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.

You’ve signed up for Virtual Hallway as a specialist. Now what?

In this short guide, you’ll learn how to setup your:

✅ Profile

✅ Account settings

✅ Availability

Setup your profile

Your profile helps colleagues identify and connect to you as a person and helps ensure that you receive consult requests right in your wheelhouse.

✅ Upload a profile picture

Specialists with profile pictures get around 3x the consult requests. How to upload a profile picture...

✅ Update your bio

Write in the 1st person and keep it brief to help colleagues understand your background and training. If you have specific areas of interest or subspecialty training, include that here. How to add a bio to your profile...

Setup account settings

Account settings allow you to personalize notifications, calendar sync, security and auto-fax options.

 Email and Text Notifications

Never miss a consult with automated email and text notifications. Learn more about how to make notification work for you.

✅ Calendar Sync

Do you use a centralized calendar? If so, subscribe to your Virtual Hallway calendar to get your consults to appear in your calendar. Learn more about how to subscribe to your calendar.

✅ Security

We recommend using a strong password and enabling two factor authentication (2FA). Learn more about how how to reset your password and enable 2FA.

✅ Auto-fax

When you complete a consult report, opt into our auto-fax feature to have all information automatically faxed to your office staff. Learn more about how to set up auto fax.

Setup your availability

✅ Recurring and single events

Setting recurring availability that fits your regular schedule is an easy, “set-and-forget” way to provide sustainable access to primary care providers. You can also set availability on individual dates and times. Learn more about times that work well for phone consultations.

✅ Enable OnDemand booking

By opting into OnDemand booking, requesting physician can indicate they are open to receiving a call from you anytime prior to your scheduled consult. This popular feature gives you the freedom to take advantage of any window of time you have to complete a consult ahead of time. Learn more about this feature.

✅ Advance notice and consult length settings

You can customize how much “buffer” time you require between when a consult is requested and the earliest it can be scheduled for. You can also customize the amount of time that a phone consult is booked for. Learn more about how to adjust your advance notice and consult duration settings.

Take control of your call flow

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.

Triage your consults

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.

Help manage your waitlists.

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.

Save time with an easy and quick platform.

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.

Grow your network.

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.

Share your expertise widely.

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.

Earning opportunity

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.

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... 

  • A psychiatrist might want to consult with an endocrinologist about abnormal metabolic bloodwork.  
  • A gastroenterologist might want to consult with a psychiatrist about a patient with anxiety.  
  • An internist might want to consult with a hematologist about optimizing a patient’s medication.  
  • A psychiatrist might want to review a case with another psychiatrist to get their opinion on a patient’s treatment.  
  • An obstetrician might want to review a patient’s cardiac condition with a general internist.  

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.

Primary care providers (PCPs) play an increasingly large role in the diagnosis and management of mental and behavioral health conditions. Often times, a quick and collaborative discussion between the PCP and a local psychiatrist is enough to optimize a patient's care plan within the primary care setting.

We often get queries about which types of questions make good psychiatry consult requests. We asked a Virtual Hallway psychiatrist for their most commonly received, yet effective, consult questions.

Making a diagnosis

Patient’s symptoms don’t always point to an obvious diagnosis. Often, it takes a historical review, physical examination and investigation to figure out what might be going on. Consulting with a psychiatrist during this process can help narrow the diagnostic possibilities and aid in formulating a plan for the next steps in a patient’s care. 

Managing complex patients 

Often times, PCPs manage notably complex patient cases with little, or no, psychiatry support. Virtual Hallway consults with a psychiatrist can aid in educating a patient on their condition, as well as understanding how to approach care and select the best models of delivery.

Psychotropic medication 

Psychotropic medications are one of most complex sets of medications to prescribe. Phone consults with a psychiatrist are a great way to clarify and confirm dosages, combination strategies and discuss second/third line options.

