The UBC Faculty of Medicine is pleased to share some of the highlights from Dr. John Pawlovich’s appointment as the Rural Doctors’ UBC Chair in Rural Health.
The Chair in Rural Health plays a vital role in identifying issues that matter to rural and remote communities and addressing the gaps in service and expertise by enhancing our capacity for research and education in these regions of the province. Over the last year, Dr. John Pawlovich has provided strategic guidance towards the development of key technological and organizational infrastructure for rural and remote regions of British Columbia with the potential to optimize clinical care capacity, standardize knowledge-sharing across care providers, and generate invaluable research initiatives and research data to inform targeted community-level and health system responses.
We are grateful to the Joint Standing Committee (JSC) and the Rural Coordination Centre of BC (RCCbc) for supporting Dr. Pawlovich’s leadership in creating pathways for rural care providers to enhance their skills and contribute to the growing body of knowledge on the health needs of individuals across British Columbia.
Strengthening relationships among rural health providers
In August and September 2021, Dr. Pawlovich met with rural care providers in based in Prince George, Fraser Lake, Stellat’en First Nation, Dease Lake, Atlin, and Whitehorse (YT). He spent time with them, hearing about their current needs, as well as their vision for the future health and well-being of their communities. While the health needs of each community are distinct, there were some commonalities that emerged through those discussions. Broadly, rural care providers expressed appreciation for the virtual supports and services, while pointing to the need for ongoing in-person touch points to augment and contextualize those virtual services.
Developing a research hub for Northern BC
Together with Dr. Paul Winwood (University of Northern BC), the RCCbc, UBC Faculty of Medicine, and the Northern Health Authority, Dr. Pawlovich participated in the launch of the Northern Centre for Clinical Research (NCCR), a nationally and internationally recognized research hub developed to enhance the capacity and cohesion of the clinical and biomedical life sciences research programs in northern British Columbia.
Located in Prince George, the NCCR will create strategic opportunities to share resources and collaborate on clinical trials and virtual health care interventions in northern, remote, rural, and Indigenous geographical, social, and cultural contexts.
The Centre recently hired its first Research Assistant and is in the process of hiring a Director.
Expanding the possibilities for health services to rural and remote communities
Dr. Pawlovich was also pleased to serve as co-lead for the Drone Transport Initiative (DTI) – a joint partnership between the University of British Columbia Faculty of Medicine (FoM), LifeLabs, First Nations Health Authority (FNHA), Northern Health (NH), Canadian Blood Services (CBS), Stellat’en First Nation, the Village of Fraser Lake and Drone Delivery Canada (DDC).
The DTI was launched in response to a need for improved health services in rural and remote regions of British Columbia. The pilot was funded by a grant from the TD Ready Challenge.
Over the period of 12 months, the project has been studying the feasibility of enhancing access to physically necessary medical services (lab, pharmacy, supplies) in the Indigenous community of Stellat’en First Nation, using bidirectional unmanned drone flights between Stellat’en First Nation and the Village of Fraser Lake.
Official launch day for the Sky Medic
The opening ceremony at Stellat’en First Nation featured singing and drumming that represented each of the clans in the Stellat’en First Nation.
In mid-May 2021, the project team hired a full-time Senior Project Manager and used the summer months to engage community members, stakeholders, partners and faculty leads to help them define how the project would be rolled out. The project team secured land to use, constructed two drone sites (one in Stellaquo and one in Fraser Lake), installed utilities and internet, and hired local community members to help operationalize the project. They have also hired and trained three local community members as drone handlers who will be employed throughout the duration of the project to support drone cargo pickup and delivery.
Dr. Pawlovich was also a key collaborator in raising the profile of the Drone Transport Initiative through UBC Giving Day 2022, which raised over $35,000 for the project.
In the coming months, the DTI project team will be focused on project closing activities such as decommissioning and restoring drone sites to their original state, feasibility assessment activities, and final reporting to the donors. Additional community members will be hired to help support the mid-project evaluation and end-of-project evaluation.
It is hoped that the DTI will serve as a model for the introduction of drone transport programs across the Interior and Northern British Columbia.
This exciting pilot project builds on Dr. Pawlovich’s existing work as Medical Director of the Carrier Sekani Family Services (CSFS). The experience he has gained working closely with CSFS has helped inform his input to UBC and the JSC to help ensure a diversity of rural voices and perspectives are brought into the discussion when future program funding and educational initiatives are developed.
Harnessing the power of virtual technology to improve research and care
As the Virtual Health Lead with the RCCbc, Dr. Pawlovich is directly involved in enhancing virtual collaborations to support research and clinical care in rural and remote regions of the province.
