Monitoring Telehealth hotline calls to give advanced warning of an impending disease outbreak.


As the area of syndromic surveillance (SS) research rapidly progresses in an effort to improve the quality of existing signals and the timeliness of detection, non-traditional data sources are being suggested as a way to increase the sensitivity of SS systems. The aim of the Telehealth project is to evaluate the effectiveness of this telephone nursing helpline as a real-time syndromic surveillance system. With the Telehealth hotline being one of the first points of access to healthcare for the population, it is feasible that monitoring these calls can give advance warning of an impending disease outbreak.


Telehealth is a toll-free helpline provided by the Ontario Ministry of Health and Long-Term Care (MOHLTC) and is available to all residents of Ontario. Users are encouraged to call with any general health questions with confidential advice being given regarding any health concerns. The system is available 24 hours a day, 7 days a week and 365 days a year with advice coming from trained and experienced registered nurses. Telehealth is available in English and French, with translational support available in 110 languages. Each nurse-led call lasts an average of 10 minutes with nurses directing patients to the most appropriate form of care. Telehealth services are provided by a private contractor “Clinidata” hired by the MOHLTC which has collected data since December 2001. Data is collected in the form of 486 guidelines which have been reviewed and approved by a team of university-affiliated medical experts.

Clinidata website
Telehealth website

Relevant Publications

Perry AG, Moore KM, Levesque LE, Pickett CWL, Korenberg MJ. A Comparison of Methods for Forecasting Emergency Department Visits for Respiration Illness Using Telehealth Ontario Calls.
CJEM. 2010;101(6).
Full Text Link

Caudle JM, van Dijk A, Rolland E, Moore K. Telehealth Ontario detection of gastrointestinal illness outbreaksCanadian Journal of Public Health 2009; 100(4):253-57
Abstract Link

Van Dijk, A.; McGuinness, D.; Rolland, E.; Moore, K. Can Telehealth Ontario respiratory call volume be used as a proxy for emergency department respiratory visit surveillance by public health?Canadian Journal of Emergency Medicine 2008;10(1):18-24.
Full Text Link

Rolland, E.; Moore,K.; Robinson,V.A.; McGuinness,D. Using Ontario’s “Telehealth” health telephone helpline as an early-warning system: a study protocol BMC Health Serv Res. 2006 Feb 15;6:10.
Full Text Link

Moore, K. Real-time syndrome surveillance in Ontario, Canada: the potential use of emergency departments and Telehealth. Eur J Emerg Med. 2004 Feb;11(1):1-2.
Full Text Link

Ontario’s Telehealth Compendium

Compendium: Integrating Ontario’s Telehealth Program into a Province Wide Public Health Surveillance System: Evaluation and Recommendations
Introduction and Executive Summary