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.

Streamline patient care and improve collaboration with fellow healthcare professionals

As a physician or nurse practitioner, you often face complex and challenging cases that require additional input from your peers. Virtual Hallway empowers you to seek this valuable expertise through peer-to-peer phone consults. Here are the top 10 indications for using these consults to enhance your practice and improve patient care:

  • Your patient is on a waitlist: Access expert advice to help manage your patient's condition while they wait for a specialist appointment.
  • You aren’t sure about a workup: Gain insights from colleagues to design the most effective diagnostic workup for your patient.
  • Your patient isn’t responding to treatment: Discuss alternative treatment strategies with experienced professionals to optimize patient outcomes.
  • You’re concerned you are missing something: Receive a second opinion to ensure you've considered all potential diagnoses and treatments.
  • You’re worried about your patient: Leverage the collective expertise of your peers to address your concerns and develop a tailored care plan.
  • Your patient wants to avoid travel: Facilitate remote consultations to save your patient time and resources without compromising their care.
  • You want to confirm a course of action already taken: Validate your approach by seeking input from others, reinforcing your confidence in your decision-making.
  • You wonder if there are new treatments available that you aren’t aware of: Stay up-to-date with the latest advances in medicine by discussing novel therapies with fellow healthcare professionals.
  • Review test results: Collaborate with experts to interpret complex test results and determine the most appropriate next steps.
  • Improve the quality of a referral: Enhance your referral process by discussing the case with a specialist beforehand, ensuring a smoother transition for your patient.

Harness the power of peer-to-peer phone consults to improve collaboration, streamline patient care, and optimize outcomes. By engaging with your colleagues in real-time, you can overcome challenges and stay at the forefront of medical practice.

Our healthcare system is faced with a number of challenges, from overcrowded emergency departments to long wait times for specialist care. In order to improve access to care and reduce overuse of emergency departments, many healthcare providers are turning to a solutions that can make specialist consultation more effective. These innovative technologies offers a range of benefits, from connecting primary care providers with specialists in real-time to bringing specialist insights to patients. In this article, we'll explore how synchronous phone consultations can help reduce overuse of emergency departments and improve access to care.

Emergency departments are often overcrowded and overburdened, leading to long wait times and delayed care for patients who need it most. One solution to this problem is the use of synchronous phone consultations, which can help reduce overuse of emergency departments by improving access to primary care providers and specialists.

The Problem

Emergency departments are overcrowded, leading to long wait times and delayed care for patients who need it most. Patients stuck on specialist waitlists are ER admissions in the making. The longer a person waits, the more likely they are to require urgent or emergent care. High frequency ER patients are often a result of inability to manage complex comorbidities. With growing specialist waitlists, the percentage of patients going untreated increases, and as a result so will potentially avoidable admissions. Are increasing ER admissions in part caused by increasing waitlists?

The Solution

Synchronous provider-to-provider phone consultations can reduce overuse of emergency departments by improving access to specialists. In traditional healthcare systems, primary care providers often have to refer patients to specialists for further evaluation and treatment. However, this process can be slow and cumbersome, and patients may have to wait months or even years to see a specialist. This wait time can lead to patients showing up in the emergency department with complex, chronic conditions that could have been managed earlier with specialist input.

The Benefits

Synchronous phone consultations offer a number of benefits. By allowing primary care providers and specialists to have a synchronous dialogue, it helps ensure that all parties are on the same page when discussing patient care. This can lead to better collaboration and more effective treatment plans, which can reduce the need for emergency department visits. Direct collaborative communication between providers can take efficiency to the next level. By exchanging information directly, doctors can avoid the time-consuming process of reviewing patient files, scheduling appointments, and waiting for specialist feedback. This direct communication not only saves time but also increases the likelihood of the advice being actioned.

Asynchronous Solutions

Asynchronous solutions like e-consults can also be part of the solution. E-consults allow primary care providers to send a secure message to a specialist, who can then review the patient's case and provide recommendations. This can help reduce the need for in-person specialist referrals, which can be unnecessary and time-consuming. This is particularly important for patients who are stuck on waitlists and may not be able to see a specialist in person for months.

Case Ilustration

Let's consider the case of a patient with borderline personality disorder and a substance use disorder, who had longstanding difficulty stabilizing their condition. This patient was previously a frequent visitor to the emergency department of a regional hospital in a rural area, staffed mainly by family doctors. Unfortunately, there were no psychiatrists in the area, and even though this patient had a family doctor, they were unable to get the patient to be seen by a psychiatrist in the closest urban centre (a 4-hour drive away).

Without psychiatric advice and support, the family doctor was limited in their ability to help the patient manage their conditions effectively. The result was that this patient frequently visited the emergency department for symptoms related to their mental health and substance use disorders.

However, after implementing phone consultations between primary care providers and psychiatrists, the family doctor was able to collaborate with specialists in real-time to develop more effective treatment plans for this particular patient. With ongoing support from these specialists via synchronous phone consultations, the family doctor was able to better manage this complex case.

As a result of these consults, this patient is no longer frequenting the emergency department unnecessarily. Thanks to improved access to expert advice and collaborative communication between providers involved in their care through these efficient consults, this patient is now receiving adequate care without having to travel long distances or wait months for specialist appointments. This demonstrates how powerful synchronous phone consultations can be in improving access to care and reducing overuse of emergency departments for patients with complex comorbidities living in rural areas where specialist resources may be scarce.


