Research Chair: Michelle Greiver, MD, CCFP, FCFP
Dr. Michelle Greiver holds the position of Gordon F. Cheesbrough Research Chair in Family and Community Medicine at North York General Hospital (NYGH) and is the Director of the University of Toronto Practice-Based Research Network (UTOPIAN). Dr. Greiver is a practising Family Physician in North York, an Associate Professor in the Department of Family and Community Medicine (DFCM) at the University of Toronto and an Adjunct Scientist at the Institute for Clinical Evaluative Sciences.
Dr. Greiver's goal is to enhance care through research that can be used in daily family practice to help patients and physicians. She has over 30 years of experience as a community-based family physician in Toronto, and has a strong track record of research achievements relevant to family and community medicine. Dr. Greiver also leads multi-site research collaborations and international studies using electronic medical records (EMR) data.
Current major research projects
Health Data Bank Collaborative
At North York General Hospital, Dr. Greiver initiated and led the development of the Health Databank Collaborative. This project joins primary care EMR and hospital data; this enables research on transitions of care, as patients with complex health problems receive care from both hospital and from their family physician in the community. Read more about the work done at NYGH on merging hospital and community data to advance research.
Dr. Greiver leads the UTOPIAN team, whose activities have grown since the research network was established in 2013. UTOPIAN is a network of over 1,400 family physicians in practices within the 14 DFCM academic sites throughout the GTA and beyond. The network brings together DFCM researchers, primary care clinicians and practices from all its academic sites to answer important health care questions and translate findings into practice.
One of the pillars of UTOPIAN is the UTOPIAN portion of the POPLAR Database, previously known as UTOPIAN Data Safe Haven. The Database is a secure researchable database comprised of de-identified primary care EMR data for more than 613,000 patients. The data is used for secondary data analyses and clinical research. With appropriate permissions and safeguards in place, it is also shared with trusted third parties such as Diabetes Action Canada (National Diabetes Repository), the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), and IC/ES for linkage with administrative data holdings.
The other pillar of UTOPIAN is the advocacy and support of clinical research and quality improvement in primary care. Family practice is the first point of contact for patients and where much of the care in Canada is coordinated. Yet relatively little primary care research has been done at this level: in fact, there are far more unanswered than answered questions. Many family physicians and practice staff members would like to contribute but find it difficult to take part in research endeavours. UTOPIAN has developed a range of supportive services for those interested, tailored to the needs of the individuals and their practices. Projects supported by UTOPIAN ranges from local studies to large international projects. Learn more about UTOPIAN.
Pimary Care Ontario Practice-Based Learning and Research Network (POPLAR)
The Primary Care Ontario Practice-Based Learning and Research Network, also known as POPLAR, is an initiative that connects six University affiliated Practice-Based Research Networks and a Community Health Centre across Ontario to securely collects de-identified EMR data and transfer the data into a researchable format to support family physicians and their practices in improving quality of care through research and quality improvement (QI) while nurturing their curiosity and life-long learning. Under the leadership of Dr. Greiver and colleagues, UTOPIAN is playing a pivot role in leading the development of POPLAR, including the establishment of strategic governance framework, the built of research and data infrastructure, and the enhancement of clinical research and QI capacities. Read more about POPLAR.
On a national level, Dr. Greiver leads a team of more than 50 investigators in a research project to support primary care practices in optimizing care for older patients with polypharmacy. The SPIDER (Structured Process Informed by Data, Evidence and Research) study will be conducted in seven Practice-Based Research Networks (PBRNs) across five provinces in one of the largest PBRN-Quality Improvement (QI) collaborations in Canada. The project involves patients, family physicians and other health professionals, health planners and QI coaches who will form a Learning Collaborative. As part of the Learning Collaborative, members will work together to test methods to improve care in ways that are practical, useful and sustainable in daily family practice. Read more about SPIDER.
National Diabetes Repository
Diabetes Action Canada is a pan-Canadian research organization consists of a diverse team of patient partners, researchers, health care providers, data specialists and health policy experts. The goal is to identify and address key areas of concerns that matter to patients living with diabetes through evidence-based research projects. Developed by Diabetes Action Canada, National Diabetes Repository provides a tool that enables researchers to unleash the power of data and to provide evidence necessary to guide the improvements in health care and the outcomes of those suffering. Led by Dr. Greiver, the proof-of-concept of the National Diabetes Repository was recently launched with success. Linked with the CPCSSN, the National Diabetes Repository currently includes data representing over 50,000 diabetic patients and the expansion of the database continues. Read more about the National Diabetes Repository.
Identifying and predicting T2 diabetic patients not receiving appropriate care at North York Toronto Health Partners, Ontario Health Team
The Chronic Care Management model specifies that care should be panel-based and proactive. Patients who are less likely to attend for care or do laboratory tests tend to have poorer health outcomes. Proactive outreach of this patient population is needed. This project leverages supervised machine learning algorithms to identify and predict patients with Type 2 Diabetes who are at high risk of missing recommended care to prompt a targeted outreach intervention. EMR data from the National Diabetes Repository will be included in the analysis. The project is led by Dr. Geiver and in collaboration with Dr. Ervin Sejdic, Research Chair in Artificial Intelligence for Health Outcomes at NYGH.
Data on Patient Record Trajectory for Linkage (DataPRinT Linkage)
Supported by the NYGH Exploration Fund, Dr. Greiver is leading this project that aims to discover methods of data linkage that do not require the transfer of data or identifiable information. If successful, this could provide more efficient ways to link health data from different databases while preserving privacy.
Phone: North York General Hospital: 416-756-6483
University of Toronto (Department of Family and Community Medicine): 416-978-5113
UTOPIAN, Department of Family and Community Medicine, University of Toronto
Institute for Clinical Evaluative Sciences
Diabetes Action Canada
Andrew Pinto, MD, CCFP, FRCPC, MSc
UTOPIAN Associate Director – Clinical Research