In the Cambrian Mall on Great Northern Road in Sault Ste. Marie, Ont., the Algoma District Public Health clinic is doing a brisk business - a smooth flow of patients coming and going for flu shots.
No frustrating lineups. No one turned away because the vaccine supply has run out or the staff is overrun.
Why is the Soo's system working so well? Because all of the vaccinations were given by appointment.
In the past week, some 23 staffers at a local call centre have been working 12 hours a day booking appointments - 3,500 a day, according to a spokeswoman - for residents of the district at vaccination clinics at the Mall and in Elliot Lake, Wawa, Blind River and other area towns.
Patients simply call the hotline, make their appointment, show up at the designated place and time and roll up their sleeves, and off they go.
As demand for H1N1 flu vaccine rises exponentially across Canada, health officials in other areas are struggling to find a model for fast and efficient delivery.
That Sault Ste. Marie (population 80,000) should be showing the rest of the country leadership on dealing with the new pandemic is perhaps no surprise.
For two decades, it has been in the vanguard of public health-care delivery, marshalling limited resources to maximum effect. Not for nothing did Roy Romanow, former head of the royal commission on the future of health care, call its approach "the best-kept secret in the country." Not for nothing did Michael Decter, chairman of the Health Council of Canada, tell local officials that the Sault Ste. Marie community had built an enviable track record in procedures and co-operation that other Ontario towns and cities were only beginning to consider.
Today, while other communities are still scrambling to organize a coherent strategy for H1N1 immunization, a private-public partnership in the Soo is using the Group Health Centre's telephone lines to book the appointments electronically and reducing waits to a minimum.
"Our philosophy is to get people in and out as quickly as possible," said Elizabeth Bodnar, spokeswoman for the health centre. "This approach allows us to know every day exactly how much vaccine and staff we will need."
Her 60-physician facility, the city's largest medical clinic, switched to electronic record keeping for patients almost two decades ago. It has been working in tandem with officials at Algoma Public Health for 12 years to expedite delivery of seasonal flu shots.
"This partnership has worked very well for us," said Allan Northan, chief medical officer of health for the Algoma district.
The effects are seamless. As patients are immunized, vaccine dosages and other relevant medical information are automatically entered into an electronic record.
The sole frustration, Dr. Northan said, is that demand for appointments is running so high that it's occasionally difficult to reach a call-centre operator.
The flood of initial calls was so great that the Group Health Centre worked with Bell Canada to isolate the flu-booking lines from its other lines, letting patients get through more easily.
Dr. Northan said that in addition to its own clinics, the public health agency is planning to hold evening vaccination clinics at schools.
The Algoma agency started discussing the electronic appointment method for H1N1 vaccination two months ago.
Dr. Northan said Algoma is the only health district in the province that he knows of that is using a computerized system for appointments. "It's probably too late for other jurisdictions to set this up," he said. "They're busy as heck. But there's no reason why, eventually, the entire province could not do it."
Although many communities might not have the infrastructure to support call centres, Ms. Bodnar suggested that the Public Health Agency of Canada could contract with commercial call centres and offer 1-800 numbers to facilitate appointment bookings for community clinics.