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How collaboration shaped my experience with innovation

On a house call with my team a few years ago, we noticed something that shocked me―my patient had neither electricity or heat at home. It was cold, and I recall my nurse kept a winter jacket on. It was the first time we had to conduct a visit by flashlight. To say I was surprised would be an understatement. That moment made an impression on me and it became clear this was a patient that otherwise would not be receiving quality care. 

We all recognize that the relationship between patients’ incomes and their health is deeply intertwined. One’s postal code or bank account should not impede their ability to access care. This recurring pattern is something I noticed early on in my practice, and it was going to sink our health care system if we didn’t address it.

I’m sure you’re wondering how I was able to reach the patient I mentioned above at home. The truth is, if I were to get in my car and drive to patients who can’t meet me in my clinic—whether it be due to limited mobility, chronic conditions, post-discharge―I would only be able to make around four to five house calls per day. For a primary care provider in the urban core of Hamilton, that’s just not feasible. The difference with my house calls is that they’re virtual.

That’s why I created Rapid Access Medical Care―or RAMCare―a virtual house call program that allows primary care physicians like me to maintain clinical visits, all while providing hard to reach patients with access to consistent care virtually.

Visiting my patients face-to-face, wherever they may be, is a nurse with a house call bag. It includes all the tools you would imagine in a traditional doctor’s bag, but with one difference―it’s boosted by technology: a stethoscope, an otoscope, a blood pressure cuff and a wifi-enabled tablet. It even includes a dermascope.

What really started to move RAMCare forward in a material way is when I began collaborating with others. While working with Joule after receiving one of their Innovation grants in 2017, I was connected with like-minded physicians. These are physicians I still work with today, such as Dr. Yanick Beaulieu who founded IIT Reacts, an integrated and secure collaborative platform we use. Thanks to that partnership, we’re in the process of adding additional tools such as a portable ultrasound attachment to our virtual house call bag.

Without disruptive change and the application of technology to health care, I think the universal health care system we’re so proud of is going to go by the wayside and I don’t want to see that happen—I think there’s a lot of people that share that opinion. My advice? Find the right allies and forge the transformational path ahead.


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This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries including Joule.  Feel passionate about physician-led innovation? Please connect with us at


About the author(s)

Dr. Dennis DiValentino is a family physician in Hamilton, ON. In 2017, he received a Joule Innovation grant for his social innovation, Ramcare, to help provide care to marginalized individuals using mobile tele-medical units. Ramcare represents a potentially transformative solution for marginalized populations encountering serious mental illnesses, addiction issues and to elderly patients who are immobile and do not have a caregiver at home.

Profile Photo of Dr. Dennis DiValentino