He currently provides leadership to the Real-Time Virtual Supports (RTVS) program, which was established during the COVID-19 pandemic to provide on-demand support to rural healthcare providers, enable timely delivery of emergency and urgent patient-centered care to rural patients closer to home, decrease inequities in access to care for rural citizens and become a support tool that emboldens physicians and trainees to venture away from urban centers.
Now two years in, the RTVS continues to develop in conjunction with community and physician feedback with the goal of long-term integration into the health care system. They are connecting with new communities, onboarding additional quick-reply specialist pathways, exploring MRP service provision for vulnerable emergency departments and nursing stations, and have begun an extensive evaluation process.
To support the expansion and ongoing development of the RTVS system, Dr. Pawlovich has participated in a number of speaking engagements and media appearances on the subject of virtual health, including for the Island Health Authority, Hospital News, the BC Emergency Network, and Global News.
He has also shared his reflections on the successes and learnings of the RTVS program with national entities, including:
- Northwest Territories Health and Social Service Authority
- Ontario Health
- Public Sector Network
- University of Saskatchewan’s College of Medicine
- Society of Rural Physicians of Canada at the 29th Annual Rural and Remote Medicine Course in Ottawa, ON
- Canadian Medical Association (in Dr. Pawlovich’s role as virtual health task force member)
As co-founder and co-lead of Virtual Health Grand Rounds, Dr. Pawlovich and his team have launched several virtual series to connect as many as 150 health care providers, information management and IT providers, health administrators, health policy makers, and academics around the possibility of technology-enabled health care delivery.
- Virtual Exam Perspectives for CPSBC and Rheumatology
- Virtual Neurological Exams
- Virtual Dermatology Exams
- Augmented Reality as a Medical Learning Tool
Dr. Pawlovich also provides guidance and support to an emerging research study exploring the implementation of handheld ultrasound devices for echocardiography within rural communities. The pilot project will determine whether community health care providers could conduct echocardiographic studies, which would be interpreted by an off-site specialist. If successful, this virtual service could remove the need for patients to travel to large centres to acquire testing. Twelve physicians will participate in the training program in the Fall 2022, which will include a two-day in person training session.
Expanding rural training and mentorship opportunities
The Rural Education Action Plan (REAP) continues to attract, prepare, and retain rural physicians by providing funding for leadership and skill enhancement training, continuing medical education courses, and Indigenous cultural safety training.
REAP also provides funding for medical students and medical residents to gain practical rural experience, which Dr. Pawlovich is facilitating through his clinical work with the Carrier Sekani Family Services.
As in previous years, REAP co-hosted a “Transition to Practice” presentation for UBC medical residents with the RCCbc and Rural CPD to bring their attention to the funding and learning opportunities available.
Presentations are also made on a quarterly basis to the International Medical Graduates through the Practice Ready Assessment (PRA-BC). It is hoped that through these presentations, physicians who may be new to the Canadian health care system might consider rural medicine to continue their career path.
Along with Dr. Deanne Taylor, the co-Scientific Director of the RCCbc, Dr. Pawlovich is developing opportunities for post-doctorate trainees to receive mentorship from himself (as Chair) as well as from the executive leadership of the RCCbc and its co-Scientific Directors. Along with RCCbc staff, these trainees are leading rural health research to understand the barriers and enablers of providing medical care for those living rurally, as well as how virtually enabled care systems might enhance that care. For example, Dr. Pawlovich and Dr. Taylor recently onboarded a trainee to the Virtual Echocardiography Research Project to lead the program evaluation.
Dr. Pawlovich is also currently supporting Dr. Ilona Hale in her capacity as Director of both the Rural Scholars Program and Clinical Scholars Program. Under her direction, rural clinicians have the opportunity to develop their leadership and scholarship skills, preparing them to enter the field of rural research. Having both the Rural Scholars and Clinical Scholars Programs housed together will allow for research collaborations and bidirectional learning opportunities.
Thank you
We are grateful to partner with the RCCbc in our shared interest of elevating capacity for research, education, and innovation within BC’s rural communities. Building upon the strong foundation created by Dr. Dave Snadden, the inaugural chairholder, Dr. John Pawlovich has made impressive strides to expand the province’s virtual network in spite of the unexpected challenges created by the COVID-19 pandemic.
Under his leadership, we are growing opportunities for rural physicians to connect with one another, build on their skills and knowledge, and contribute data drawn from the lived experience of people inhabiting diverse geographies, with unique histories and governance. With the restrictions lifting, Dr. Pawlovich looks forward to scaling up his efforts and implementing the learnings from the past two years. Thank you for your generous support of his leadership.