Hospitals & Health Authorities · British Columbia

    BC hospitals have world-class protocols carried by pagers, phone trees, and one nurse dialling.

    MarcoMed sits alongside the PBX, the EMR, and the on-call roster — and turns a serial chain of phone calls into one simultaneous, acknowledged activation.

    The Gap

    The protocol is written. The minutes are lost in the dialling.

    Read the province's own STEMI workflow: the ED provider activates Code STEMI, then calls the interventional cardiologist, and the cath lab team is notified separately by call-out. Every arrow in that diagram is a human picking up a handset and hoping someone answers. Stroke Services BC names pre-hospital notification a pillar of hyperacute care — then leaves the carrying of it to whatever each site has. Marco is that carrier.

    Code Stroke · serial chain vs. simultaneous fan-out
    Today
    Nurse calls switchboard
    Switchboard dials list one by one
    Today
    Waits for callbacks
    No record of who heard it
    Today
    Overhead page
    Only reaches people in the building
    With Marco
    One activation
    Neuro, CT, lab, ED paged at once
    With Marco
    Acknowledgement
    Who responded, and when — logged
    With Marco
    Auto-escalation
    No ack in 90s → next on the roster
    Where MarcoMed Sits

    Six inbound lanes. One consistent voice.

    Channel · 01
    Code Team Activation

    Code STEMI, Code Stroke, Trauma, Sepsis. In most BC sites this is still the ED nurse phoning switchboard, switchboard paging the list one by one, then waiting for callbacks. Marco fans the activation out simultaneously and shows who acknowledged, in seconds.

    Channel · 02
    Switchboard Overflow

    Absorbs abandoned-in-queue calls at the main line during shift change, code events, and overnight staffing dips. Answered on the first ring, routed by your existing call tree.

    Channel · 03
    On-Call Roster Paging

    Marco reads the live roster — VCH/PHC MOCAP on-call, Pathways BC specialist listings, Amion, QGenda, PetalMD, or the ward's shared spreadsheet — and pages the person actually on shift, not the name printed last month.

    Channel · 04
    Rural & Transfer Intake

    Structured intake from referring sites and rural EDs — patient identifiers, acuity, FAST-VAN or CTAS score, bed request — then pages the accepting service and the receiving ED at the same time.

    Channel · 05
    ED Closure & Diversion Line

    When a site goes on diversion, Marco answers the closed ED's line with the current redirect, logs every caller, and notifies the on-call administrator. No unanswered ring at a dark department.

    Channel · 06
    Language Access at Reception

    Live Punjabi, Mandarin, Cantonese, Tagalog, Farsi, Spanish, Korean, Vietnamese. Handles the reception-level call without burning a paid interpreter-line minute.

    Fits Your Stack

    Alongside your PBX, EMR, and paging — never in place of.

    MarcoMed is a voice + logic layer. It receives the calls your Cisco / Avaya / Mitel PBX routes to it, executes your protocol, and hands off to the systems you already trust.

    On-Call Rosters
    VCH-PHC MOCAP · Pathways BC · Amion · PetalMD
    Secure Messaging
    Vocera · Hypercare · TigerConnect
    EMR / EHR
    Cerner CST · MEDITECH Expanse · Oracle Health
    Telephony
    Cisco · Avaya · Mitel · Genesys
    Language Access
    LanguageLine · Voyce (fallback only)
    Identity
    Active Directory · Okta · SAML SSO
    The Regional Audit

    What BC emergency departments actually run on today.

    Drawn from public health-authority documents, provincial guidelines, and the authorities' own published clinical workflows. Not vendor marketing.

