Healthcare should be about providing the right care, at the right time, with the right information. However, our recent poll of specialists revealed a different story—one where inefficiencies in the referral process create avoidable roadblocks that affect both doctors and patients. You can read the full report here: Specialist Referral Report.
One of the most striking findings from the poll is that 60% of specialists receive in-person consult requests with incomplete information. Imagine trying to solve a complex puzzle without all the pieces—that’s the reality for many specialists when faced with insufficient referral details. This not only leads to frustration but also results in significant delays as specialists must track down missing information, ultimately delaying patient care.
Another key insight is the heavy reliance on outdated technology. 70% of specialists still receive referrals via fax. While many sectors have embraced digital tools to improve efficiency, healthcare has often lagged behind—and this poll clearly highlights that challenge. Moving towards modernized communication channels could save valuable time and reduce administrative burdens on healthcare professionals.
Perhaps one of the most significant findings is that many in-person referrals aren’t necessary. Specialists estimate that a significant portion of the patients they see in person could have been effectively managed through a phone consult or e-consult. In fact, 20% of specialists reported that over 40% of their in-person visits could have been addressed through a simpler, less resource-intensive method. This suggests a substantial opportunity to streamline care and alleviate unnecessary strain on the healthcare system.
Specialists Are Dissatisfied with the Current Process
It’s no surprise, then, that dissatisfaction with the referral process is high. 60% of specialists polled expressed dissatisfaction or partial dissatisfaction with their current process for accepting and triaging referrals. From needing to look up missing information to dealing with redundant or inappropriate referrals, these challenges create a stressful environment for specialists who want to focus on patient care, not bureaucracy.
The Path Forward
These insights highlight a significant opportunity for innovation in healthcare communication. By modernizing referral methods, embedding referral pathways, ensuring referring physicians provide complete information, and embracing telehealth options where appropriate, we can reduce inefficiencies and improve the experience for both specialists and patients.
Have Thoughts? We’d Love to Hear Them
What do you think about these findings? Are these issues you’ve experienced in your own practice? We invite you to share your thoughts in the comments or reach out to explore how we can tackle these challenges together.
Read More About Modernizing Referrals and Improving Patient Flow
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:
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."
As we observe Women's Health Month, let’s broaden our focus beyond reproductive health to address the leading causes of morbidity and mortality among women—non-communicable diseases (NCDs). At Virtual Hallway, our commitment is to empower healthcare professionals with the knowledge and tools to tackle these health challenges through expert-led discussions and collaborations.
NCDs are the principal cause of death and disability globally, especially among women, overshadowing other health concerns traditionally emphasized in women’s health narratives. In 2012 alone, an estimated 18.1 million women died from NCDs, with cardiovascular diseases, cancers, and respiratory diseases leading the list.
Contrary to the longstanding view of CVD as a male-centric issue, it is actually the leading cause of death among women worldwide. Research shows that sex differences in healthcare access, treatment, and outcomes are stark, with women often receiving less aggressive treatment than men for similar conditions. Virtual Hallway’s specialists, like those focusing on cardiology and diabetes management, are important resources for bridging these gaps in care.
Our platform offers a series of lectures and the ability to consult with specialists across various fields—including cardiovascular health, diabetes, and mental health. These resources are designed not just to educate but to actively support primary care practitioners in providing care tailored to the needs of women.
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.
The landscape of healthcare is rapidly evolving, and virtual care is becoming an integral part of modern medical practice. Dr. Shirley Lee, a renowned physician advisor at the Canadian Medical Protective Association, recently delivered a captivating lecture on the medicolegal considerations for virtual care and hallway consults. Hosted by Virtual Hallway in a hybrid format, both in person and online, the session sparked engaging discussions and raised thought-provoking questions.
Dr. Lee highlighted several key points during her talk:
Dr. Lee's insightful lecture not only provided valuable guidance for healthcare professionals navigating the world of virtual care but also sparked essential conversations on the topic. As a follow-up, Dr. Lee will be providing resources and articles that will be uploaded to the Virtual Hallway portal for further exploration.
Stay tuned for more updates on this crucial aspect of modern healthcare, and be sure not to miss future lectures and events hosted by the Virtual Hallway platform.
To view Dr. Lee’s lecture please login to your account under the Lectures Tab.
Coming up will be Dr. Phil Tibbo’s lecture on Management of Early Psychosis and Schizophrenia, date to be announced soon!
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.
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?
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.
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 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.
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.
Imagine being more available to help your primary care colleagues with challenging cases while eliminating interruptions throughout your day.
