LINK-ED: Strengthening Rural Emergency Care

Innovation rarely arrives with a roadmap. More often, it begins with a willingness to step into something unfamiliar, especially in rural health care, where challenges are evolving.

That’s the reason behind LINK‑ED, a pilot project Interior Health (IH) launched in December 2025 to sustain overnight emergency care in small hospitals. Through this new model, on‑site emergency-trained nurses in Lillooet, Clearwater, Nakusp and Princeton can connect with a doctor in another community through secure video or phone overnight to provide patient care. If someone needs hands‑on care quickly, a local doctor is always available to help.

The pilot started gradually, with one doctor supporting their home hospital in person and one additional site virtually per night. This gave teams time to learn new tools and build confidence working across distances.

For long‑time Lillooet physician Dr. Nancy Humber, joining early was an easy decision.

“No one wants to see any emergency departments close,” Dr. Humber said. “It’s important for the emergency care teams to work collaboratively across sites to find sustainable ways to minimize the chance of this happening.”

A formal evaluation is underway, but early results have been encouraging:

• Virtual care added a meaningful layer of support. On a typical 12‑hour night, a LINK‑ED physician supported about two patients in person and two more virtually at another site.

• In several cases, on‑site nurses and virtual doctors were able to manage emergent situations without requiring additional support from the local on-call doctor
• Patient safety was maintained, and communication between sites remained strong
• Most importantly, there were no emergency service interruptions in the first two months of the trial (Dec. 8, 2025 to Feb. 8, 2026)

As with any new model, there has been a learning curve. Both physician and nursing staffing require ongoing improvement. Supporting another site requires adjusting to new processes and collaborating virtually with colleagues who aren’t physically in the room. Regular check‑ins have helped teams address issues quickly, and the process continues to improve each shift.

Physician lead Dr. Wessel Joubert expects the workload to ease as more physicians join the rotation:

“We’re working toward full participation from all 24 physicians across the four sites. With full coverage, each physician would support multiple sites only once per month instead of weekly. That means less on‑call frequency and more balance.”

The next phase is underway, with doctors now supporting two additional sites virtually each night. IH is also preparing to move all four LINK‑ED hospitals to full electronic medical records—a shift that will create a single, shared source of patient information and improve communication across communities.

Reflecting on the first month of the pilot, Karen Cooper, project co-lead and executive director of clinical operations for the Thompson-Cariboo Rural, noted:

“System-level innovation often requires a lot of heavy lifting at the beginning and a willingness to learn and adapt as we go. This is no small feat, so I’m truly grateful for the collaboration and support from everyone in the frontline. As we continue this journey, the spirit of learning and partnership will remain at the heart of the work.”

This week, Interior Health is bringing in a new virtual care pilot, IH LINK-ED, to emergency departments in Lillooet, Clearwater, Nakusp and Princeton.

IH LINK-ED blends in person care with virtual physician support, so people living in these communities can count on having more reliable access to emergency departments overnight. The benefits to patients are same quality care, fewer service interruptions and no long travel unless specialized care is needed.

How does it work?

• When patients walk into an ED, an emergency-trained nurse will determine the level of care needed.
• The nurse may connect with a doctor in another community through a secure video or phone call to review patient condition and guide the treatment
• If patients need rapid, hands-on care, a local doctor is always on standby in each community and can come to the hospital to help

Care teams will ease into the new model by trying it out a few nights each week, while keeping regular in person coverage on the other nights. The plan is to build up gradually, with full seven day a week implementation expected in the new year.

To learn more, visit: https://www.interiorhealth.ca/media/interior-health-link-ed-pilot-project-begins

To sign up for updates, or or submit your feedback/questions, visit: https://engageih.ca/link-ed