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When Dr. Justin Hall started his 7 a.m. shift in the ER at Toronto’s Sunnybrook Health Sciences Centre on a recent Wednesday, there were already more than 60 patients waiting.
Sunnybrook is one of the busiest hospitals in Canada, with the country’s largest trauma centre and burn centre.
It also has the distinction of having the longest wait time in Ontario. In 2024, the median length of stay for patients at Sunnybrook was eight hours and 13 minutes.
That means half the patients in Sunnybrook’s emergency department waited even longer, from the moment they first registered to the moment they left.
“It’s a big problem,” said Hall, who is Sunnybrook’s chief of emergency medicine.
But in July, the hospital started a pilot using artificial intelligence to help speed up service in the ER.
As Hall asks patients to describe their symptoms, an AI-enabled app called DAX Copilot listens in from his pocket and acts as a scribe. The app organizes and summarizes the conversation between doctor and patient.
Physicians are also able to input anything they know about the patient before having the conversation — such as if they had bloodwork or tests done. The doctor reviews the AI-gathered information, which is then transferred to the patient’s file.
Hall said it means doctors spend less time on note-taking and more focusing on people.
“When I see the patient, I can make a decision faster for them, trying to decrease their length of stay here,” Hall explained, noting that he gets the patient’s consent before using the AI tool.
Hall said the hospital is currently analyzing how much time the AI trial is saving doctors. But in a document on its website, Sunnybrook says the app will reduce the time physicians spend on manual documentation by an average of seven minutes per encounter.
Hall said it supports “a better patient interaction and decreases some of the cognitive burden [for the doctor] because it’s taking away some of that thought process … we still have to apply our medical knowledge to that, but it does certainly take away a bit of the administrative burden as well.”
The Toronto hospital let Marketplace shadow its chief of emergency medicine for a shift to show the daily reality for patients and staff in the emergency department as it tries to reduce long wait times.
Private donor dollars allow for extra overnight doctor
Sunnybrook has also been looking beyond technology to find solutions — including using funding from private donors.
When determining how many hours of physician coverage a given hospital receives money for, Ontario’s current funding model doesn’t account for the complexity of individual patients’ cases.
For example, during Hall’s recent shift, two patients were assessed at the same triage level. Hall discharged one of them and recommended they take over-the-counter cough medication. The other patient stayed for 12 hours, required multiple exams and saw doctors from multiple departments.
Under the current system, the hospital gets the same amount of funding for both patients.
Hall said Sunnybrook has been using donations from private hospital funders to add another doctor to the overnight rotation — something many hospitals in the country can’t afford to do. The hospital says the overnight physician is a part of a temporary pilot study.
Sunnybrook says it has brought down the wait to see a doctor in the emergency department by about 30 minutes.
“I’m grateful that we have donors who are willing to step up here, because they see the potential and we’ve been able to show that in our results in our data as well,” Hall said.
Ontario’s health minister, Sylvia Jones, declined an interview with Marketplace about how the province is addressing long wait times.
In a statement, ministry spokesperson Ema Popovic said the province has made “record investments” in health care in the past three years, including $44 million to tackle ER wait times.
