Case Study

Rapid Access to Consultative Expertise (RACE)

5 Minute Read


The challenge

General practitioners were unnecessarily referring patients to the emergency department because the wait time for specialist appointments was too long. As a result, the emergency department had an unnecessarily high demand because they were treating patients with non-urgent conditions.

The organization

Providence Health Care is a seven-facility Catholic health care system in Vancouver, British Columbia, Canada.

The approach

Established a hotline called RACE or “Rapid Access to Consultative Expertise” to help connect general practitioners with specialists. To effectively run the hotline, Providence kept specialists on-call during the workday to support general practitioners and to help reduce emergency department demand.

The result

One-third of patients whose general practitioners used the RACE line avoided a trip to the emergency department.



Providence Health Care in British Columbia, Canada, established a hotline for general practitioners to call and speak directly with specialists, called RACE: Rapid Access to Consultative Expertise.

RACE provides on-call specialist expertise to general practitioners faced with complex patient needs. Rather than referring their patient to a specialist, and the patient having to wait months or referring the patient on to the emergency department, the general practitioner can call the RACE line and be connected with the necessary specialist. The initial call routes through a centralized phone line and a specialist contacts the general practitioner by phone to discuss the patient’s case and the best course of treatment.

Specialists bill for the consultative services they provide, creating an incentive for participation in the RACE program.

RACE’s three components


This different type of partnership between providers across the system resulted in significant gains for the emergency department. One-third of patients whose general practitioners used the RACE line avoided a trip to the emergency department, saving scarce emergency department resources.

Considering the gains for the health system more broadly, the RACE line has also reduced the number of specialist referrals made by general practitioners.

Although there are costs associated with specialist services billed to the system, which are much lower than if the patient had seen the specialist, the direct cost of the RACE line is quite low, requiring only a phone line.

1 out of 3

Patients who avoided hospital and ED visits


Patients who avoided subsequent specialist referrals


Estimated cost savings per call

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