Phoning It In

Help is just a phone call away with Nova Scotia’s 811 service.

Let’s face it—sometimes you have an immediate health concern and you just can’t get to a doctor. Nova Scotians, fortunately, have access to 811—a free health information service that offers callers, whether they are residents or visitors to the province, access to trusted health information in minutes. Registered nurses (RNs) listen to each caller’s concerns and provide information and direction on what that caller’s next steps should be.

“The 811 service was created to provide more and enhanced access to the health care system,” says Cheryl Purcell-Cotnam, manager of primary care operations for the Nova Scotia Department of Health and Wellness, which oversees the program.

The service, which began in 2009, has seen demand grow since its inception. During the period of the H1N1 outbreak in late 2009, calls spiked from an average of 250 a day to 1,000.  From April 1, 2011, to March 31, 2012, the service handled almost 137,000 patients. It operates 24 hours a day, seven days a week and is available, through an interpretation service, in more than 170 languages. Purcell-Cotnam says this is particularly helpful to new residents, even those who do not have a health card. “If they are at a phone in Nova Scotia, they can access the service,” she says. “They do not need a health card.”

Those who dial 811 during busy periods will first speak to a telehealth representative who will register them and pass them on to the nurse, or arrange a time for the nurse to return their call. If, at any time, the telehealth rep or the nurse determines that the caller is in need of emergency care, he or she will connect the caller to a 911 operator or to poison control, and will stay on the line to make sure they get through.

The most common reasons people called 811 in the past year were abdominal pain, chest pain, medication questions and concerns over coughs, colds and fever in children. All of the RNs who take calls have a minimum of five (and an average of 10) years of nursing experience; they also receive ongoing training in a variety of areas, such as dealing with mental health issues.

“The service is not just about nurses relying on their own experience,” says Purcell-Cotnam. “There are evidence-based clinical guidelines that we have to follow. If you call today with one clinical symptom, then you call tomorrow with that same symptom, you will get the same advice.” The nurses also have immediate access to another nurse or to their clinical supervisor, and a physician oversees the service. The number of nurses working varies with demand; currently, there are approximately 40 nurses who work from home, all linked electronically.

In addition to the telephone services, 811 has an extensive catalogue of health information at 811.novascotia.ca. The website provides accurate medical information based on Nova Scotia medical practice. This year, 200 topics will be added to the existing 350 topics.
The service’s nurses also have access to a database produced by the Department of Health and Wellness that lists 900 resources that nurses can refer callers to. It includes every community pharmacy in the province and the free blood collection services offered by the district health authorities closest to any caller’s location.

It’s not yet clear whether the service has reduced the number of visits to family doctors’ offices or to emergency departments, but that data will be analyzed in future. Says Purcell-Cotnam: “The service is not about (reducing those visits). It is about making sure the patient receives the right care, from the right provider, at the right time.”

Telehealth services in the rest of Atlantic Canada

New Brunswick: Tele-care 811/Télé-Soins 811; bilingual, registered nurses offer advice for non-urgent medical problems, 24/7; 320 recorded topics for general information requests; gnb.ca/0217/Tele-Care-e.asp.
Prince Edward Island: PEI government policy makers are actively looking at the 811 system.
Newfoundland & Labrador: HealthLine at 1-888-709-2929; TTY (for people with hearing or speech difficulties) 1-888-709-3555; a team of experienced registered nurses gives advice and information, 24/7; yourhealthline.ca/en.