After getting set up on Virtual Hallway, your primary care colleagues can book phone calls with you… at times that work for you. That means both you and your colleague are in the right headspace to share your expertise.
Use your appointments for the most pressing cases, while still being able to support patients with lower acuity problems. Have the peace of mind knowing that if a primary care colleague needs your advice on a case, that they have a mechanism to reach you.
Use Virtual Hallway to regularly consult with a family doc about a patient with a complex issue. Specialists have found that the primary care provider is able to effectively care for that patient with their guided insights on Virtual Hallway, rather than have that patient referred to their waitlist.
We have heard the laments of cumbersome and time-consuming solutions, and are proud to boast a 4.9/5 satisfaction rating from specialist physicians. Easy, smooth, quick, and friendly are the words we hear when we ask specialists about using Virtual Hallway. By connecting with a primary care provider over the phone, you avoid the back-and forth than often comes with asynchronous solutions.
Make yourself available to primary care clinicians outside of your network for compensated consults. Our team assists and executes promoting your availability on Virtual Hallway to any area or network you are interested in accepting VH consults from. We facilitate e-faxing, OMA related advertisements, and other means of informing clinicians on how to access your support.
With one of the fastest growing CME Lecture series in the country, we handle all accreditation, sponsorship, hosting and outreach about CME lectures. Just let us know you’re interested in participating as a speaker, and we’ll handle the rest. Learn more about our CMEs.
Consulting on cases is work, and being fairly compensated for providing patient care is important. With Virtual Hallway phone consults, we ensure that all eligible fee for service physicians get reimbursed for their work.
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.
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:
Did you know: in Ontario, 40% of eConsults avoided an unnecessary referral and 60% do not require an in-person followup visit. Source.
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:
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:
Meet Liz, 24. She has a hard time focusing at work.
Liz visited her family doctor for this reason. While assessing Liz, they found she had a fast heartbeat and an abnormal ECG, causing hesitancy about prescribing ADHD medication to improve her attention. With Liz's best interest in mind, she was referred to an internist for an in-person appointment.
3 months passed; Liz heard nothing. Still having trouble focusing, she called her family doctor's office for an update. She was told that the referral was sent and to keep waiting.
Another 3 months passed; Liz’s troubles continued. Her performance at work was suffering and her trouble focusing was interpreted by her manager as lack of interest in her role. Liz had several write-ups due to lack of productivity and missed deadlines.
Liz was frustrated and concerned; but kept waiting.
3 more months; Liz visited an internist. The internist interpreted the ECG and created a treatment plan that allowed Liz to best manage her condition and improve her performance at work.
Liz was still frustrated; it took 9 months of waiting to get the treatment she needed. She asked herself ‘isn't there a better way?’
Long story, short solution - a Virtual Hallway consult.
Virtual Hallway phone consults are available within 1-2 days, enabling specialist input earlier on in the course of a patient’s illness. The platform facilitates knowledge sharing between specialists and primary care providers, in turn, motivating more timely and effective care.
A Virtual Hallway consult in the case of Liz?
9 months of waiting, worsening and wondering – avoided.
Professional knowledge and confidence – shared.
Specialist waitlist – one patient shorter.
“Can I get your thoughts on this?”
“Can I run something by you?”
These are familiar questions asked by primary care providers to specialists. Questions like these are part of the daily discourse of medicine, coined hallway consults.
Let’s take a look back
Traditionally, hallway consults occurred in elevators, lunch rooms or hospital corridors (earning their name). These brief clinical interactions were localized, casual, undocumented and aimed at solving a particular question on the spot. Such interactions relied on chance encounters with a colleague – bumping into someone or finding shared free time – an unreliable method for gaining advice. Given that Canada is geographically vast and not densely populated in some areas, oftentimes there are few or no specialist colleagues to consult with.
Entering the digital era, hallway consults have shifted to take place by way of email, phone or video. In turn, reducing the traditional reliance on chance encounters with a colleague. These new means of connecting have caused a shift in how we consult, increasing access to specialists both in and outside of one’s institution.
Hallways are not what they used to be.
Current day, how do we connect and gain advice on patient care?
Both traditional and digital consults are tried-and-true methods for gaining advice from a specialist, though they are plagued with challenges.
We haven't reinvented the wheel; we’ve just made it better. Like a traditional hallway consult, after a few minutes of collegial discussion you can confidently deliver the highest quality of care based on actionable advice.
It’s a hallway consult, several a day are a-ok.
Streamlined and simple – book, consult via phone, receive report, receive payment.
Virtual Hallway doesn’t take time away from you, it gives it back.
…to teach them this Art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples …
Hippocrates