INSPIRE PHC - Primary Health CAre Program:INnovations Strengthening PrImary Healthcare REsearch
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Research Leads

Dr. Clare Liddy Dr. Clare Liddy
Research Director and Professor, Department of Family Medicine, McMaster University
Clinical Scientist, C.T. Lamont Primary Health Care Research Centre of the Bruyère Research Institute; Associate Professor, Department of Family Medicine with a cross-appointment to the Department of Epidemiology and Community Medicine, University of Ottawa.
Lisa Dolovich, Erin Keely, Claire Kendall, Cathy Smyth, Amardeep Thind
Lois Crowe
Project Manager
Research Project Links

PC Reform
Optimizing quality, access, integration and equity in Ontario primary care

Care in the Home (TAPESTRY)
Primary health care linking with community (TAPESTRY-CM)

Community Linkage - SCOPE
Enhancing PHC linkages with home care and hospitals (SCOPE)

Specialist Linkage -eConsult
Creating new PHC linkages with specialists

Knowledge Translation Exchange (KTE)

Sex and Gender Analysis

Research Projects...


Specialist Linkage - eConsult
Creating new PHC linkages with specialists - eConsult


Champlain Base - eConsult

Research Question:
What is the impact on referral rates of, and the patients' perceptions of, an electronic consultation service (eConsult) between primary care professionals and specialists? Intervention: Using a pre-existing, secure web-based collaboration space, PC professionals will submit a patient-specific clinical question to a specialist using a standardized electronic form that permits attachments (e.g., laboratory results, digital images).

The specialist responds within one week by either:

  • directly answering the question (negating the need for referral);
  • asking for additional patient information; or
  • requesting an in-person referral..

A mixed methods evaluation approach will be used.

A clustered randomized controlled trial will use a stepped wedge design, a type of crossover study in which different groups cross over from the control arm to the intervention arm at different time points. The change in referral rates will be compared from ICES through OHIP and Physician Database (IPDB) databases (including referrals and their costing algorithms), between baseline and intervention years for both Groups while controlling for temporal effects.