Perceived Emergency Department Avoidance Following Virtual Provider-to-Provider Consultation: A Cross-Sectional Study

BackgroundLimited access to specialty care contributes to emergency department (ED) crowding in Canada. Virtual provider-to-provider consultation platforms may support primary care management and reduce unnecessary ED utilization. The purpose of this study was to assess primary care providers' perceptions of whether virtual peer-to-peer consultations prevented ED visits.MethodsWe conducted a cross-sectional analysis of post-consultation surveys completed by clinicians using the Virtual Hallway platform, an electronic consultation system enabling synchronous specialist advice to primary care providers, in Nova Scotia, Canada. Providers reported whether the consultation helped manage the patient's condition and whether it potentially prevented an ED visit. Urgency of avoided escalation was also recorded. Descriptive analyses examined responses by provider type, specialty, and geographic zone.ResultsAmong 587 respondents, 29.1% believed the consultation prevented an ED visit, 51.6% did not, and 19.3% were unsure. Perceived ED avoidance was higher in rural zones (35.0%) than in the urban Central Zone (22.4%). Among avoided visits, 9.9% were classified as highly urgent, 53.2% moderately urgent, and 36.8% not urgent. Nearly all respondents (96.3%) reported improved patient management.ConclusionsVirtual peer-to-peer consultation was perceived to prevent ED visits in nearly one-third of cases, with greater impact in rural settings. These findings suggest potential system-level benefits in reducing avoidable emergency care utilization.