As the holidays approach, COPD patients face an increased risk of exacerbations due to seasonal stress and winter illnesses. In his recent Virtual Hallway lecture, respirologist Dr. Pierre Landry shared strategies for preventing these flares and optimizing treatment, including the advantages of single inhaler triple therapy (SITT). Here’s a quick dive into his clinical insights.

Why Exacerbations Matter

Each COPD exacerbation causes a loss of lung function, pushing patients further from their baseline. Older adults often fare worse, with hospital stays leading to rapid deconditioning. Avoiding these exacerbations isn’t just about lung health—it’s about preserving quality of life.

First-Line Defense: Lifestyle Changes and Rehabilitation

For prevention, nothing tops smoking cessation. Dr. Landry recommends a mix of pharmacologic aids, such as nicotine replacement and varenicline, to support patients ready to quit. He also emphasizes the benefits of pulmonary rehabilitation, though access remains limited.

SITT: Simplicity in COPD Care

Single inhaler triple therapy (SITT) combines a LAMA, LABA, and ICS in one device. SITT’s simplicity increases patient adherence and reduces exacerbations by up to 33% compared to multiple inhalers. Dr. Landry is clear: for patients struggling with adherence or facing frequent exacerbations, SITT can simplify management and improve outcomes.

Essential Vaccinations for COPD Patients

Vaccinations are another key. Dr. Landry advocates annual flu and COVID-19 shots, as well as pneumococcal and RSV vaccines, to guard against infections that worsen COPD. Prevention here means fewer exacerbations and safer winters.

For the Tough Cases: Oral Therapies

When inhaled therapies fall short, Dr. Landry turns to oral treatments like azithromycin and N-acetylcysteine (NAC) to control inflammation and mucus. These additions, especially in non-smokers, can make a critical difference for those with chronic bronchitis symptoms.

Biologics on the Horizon

While still in clinical trials for COPD in Canada, biologics like dupilumab could soon offer new options for patients with an eosinophilic phenotype. Until then, Dr. Landry advises focusing on proven treatments.

The Takeaway

Dr. Landry’s approach to COPD management focuses on strong adherence, preventive care, and comprehensive treatment, all designed to keep patients out of hospitals and living fuller lives. Single inhaler triple therapy, combined with vaccinations and lifestyle support, can be a straightforward yet powerful approach.

Catch the full recording on the Virtual Hallway platform to get all of Dr. Landry’s practical tips on COPD management.

Disclaimer: This post shares educational insights and does not replace personalized medical advice.

As we enter flu season, it's crucial to be prepared for the increased risk of COPD exacerbations in our patients. Dr. Landry, in his webinar on "Preventive Care in COPD," emphasizes that viral infections are one of the most common triggers for these exacerbations, making this a particularly important topic during flu season12.

The webinar, "Preventive Care in COPD: The Role of Vaccination in Reducing Exacerbations During Flu Season," emphasizes a multifaceted approach to managing COPD, going beyond just addressing symptoms.

Here's a summary of key takeaways:

  • The Urgency of COPD Exacerbation Prevention: Dr. Landry underscores the seriousness of COPD exacerbations, reminding us that 20-40% of patients die within a year of their first exacerbation3. This statistic highlights the critical need for proactive management to prevent these events.
  • Triple Inhaled Therapy: A Cornerstone of COPD Management: The 2023 COPD Treatment Guidelines, as explained by Dr. Landry, recommend triple inhaled therapy as a mainstay for patients with moderate to severe COPD456. This approach combines a long-acting antimuscarinic (LAMA), a long-acting beta-agonist (LABA), and an inhaled corticosteroid (ICS) to effectively manage symptoms and reduce exacerbations4. Dr. Landry further points out that single-inhaler triple therapy is preferable as it has been shown to improve patient adherence and lead to better outcomes467.
  • Vaccinations: A Powerful Tool for COPD Patients: Dr. Landry strongly advocates for vaccinations as a critical component of COPD management, especially during flu season8. He emphasizes that while inhaled therapy is essential, vaccinations offer an additional layer of protection against exacerbations, which are often triggered by respiratory infections like the flu.

Influenza Vaccination: Dr. Landry recommends annual influenza vaccination for all COPD patients. He suggests the high-dose vaccine for eligible patients as it elicits a stronger immune response, which is especially important for older adults who may have weaker immune systems9.

Pneumococcal Vaccination: Given the potential for pneumococcal infections to trigger exacerbations, Dr. Landry recommends pneumococcal vaccination with both the PCV15 or PCV20 followed by the PCV23 for optimal protection.

COVID-19 Vaccination: Dr. Landry advises healthcare professionals to stay informed about the latest COVID-19 vaccination guidelines, as these recommendations can change based on the circulating variants and guidance from public health authorities.

