.
Check out this short video on Dr. Pawlovich's work.