Phone consultations are a promising solution to the challenges facing our healthcare system today. By connecting primary care providers with specialists in real-time, phone consultations can help address issues before complications arise, reducing the need for emergency department visits. Additionally, asynchronous solutions like e-consults can also be part of the solution by reducing the need for in-person specialist referrals. Overall, phone consultations are powerful tools for improving access to care and reducing overuse of emergency departments. By reducing the number of potentially avoidable admissions, we can help alleviate the burden on emergency departments and improve patient outcomes.

For Family Doctors and Nurse Practitioners in Ontario who need access to specialists, asynchronous eConsults and synchronous phone-based Virtual Hallway are both secure and free-to-use solutions.

Most importantly, each tool helps primary care providers keep patients off the wait list and deliver better, faster and often life-saving outcomes to patients.

When considering which tool to best suited for each case, it's helpful to consider the ways in which they are unique. This will help primary care providers determine which one might be the best fit for their working preferences and patient needs.

Email-based consults

E-consultations are a long-standing and widely adopted solution that recreates some aspects of a live, hallway-style consultation. The asynchronous nature of emails is helpful in many contexts and many clinics and hospitals have integrated it into their standard workflows.

Benefits of email-based consultation through eConsult include:

  • Familiarity. Many people already understand how to use it. This is helpful for those who aren't as tech-savvy or interested in trying out a new tool.
  • Choice. At the moment, it may be easier to find a specific type of specialist or sub-specialist through well-established eConsult networks. Is there a specific speciality or specialist you'd like to see on Virtual Hallway? Let us know at [email protected]
  • Convenience for less complex, less time-specific cases. Some questions are relatively straightforward, routine or do not require certainty around when a response might arrive. These cases are asked and answered fairly easily through email.

Did you know: in Ontario, 40% of eConsults avoided an unnecessary referral and 60% do not require an in-person followup visit. Source.

Phone-based consults

Discussing a patient’s case with a colleague in a clinic or hospital hallway is the original gold-standard in patient-specific medical consultation and knowledge sharing. Phone-based consultations allow primary care providers to experience the benefits of a “hallway”-style conversation outside the confines of their immediate network, clinic or hospital.

Virtual Hallway brings ease and convenience to this approach with technology aligned to CMPA guidelines, modern clinic workflow and billing criteria.

Benefits of phone-based consultations through Virtual Hallway include:

  • In-depth answers. Live conversations offer detailed insights in a short amount of time. This is especially useful for more complex, less routine cases.
  • Simple consult requests. Communicating detailed context in a live conversation is easy, reducing the need to write it all out in the consult request.
  • Personal and collegial. The engaging nature of a live, problem-solving discussion is energizing and can help foster new, meaningful professional relationships.
  • Answers on a schedule. Primary care providers choose the time of the consultation so they know when they will have their answer. This can help plan follow up next steps with a patient. One family doctor in Ontario described this as, “I pick up the call [from the specialist] with a question and hang up with an answer.”
  • Easy billing and documentation. For qualifying primary care providers, OHIP reimburses phone consultations at $31.25, nearly twice the rate of email-based consultations. Virtual Hallway bills on behalf of the primary care provider. When the specialist submits consult documentation via the Virtual Hallway platform the primary care provider has the option to have that report automatically faxed or emails to their office.

Did you know: in Nova Scotia, 84% of phone consultation through Virtual Hallway helped a patient avoid a specialist waitlist entirely. Source.


Email and phone-based consultations are both important tools that help primary care providers provide better, faster often life-saving patient care. Consider your patient case and personal preferences when determining which tool is the best fit:

  • eConsult is a familiar email-based tool in Ontario. It offers more speciality choice at the moment and can work well for more routine consultations with less complexity.
  • Virtual Hallway phone-based consultations consultations are personal, offer worry-free billing and documentation and can work well for less routine consultations.

Trust is the foundation of consulting. The more we trust, the more we can accomplish together. On Virtual Hallway, trust is the foundation of the consulting process. When someone sends a consult request to a specialist, they trust that the specialist will be ready, willing and able to help them. The specialist trusts that the family physician or nurse practitioner will integrate their discussion in the patient’s care.

Trust is at the core of all meaningful relationships.

A great biography can accelerate the development of trust. When someone is considering consulting with you, they can review your biography to get a sense of who you are. 

Write in the first person

You don’t have to be a great writer to create a warm, inviting description. We recommend writing in the first person. While academics make for great biographies at conferences, what we’ve found that on Virtual Hallway a more personal touch primes the development of the clinical relationship. 

Imagine that you are describing to a friend, or a clinician you have just met, who you are and what you do. What comes to mind immediately? Chances are that these cues will fit well into your biography. 

Though you may want to list off all of your academic credentials, resist going into too much depth. Highlight the most important aspects of your clinical work and your background. Feel free to list a couple of interesting things about you as a person too. This helps set the expectations for the phone call

Keep it brief

Think about your state of mind when you’re getting through your clinical day. You are often trying to get a lot of things done quickly and efficiently. Write your bio for scanning, not reading. 

Include important information at the beginning of your description so that it doesn’t get lost.

Have a look at other people’s biographies when writing your own. See what you like about theirs, and incorporate it into your own. 

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