RSV Vaccination: Dr. Landry highlights the underappreciated burden of RSV infection in older adults, with a 1 in 9 chance of death for those hospitalized. He strongly recommends the RSV vaccine, particularly for patients over 60, as studies show it is safe and effective in preventing severe RSV infections, a significant risk factor for exacerbations.

By embracing a comprehensive approach that includes both pharmacological interventions like triple inhaled therapy and preventive measures like vaccination, healthcare professionals can make a significant difference in the lives of their COPD patients, particularly during the challenging flu season.

Remember, the webinar recording is available for free on the Virtual Hallways platform. Don't miss this opportunity to enhance your understanding of COPD management and access practical tools to improve patient care!

Disclaimer: This lecture is for educational purposes only and does not replace medical advice or treatment plans tailored to individual patients."

Virtual Hallway's 'Notes' Simplifies Your Clinical Documentation

In a clinician’s day packed with patient consultations, impromptu discussions with colleagues, and countless phone calls, the challenge isn’t just about capturing patient encounter details—it's about efficiently documenting the myriad of interactions that inform patient care. That's where the "Notes" feature in the Virtual Hallway mobile app comes in, offering a straightforward solution to a common, yet critical, aspect of medical practice.

Keeping Track Made Simple

At its core, "Notes" is all about being able to capture clinical notes whenever you need them. With a few quick taps on your phone, you can open a new note, jot down information from any interaction, and even include essential patient details, no matter where you are. It's this ease of use that transforms your mobile device into a powerful tool for secure, compliant documentation on the go.

User Experience at Its Best

Designed with the hectic schedule of healthcare professionals in mind, "Notes" prioritizes user-friendly functionality. Whether you’re capturing consultation notes, patient observations, or even billing details, the process is intuitive. For those moments when typing is too cumbersome, voice-to-text input allows you to speak your notes into existence, ensuring that your focus remains on patient care.

Practical Applications in Daily Practice

From a quick consult in the hospital corridor to an unexpected call about a patient while you’re out of the office, "Notes" has you covered. This feature is particularly handy for documenting those bits of information that are crucial for comprehensive patient care but might not make it into the EMR until much later—if at all. It’s about making sure that every piece of information has its place, securely and accessibly.

Technical Features That Stand Out

Beyond its basic note-taking capability, "Notes" offers functionalities like autofaxing to send documents directly where they need to go, ensuring that patient care continuity is maintained. The secure and compliant framework of the app means you can trust that patient information is handled with the utmost care.

The Future Is Now

With upcoming enhancements like automated billing, "Notes" is set to become even more integral to the daily operations of a medical practice. It’s about not just keeping up with the pace of healthcare but staying a step ahead, ensuring that both clinicians and patients benefit from the efficiency and accuracy it brings.

How to Get Started

Dive into a smoother workflow today by downloading the Virtual Hallway app and exploring the "Notes" feature. It’s designed to fit seamlessly into your practice, offering a simple yet effective way to capture the important interactions that shape patient care.

The "Notes" feature by Virtual Hallway shows how small tools can make significant impacts in the healthcare field. It’s time to move beyond scattered sticky notes and disjointed documentation—embrace the simplicity and security of capturing clinical interactions with Virtual Hallway’s mobile app.

With Dr. Rodrigues

Irritable Bowel Syndrome (IBS) presents a complex challenge in gastroenterology, characterized by a spectrum of symptoms that defy a one-size-fits-all approach. The recent lecture, "Ins and Outs of IBS," offers clinicians a deep dive into the nuanced understanding of this prevalent condition, blending the latest research with clinical insights to advance patient care.

IBS, often encountered in clinical practice, demands a multifaceted approach. This lecture moves beyond traditional diagnostic criteria to explore emerging paradigms in pathophysiology, patient management, and therapeutic innovation. It serves as a primer for clinicians seeking to enhance their understanding and approach to IBS, emphasizing the importance of a personalized treatment strategy.

Key highlights include an examination of the gut-brain axis and its implications for IBS management, an overview of novel dietary interventions, and a critical analysis of pharmacological versus non-pharmacological treatments. The lecture elucidates the interconnectivity of psychological, dietary, and lifestyle factors with IBS symptoms, offering a comprehensive framework for holistic patient care.

What sets this lecture apart is not just the caliber of the content but the engaging presentation style, tailored for the intellectual curiosity of clinicians. It challenges conventional wisdom, encourages critical thinking, and fosters a dialogue on innovative practices in IBS treatment.

For clinicians dedicated to advancing their practice and improving patient outcomes, this lecture is an invaluable resource. It's an opportunity to refine diagnostic acumen, explore new therapeutic avenues, and join a community of thought leaders in gastroenterology.