Waiting for an in-person referral

When a patient is referred for an in-person psychiatric assessment, they will most likely face a long wait (a year or more in some cases). Managing a patient's condition as they wait is critical to their care - Virtual Hallway consults enable access to specialist input on emerging or ongoing challenges. In some cases, specialist advice is enough to optimize the care plan and their in-person appointment may no longer be required.

Confirmation of existing plan 

Many Virtual Hallway consults are simply to review, discuss and provide confirmation by a psychiatrist that the existing care plan is reasonable given the patient’s presentation. A second opinion only takes 10 minutes, instilling confidence and confirmation on the best path forward.

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. 

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.

  • Finding the right colleague to consult with. 
  • Phone tag and missed emails. 
  • Administrative burden. 
  • Absence of record keeping or follow-up. 
  • Medico-legal risks. 
  • Not getting paid. 

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 

These simple practices will increase consult requests and maximize your time.

In the past several months, we’ve seen consult numbers increase as awareness of phone consult has increased. As practitioners learn that it is possible to consult with specialists whenever it’s needed, a further increase in requests is likely.

We’ve learned that a few simple practices can increase the number of phone consult requests you receive. Adhering to these practices can fill your calendar and generate the income you want from phone consults. 

Update your biography and have a photo

Did you know that you can add a biography and photo to your profile? That way, physicians and nurse practitioners will know a bit about you before they send a consult. It can also help you receive consults that are more specific to your area of expertise. 

Adding a biography and profile photo is simple. Login to your portal, select the Account tab. Scroll to the bottom of the screen. Under Public Profile Info you can update your Bio. Under Public Profile Picture you can upload a photo of yourself. 

Be available at the busiest times

You already have a schedule that involves clinics, teaching, committees and other commitments. Look for gaps in between meetings, on a drive between clinic sites, or on the drive to or from work. Sometimes these gaps might be prime time for phone consults. 

Family physicians and nurse practitioners tend to book most consults during midday, at the end of the day or early in the morning (before clinic starts). So if you have time available during those windows, consider making yourself available. Remember, you can make yourself available for as long or as little as you like. If all you have is ten minutes, then you can block off a ten minute slot. That ten minute slot may be exactly what a family doctor is looking for.  

Block off a lot of time

There is a strategy that works for specialists who are busy, but have practices where stepping out of the room for 5-10 minutes isn’t disruptive. If this fits with your practice, you might consider making yourself available for larger periods of time. While you might not get fully filled up, you will get more consult requests. It’s no coincidence that specialists with the most availability also get the most consult requests.  

Keep your buffer low

You control how far in advance people must book consults with you. We call this the consult buffer. Your buffer can be as short as one hour, which means people can book a 2 p.m. consult at 1p.m. Lowering your consult buffer is an effective method of getting more consults.

To adjust your buffer login to your portal, click the Account tab. Then click Preferences. Here you can adjust you buffer duration. 

Be open to reconsulting

Being part of Virtual Hallway means being part of a community of practitioners. Over time you will develop clinical relationships with colleagues from around the province. Specialists often get repeat consults from the same practitioners because they have built solid working relationships. 

However, you may also get repeat consults on the same patients you have consulted about. This is a feature that allows continuity of care. Sometimes more than one call is needed to get a patient along the right path. A lot of specialists encourage family physicians and nurse practitioners to reconsult if the recommendations made in the call or not effective, or if the clinical situation changes. 

You might even consider including a line to that effect in your note. This lets the family doctor or nurse practitioner know that you want to hear from them again.

Notify your waitlist

Specialists have waitlists and you’re likely no different. Consider letting people who send traditional referrals to you know that you’re also available for phone consults. In a lot of cases, many of those patients’ problems might be fully addressed by a phone consult and not need to see you for the traditional referral. 

Many specialists inform referral sources that they are available for phone consults. When these specialists receive a traditional referral, they will send a note (usually by fax) to the referral source that their patient is on their waitlist. 

Along with that note they also inform them that they are available more quickly for phone consults on Virtual Hallway. 

This gives the referral source an extra option to more quickly help their patient.

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