Project ECHO Occupational and Environmental Medicine (OEM): Implementation and evaluation

Reasons for the study

Primary health-care providers in Ontario play an important role in the recovery, return to work and disability management of injured workers. However, they receive little training related to occupational medicine, work functioning and workers' compensation systems, and they complain of frustration with complex cases and the burden of dealing with the Workplace Safety and Insurance Board (WSIB).

Project ECHO (Extension for Community Health-care Outcomes) is an innovative, telementoring program that was first conceived in 2003 by a doctor at the University of New Mexico who was looking for a way to reach remote, under-served communities. The ECHO model uses a hub-and-spoke knowledge-sharing approach where expert teams lead virtual clinics, amplifying the capacity for providers to deliver best-in-practice care to the underserved in their own communities. Since then, the model has been taken up in countries around the world.

In 2014, IWH Scientist Dr. Andrea Furlan (in her capacity as a physician at Toronto Rehabilitation Institute) implemented the first Project ECHO in Canada, with a focus on increasing capacity of primary care physicians in Ontario to manage complex chronic pain cases. Now, Furlan is leading a research team based at IWH that is implementing another Project ECHO—this one a pilot to develop, implement and evaluate the first ECHO in occupational and environmental medicine (OEM) in the world.

This pilot will use weekly, videoconference case-based discussions to connect an inter-professional team of OEM experts with physicians and nurses in rural and remote areas of Ontario. The aim is to increase the capacity of primary health-care providers across the province to better manage patients with complex work-related injuries and diseases or environmental exposures.

Objectives of the study

  • Successfully implement an ECHO OEM in Ontario
  • Evaluate the performance of ECHO OEM in increasing the capacity of primary-care settings to manage patients with work-related injuries and diseases or environmental exposures
  • Improve the engagement of primary-care physicians with the WSIB with respect to patient care

Target audience

ECHO OEM has the potential to positively improve the outcomes of injured and ill workers in Ontario, thus improving the outcomes of Ontario's health system more broadly.

Related research summaries

Related scientific publications

Related interviews and articles

Project status


Project website

Research team

Collaborators and partners

  • ECHO Institute at the University of New Mexico
  • ECHO Ontario Superhub
  • Association of Family Health Teams of Ontario (AFHTO)
  • Canadian Board of Occupational Medicine (CBOM)
  • Centre for Addiction and Mental Health (CAMH)
  • Centre for Research Expertise in Occupational Disease (CRE-OD)
  • Lakehead University
  • Nurse Practitioners’ Association of Ontario (NPAO)
  • Occupational Health Clinics for Ontario Workers (OHCOW)
  • Occupational Medicine Specialists of Canada (OMSOC)
  • Ontario Occupational Health Nurses Association (OOHNA)
  • St. Michael’s Hospital
  • University of Toronto
  • Workplace Safety and Insurance Board (WSIB)

Funded by

Workplace Safety and Insurance Board