Embark on this intellectual journey through the "Ins and Outs of IBS," and arm yourself with the knowledge to navigate the complexities of this disorder with confidence and competence.

physician watching continuing education lecture on virtual hallway

In the rapidly evolving field of healthcare, Continuing Medical Education (CME) remains a cornerstone for professionals aiming to enhance their knowledge and skills. Virtual Hallway offers a suite of CME events designed to meet your learning needs. Here’s how you can maximize the value of these offerings:

1. Watch It Live

The best way to immerse yourself in our CME events is by attending live. Register early, mark your calendar, and join the event to not only absorb real-time insights but also feel the pulse of contemporary medical discussions. Live participation brings the unique advantage of immediacy – you're learning in the moment, alongside peers who are equally eager to expand their horizons.

2. Engage in the Discussion

Our live sessions thrive on interaction, featuring active Q&A segments with over 30 questions typically asked and answered. This is your chance to probe deeper into subjects, clarify doubts, or explore new perspectives. If you have a burning question, don’t wait! Submit it beforehand when you register to ensure it gets the attention it deserves. Engaging actively not only enriches your learning experience but also contributes to the collective knowledge of the community.

3. Watch On-Demand

Can't make it to a live event? No problem. Virtual Hallway boasts an extensive backlist of over 20 lectures available on-demand. This flexibility allows you to tailor your learning journey according to your schedule, ensuring you never miss out on valuable insights. Whether it’s a deep dive into a specialized topic or a broad overview of emerging trends, our on-demand library has you covered.

4. Claim Your Credits

Continuing your education is rewarding in more ways than one. With Virtual Hallway, you can claim your credits for MAINPRO in Canada or the equivalent in the U.S. after participating in our CME events. This ensures that your professional development is recognized, keeping you compliant with accreditation requirements and at the top of your game.

5. Listen on the Go

Our mobile app revolutionizes how and where you can engage with CME content. Whether you're commuting, exercising, or between appointments, you can listen to or watch our lectures wherever you go. This convenience means that your learning never has to pause, integrating seamlessly with your busy lifestyle.

Virtual Hallway's CME events are more than just lectures; they're gateways to advanced practice and heightened patient care. By attending live, engaging in discussions, utilizing our on-demand resources, claiming your credits, and leveraging our mobile app, you ensure that your educational journey is rich, rewarding, and uninterrupted. Dive into our CME offerings today and take a significant step toward your professional excellence.

Healthcare access, specifically to specialist care, has remained a persistent challenge for rural communities worldwide. Countries like Canada and the United States experience significant disparities in the number of physicians and specialists per 100,000 residents compared to their urban counterparts. The resulting impact? Rural patients tend to experience higher rates of chronic diseases, preventable hospitalizations, and mortality rates. Virtual Hallway (VH) is a unique platform that uses technology to bridge the rural-urban healthcare divide.


While the struggle to provide patient care in rural areas is not new, it's fraught with an array of challenges. Patients often face a difficult choice between long waits for appointments at distant clinics or forgoing specialty care altogether. With internal medicine, surgical specialty services, and mental health services witnessing unpredictable coverage gaps, this lack of system redundancy in rural healthcare only amplifies the issue. These scenarios inevitably lead to an increase in complex and often costly patient transfers.


However, the solution to these challenges may lie in digital tools like Virtual Hallway. Designed to facilitate phone consultations between primary care providers and specialists, VH's aim is to dismantle geographical barriers in healthcare provision.


VH's impact is not just theoretical. Real-world data from VH users reveal an astounding 84% of phone consultations successfully avoided the need for an in-person referral. Think of it: near-instant access to a specialist, right within your rural community. This effectively eliminates long waits and reduces the need for lengthy travel to urban centres.


Recent user surveys indicate that around 95% of primary care respondents either "strongly agreed" or "agreed" that VH increases access to specialist consultation. In fact, 98% affirmed that VH enhances their capacity to manage care plans in their communities. Additionally, VH garnered high satisfaction rates, with 99.4% of users reporting they were "very satisfied" or "satisfied".


The introduction of VH offers hope in the quest to level the healthcare playing field between rural and urban communities. To uncover more about the potential of VH and its impact on rural healthcare, dive into our comprehensive white paper "Bridging the Rural-Urban Divide". Find out how VH is changing healthcare, one call at a time.

We're excited to introduce the Billing Export feature in Virtual Hallway, an essential tool for physicians who perform shadow billing. This feature enables you to generate a well-structured CSV file with all your necessary billing information.

