New AI tool ‘Asklepius’ brings Canadian-sourced guidelines to doctors’ fingertips

Doctors looking for Canadian sourced guidelines and drug information won’t find it using OpenEvidence, but a recently launched clinical decision support tool called Asklepius returns “evidence-based, verifiable answers grounded in trusted Canadian sources from more than 500 clinical guidelines, provincial formularies, Health Canada drug monographs and CPS drug information,” the makers say. Developed by Halifax, N.S.-based Virtual Hallway, a physician-founded healthcare group with a platform for peer-to-peer consultations between primary care clinicians and specialists, Asklepius can be accessed free of charge by Canadian doctors registered to use Virtual Hallway.“The difference between Asklepius and other similar tools,” said Virtual Hallway’s co-founder and COO Dr. Daniel Rasic, a psychiatrist, “is that it’s very heavily Canadian-weighted.” It uses an underlying foundational model that also returns answers based on U.S. and internationally based sources, but it favours Canadian data, he added.A soft launch of the tool earlier this year gave hundreds of physicians and nurse practitioners access to the tool to help refine it. Named for Asclepius, the Greek god of medicine and son of Apollo, the Canadian-based clinical decision support tool is now available for use by some 14,000 Virtual Hallway registrants.Where guidelines differ from one Canadian jurisdiction to another, Asklepius automatically returns answers consistent with the province in which a clinician is practising. As an example, “someone from Nova Scotia asking a question about anti-microbial guidelines might get a slightly different answer than someone from Saskatchewan,” said Dr. Rasic. However, guidelines and other information can always be requested for other jurisdictions.Asklepius—like any AI clinical decision support tool—can hallucinate, but a safety layer in the platform limits hallucinations by checking the citations to confirm they match the answers.Virtual Hallway’s peer-to-peer consultation platform, which is also free of charge for doctors, provides primary care clinicians with the experience and expertise of medical specialists through short telephone consults.Primary care clinicians can search through a directory of approximately 1,000 specialists that identifies their area of expertise, their province of practice and the blocks of time they are available for a consult. A clinician selects a specialist, provides some information about their patient and schedules the consult. Fifty-five different specialties are represented in the directory.According to Dr. Rasic, one of four co-founders, including two other psychiatrists, 84% of phone consults eliminate the need for a referral, dramatically reducing wait times for patients. Consults usually take an average of seven to 10 minutes and conclude with a short written report by the specialist. Approximately 15,000 phone consults have been conducted so far this year, he said.Consults occur in jurisdictions that have billing codes for phone consults with specialists and in provinces that enter into enterprise level licences for use of Virtual Hallway. The six provinces currently served include Newfoundland and Labrador, Prince Edward Island, Nova Scotia, Ontario, Saskatchewan and Alberta. The addition of a seventh province—British Columbia—is in the works.A similar provincially funded eConsult service operates in Ontario, but it’s text-based and used for more specific questions, said Dr. Rasic. Connecting on the phone via Virtual Hallway is preferable when there’s more complexity, he added, “so different use cases.”“Specialists volunteer to join Virtual Hallway because they’re interested in education, want to cut down their wait list or improve their connection to referring providers in their community,” said Dr. Rasic. Both specialists and primary care providers can bill for consults provided they’re paid on a fee-for-service basis and the province in which they practise has the appropriate billing codes.In the absence of Virtual Hallway, said Dr. Rasic, a primary care provider requiring a consult with a specialist would end up playing phone tag after calling into the specialist’s front desk. “Knowing who to call can also be a problem because you might know a few specialists from medical school, but you may not know a geneticist or a child psychiatrist,” said Dr. Rasic. Virtual Hallway solves both problems.Dr. Rasic came up with the idea for Virtual Hallway six years ago when he went out for a coffee one day and met a family doctor who quizzed him about a patient she was concerned about. At that time, psychiatry had the unfortunate distinction of having the longest wait times in Canada and Nova Scotia had the longest wait times of all provinces, he said. “We’re talking years.”“Following a five-or-10-minute discussion, we came up with a solid plan and that tweaked something in me. I felt great, she felt super reassured, and the patient would be getting the same care they would have received if I had met with them for an hour and a half, so I asked myself why can’t this happen more often?”Virtual Hallway funds Asklepius and its peer-to-peer consulting service through enterprise licences with Nova Scotia Health, PEI Health and Newfoundland and Labrador Health Services, as well as through as many as 40 sponsored and accredited medical education lectures led by participating specialists.

New AI tool ‘Asklepius’ brings Canadian-sourced guidelines to doctors’ fingertips

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