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.

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.

Conclusion

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.

Answering consult questions is a fundamental aspect of specialty medicine. However, specialists see patients of their own and often want to run patient cases by other physicians. Similar to other healthcare providers, specialists face the same barriers to connecting with colleagues - endless phone tag, misaligned schedules, and challenging documentation requirements.

Solution: Virtual Hallway Specialist to Specialist phone consultations.

Specialists can consult with any other specialist on the platform. They can consult within their own or different specialty areas, as there are countless reasons specialists might want to consult.

Here’s a few... 

In the status quo, if a specialist is unsure about a course of action, they have to either (a) make a decision outside their comfort zone on a patient’s care; or (b) send a formal referral leading to a multi-month wait for the patient. Now, specialists can now get their questions answered by a local expert just like primary care providers. 

To book a consult simply select a specialist to consult with, select a date and time then enter brief patient details. 

Pick up with questions, hang up with answers.