Here's how to use it:

  • Sign in to your Virtual Hallway account and click on the 'Billing' tab.You'll find a table of all your consultations.
  • You can choose which consultations you want to include in your export by ticking the box beside each one. If you want to select all consultations, simply click the checkbox at the top left corner of the table.
  • Every consultation will show a status: 'Exported' or 'Ready'. An 'Exported' status means you've already exported that consultation's billing information before. A 'Ready' status indicates the billing information for that consultation hasn't been exported yet.
  • If you wish to only export new billing information, you can filter the table to show consultations with a 'Ready' status.
  • Once you've selected your consultations, hit 'Export' and your CSV file will start downloading instantly.

This new feature is designed to streamline your billing process, making it more efficient and less time-consuming. Enjoy your simplified billing experience with Virtual Hallway!

Managing documentation is important but can be burdensome. We've introduced Autofax to make document management simple. This innovative addition allows you to automatically send reports to a designated fax number, creating a seamless link between your consultations and office document management system.

If your fax number is linked to your Electronic Medical Record (EMR), Autofax offers even greater convenience, ensuring your consultation records are integrated swiftly into your patient management system.

Setting up Autofax is straightforward:

Log into your Virtual Hallway account.

  • Click on 'Account'.
  • Select 'Fax Number'. Enter the fax number (or numbers) where you'd like your reports sent.
  • Whenever a specialist completes their consult report, these report will be automatically sent to the fax number. These can be modified at any point to suit your changing needs.

For more customized control, you can manually decide the destination of individual consultation reports:

  • Go to the desired report.
  • Click on 'Download'.
  • From the dropdown menu, choose where you want to send that specific report.

We're confident that the Autofax feature will significantly enhance your experience on Virtual Hallway, making it easier than ever to manage your consultations and documentation. Happy consulting!

Medicine. Together. | Doctors helping doctors helping patients

In the past, doctors often worked in central locations, frequently crossing paths in hospital hallways and exchanging invaluable advice on patient cases. This sense of camaraderie and collaboration was crucial to providing the best possible care. As healthcare evolved and doctors moved into communities, this connectivity between healthcare professionals diminished, and something valuable was lost.


That's where Virtual Hallway comes in. Our mission is to revive the spirit of collaboration and make connecting with colleagues as simple as stepping down the hall. As Canadian waitlists for specialty care reach all-time highs, with the Maritime provinces hit the hardest, our mission has never been more vital.


We, the founders of Virtual Hallway, are doctors who have experienced these logistical challenges first-hand. Our passion for transforming healthcare and fostering stronger connections between primary care providers and specialists led to the creation of our platform.


Now, we are proud to expand Virtual Hallway to Prince Edward Island. This expansion holds special meaning for us, as the sense of unity, pride, and mutual support that characterizes the Maritime provinces aligns with our ethos. Together, we can overcome the challenges facing our region's healthcare system and provide better patient care across the Maritimes.


Our commitment to you is unwavering: we will listen, learn, and operate with passion and integrity. We believe that by working together, sharing our knowledge, and harnessing the power of collaboration, we can create a brighter, healthier future for our patients.


As we embark on this exciting new chapter in PEI, let us come together and rekindle the spirit of those bustling hospital hallways, fostering connections, and improving healthcare one consultation at a time.

With gratitude and determination,


The Virtual Hallway Team

Millions of people worldwide are affected by Irritable Bowel Syndrome (IBS), a chronic gastrointestinal disorder. In a recent webinar, Dr. Geoff Williams, a Gastroenterologist, reviewed the presentation of IBS, its diagnosis, and treatment approaches. Physicians are encouraged to watch the full webinar to gain a better understanding of IBS and learn how to manage symptoms in their patients. In the meantime - Here is a short video showcasing the clinical pearls from the webinar.

Symptoms of IBS

The most common and distressing symptoms of IBS are abdominal pain and bloating. However, other symptoms may include constipation, diarrhea, or a combination of both. These symptoms can be triggered by a variety of factors, including stress, certain foods, and hormonal changes.

Diagnosis of IBS

Diagnostic testing in patients with suspected IBS will include a CBC. In people who have ALARM features for potential colorectal cancer, an investigation to rule out this diagnosis is required. Further tests are available, depending on the subtype of IBS.

Useful diagnosis charts
Diagnosis and management algorithm

Treatment of IBS

Treatment for IBS varies by type of IBS presentation, but includes non-pharmacologic methods such as exercise, diet changes, and potentially psychological therapy. Medication options include antidepressants, sodium hydrogen exchanger 3 inhibitors, guanylate cyclase c agonists, antibiotics targeting the gut biome, opioid receptor modulators, and probiotics. Dr. WIlliams reviews which clinical presentations warrant these trials of these treatments.

Key points for treatment

Conclusion

The takeaway from Dr. Williams’ webinar is that IBS is a common but complex disorder that needs to be taken seriously. Treatment should be tailored to the individual and may involve dietary changes, exercise, and medication, and the optimal treatment depends on the patient's clinical presentation. Watch the full lecture to get details on how to optimize treatment for your patients.

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