App gives rural doctors 24/7 access to medical specialists

An app that gives small-town physicians immediate access to critical-care specialists in other parts of B.C. is having a big impact, its developer says.

The Critical Outreach and Diagnostic Intervention (CODI) video call system was recently installed in hospitals in the Peace Region of northeastern B.C., following other rural areas of the province.

Dr. Don Burke, who developed the iPhone and iPad app, says rural physicians face challenges like low resources, minimal specialist backup and few to no nurses, as well as geographic isolation. 

"There was an incredible need for this," Burke told Carolina de Ryk, host of Daybreak North. 

Emergency room doctors in communities including Dawson Creek, Chetwynd and Tumbler Ridge can now contact specialists 24 hours a day, every day of the year. It could be to seek advice when dealing with an overdose, heart attack or a coma with unclear causes, Burke said. 

"We tried to come up with something that would be there immediately for them to take away the fear and anxiety of taking something on on your own without any backup," he said.

How it works

If a physician needs support, they just have to press a button on the app to be put in immediate contact with a volunteer medical specialist, who in turn have greater access to medical experts.

That specialist is just as liable for the patient's care as the doctor in the room with the patient. 

"We can walk them through whatever question they have ... whatever need they have," Burke said. 

The app can be simply accessed through a handheld device, while some facilities, such as the ones in the Peace Region, have been mounting iPads on portable stands and connecting them to televisions for easier and clearer use.

The app stores each call and converts them into text format. Rural doctors can sort these calls through the app's archival system by using hashtags and keywords. Burke says this makes learning and consulting with past medical cases easy.

As of October, CODI has been downloaded by more than 300 doctors across B.C.

Burke says the app saves money for facilities, the Ministry of Health and taxpayers in the long-term, as fewer patients have to be airlifted out of towns and fewer doctors are needed to be recruited to replace the ones who leave small towns. 

'Someone in the room who can guide you'

Dr. Stefan Du Toit, who works at the health centre in the village of Valemount, B.C., says CODI has helped his facility treat patients that normally would have to go to larger facilities. 

When Du Toit is on call, it's just him and a nurse. He says that it helps to have a third "pilot" to control the plane when there's a critically ill patient and the situation is high stress. 

"You have tunnel vision in those situations. As a rural general practitioner, we don't deal with certain emergencies regularly enough so that we feel confident in dealing with those crises," said Du Toit, who has been a physician in rural areas for 20 years. 

"It's so helpful to have someone in the room who can guide you and remind you of things that are important to check."

Burke says he is funding the project mostly by himself, with the help of some grants. But he hopes to attract more sustainable support from the province soon.