{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:40:53Z","timestamp":1792705253872,"version":"4.5.0"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Healthc Manage Forum"],"abstract":"<jats:p>The Thunder Bay Regional Health Sciences Centre On-Call Cardiology Support Service serves a geographically vast region across Northwestern Ontario where cardiovascular disease is a major burden. The objective is to analyze service utilization patterns including locations, indications, interventions, and barriers. In this 6-month prospective study, cardiologists collected data via survey on calls from rural and remote providers. Descriptive statistics and Fisher\u2019s exact test were used. The Canadian Institute for Health Information\u2019s Rural Health Systems Model was used for interpretation. Two hundred and six responses across 19 locations identified: common consultations\u2014chest pain, dyspnea, and atrial fibrillation; frequent interventions\u2014medical recommendations, education, and transfer decisions; key barriers\u2014limited personnel knowledge and infrastructure. Significant associations were identified. This study characterized cardiology support service utilization across Northwestern Ontario, identifying key barriers and opportunities to strengthen rural health systems planning and cardiovascular care. 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