    Vancouver Coastal / Providence / PHSA
    Cerner (CST Oracle Health)
    Code STEMI is activated by the ED provider and confirmed by phone call to the interventional cardiologist; cath lab team notified by call-out. On-call coverage and MOCAP claims live in the VCH-PHC web app — a portal whose last posted notice dates to 2015.
    Fraser Health
    MEDITECH + overhead paging policy
    A standing corporate policy governs overhead paging across all sites. Codes still travel over speakers and switchboard consoles — effective in the building, invisible to a physician who is at home or between sites.
    Island Health
    Cerner + Vocera (SMaCCS)
    The furthest ahead in BC: Island Health ran a formal Secure Mobile and Clinical Communication Solution study — switchboard operators, pharmacists, physicians on Vocera secure messaging. Their own paper opens by naming pagers, fax, and telephone as inadequate.
    Interior Health
    MEDITECH Expanse (rollout)
    Wide geography, many small sites. Code and transfer coordination leans on switchboard phone trees and per-site paper call lists.
    Northern Health
    MEDITECH + site call lists
    Single-physician communities. Hudson's Hope has run on one doctor with repeated multi-week ED closures — the call routing problem is not overflow, it is that there is no one at the other end unless the right locum is reached.
    Provincial (Stroke Services BC)
    2025 Triage & Transport Guideline
    The provincial guideline makes pre-hospital notification to the receiving ED a named pillar of hyperacute stroke care. It specifies the pathway; it does not supply the technology that carries the notification.

    Sources: CST Cerner clinical workflow library (In-Field / Transfer STEMI), Fraser Health Overhead Paging corporate policy, Island Health SMaCCS evaluation (Vocera), VCH–PHC On-Call & MOCAP application portal, Stroke Services BC 2025 Provincial Pre-hospital Triage and Transport Guideline, and Postmedia's analysis of Ministry of Health ED closure data.

    Six Findings

    The province has the protocols. It does not have the layer that carries them.

    Finding · 01
    Pagers are still the backbone

    Island Health's own SMaCCS evaluation states plainly that current modes of communication — pagers, fax, and telephone — are inadequate for contemporary clinical needs, requiring laborious manual processes.

    Finding · 02
    Code activation is serial, not parallel

    The CST Cerner STEMI workflow has the ED provider activate Code STEMI and then call the interventional cardiologist, with the cath lab team notified separately by call-out. Each link is one human dialling one number.

    Finding · 03
    On-call data lives apart from the phone

    VCH/PHC on-call scheduling and MOCAP sit in an internal web application. Switchboard reads it; nothing dials from it automatically.

    Finding · 04
    Overhead paging assumes you are in the building

    Fraser Health maintains a formal overhead paging policy. It is a broadcast to a physical space — not a routed, acknowledged message to a named person.

    Finding · 05
    There is no acknowledgement layer

    Across these workflows, nothing records who received an activation, when, and whether they responded. Escalation depends on someone noticing the silence.

    Finding · 06
    Departments go dark and the line still rings

    Nearly 2,400 temporary ED closures were recorded in B.C. between 2023 and 2025 — at least one department closed on more than 900 of 1,095 days. Those phone lines do not close with the doors.

    Data resident in Canada (AWS ca-central-1 / Azure Canada Central). PHIPA, PIPA-BC, PIPEDA-aligned. US health systems served from HIPAA / HITECH-compliant regions with BAA in place.

    Governance

    Procurement-ready from day one.

    Full documentation package for your Privacy Officer, CMIO, and CIO — PIA / TRA templates, BAA, DPA, penetration test summary, and a named clinical safety officer.

    §Privacy Impact Assessment (PIA) — pre-filled for BC health authorities
    §Threat Risk Assessment (TRA) — SOC 2 Type II underlying controls
    §Business Associate Agreement (BAA) — HIPAA §164.504(e)
    §Data Processing Addendum (DPA) — PHIPA / PIPA / GDPR-aligned
    §Clinical Safety Case File — DCB0129 / DCB0160 style
    §Named Clinical Safety Officer & 24/7 escalation contact
    The Ward-Level Pilot

    Start with one ward.
    Measure the silence recovered in 30 days.

    We deploy MarcoMed on a single unit — often after-hours nurse-line or a specialty clinic within the hospital — with your protocol, your voice, your escalation. You keep the log. You keep the metrics. You decide.