Michelle Greiver

Dr Greiver is a family physician and primary care researcher at the University of Toronto. As Acting Director, she oversees the Electronic Medical Record data system as well as clinical research activities for UTOPIAN, the University of Toronto Practice Based Research Network (PBRN), which includes over 1,400 family physicians and is the largest PBRN in Canada. She chairs the PBRN national Action Group and is a member of the Council, Section of Researchers, College of Family Physicians of Canada. She leads the Health Informatics Goal Group for the CIHR SPOR Network, Diabetes Action Canada, which is initiating a national Diabetes Data Repository.

Dr Greiver’s research project, Implementation of electronic medical records: Effect on the provision of preventive services in a pay-for-performance environment, won the 2012 Canadian Family Physician best original research article award.

Research Synopsis

I have chosen the path of being a community-based, practice-oriented researcher.   Relentless curiosity about problems affecting my patients, my practice, my colleagues’ practices and our broader primary care context is my core driver.   I have organized this curiosity into a body of work that uses research to improve daily care and bring evidence into practice and I have created practical tools used to improve the quality of care provided to patients.  

My research has concentrated on meaningful use of electronic data to support the development of primary health care, through increasing research capacity and translating the use of data into better care. I was a founding member of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), Canada’s multi-EMR chronic disease surveillance system, and continue to be the director of its Toronto network.  The Toronto network is the largest single contributor of data at CPCSSN, with over 400,000 EMR records, and has the largest number of publications.  It was the site of the first collaboration between CPCSSN and Canada Health Infoway.

I have contributed to building community-based Practice Based Research Networks, through NorTReN (both as a founding member and lead for some years) and UTOPIAN, the University of Toronto Practice Based Research Network (as one of the founders and an executive committee member).  UTOPIAN is the largest PBRN in Canada; it includes all 14 academic units at the Department of Family and Community Medicine, University of Toronto, and its affiliated teaching practices, about 1,400 clinicians.  I am UTOPIAN's Deputy Director.  I have mentored others within the PBRN: two of the first three UTOPIAN seed studies were led by local investigators at North York.  Locally, PBRN research has been an integral part of Family Medicine at North York for years.  

Recent Publications

Greiver M, Sullivan F, Kalia S, Aliarzadeh B, Sharma D, Bernard S, Meaney C, Moineddin R, Eisen D, Rahman N, D'urzo A. Agreement between hospital and primary care on diagnostic labeling for COPD and heart failure in Toronto, Canada: a cross-sectional observational study. npj Primary Care Respiratory Medicine. 2018 Mar 9;28(1):9. Principal Author
 

Kalia S, Greiver M, Zhao X, Meaney C, Moineddin R, Aliarzadeh B, Grunfeld E, Sullivan F. Would you like to add a weight after this blood pressure, doctor? Discovery of potentially actionable associations between the provision of multiple screens in primary care. J Eval Clin Pract. 2018 Jan 19. Senior Responsible Author
 

Birtwhisle R, Greet ME, Frymire E, Dahrouge S, Whitehead M, Khan S, Greiver M, Glazier R. Hospital admission rates and emergency department use in relation to glycated hemoglobin in people with diabetes mellitus: a linkage study using electronic medical record and administrative data in Ontario. CMAJ Open. 2017 Jul 11;5(3):E557-64. Coauthor
 

Coons MJ, Greiver M, Aliarzadeh B, Meaney C, Moineddin R, Williamson T, Queenan J, Yu CH, White DG, Kiran T, Kane JJ. Is glycemic control in Canadians with diabetes individualized? A cross sectional observational study. BMJ Open Diab Res & Care. 2017 Jun 8;5(1):e000316. Senior Responsible Author
 

Loo CKJ, Greiver M, Aliarzadeh B, et al. Association between neighbourhood walkability and metabolic risk factors influenced by physical activity: a cross-sectional study of adults in Toronto, Canada. BMJ Open 2017;7: e013889. doi:10.1136/bmjopen-2016-013889. Coauthor
 

Southgate D, Greiver M, Hubka G, Kostka K, Moineddin R, Moienedin M, Pencharz J, Bogetta H, Mazariegos C, Guindon JA, Petroff A. Effect of a group behavioural management program on emotional regulation of food choices: a pilot Randomized Controlled Trial. Canadian Journal of Dietetic Practice and Research. 2017 Mar 23:1-4. Senior Responsible Author
 

Greiver M, Wintemute K, Aliarzadeh B, Martin K, Khan S, Jackson D, Leggett J, Lambert-Lanning A, Siu M. Implementation of data management and effect on chronic disease coding in a primary care organisation: A parallel cohort observational study. J Innov Health Inform. 2016 Oct 12;23(3):843. Principal Author.
 

Aliarzadeh B, Meaney C, Moineddin R, White D, Birken C, Parkin P, Greiver M. Hypertension screening and follow-up in children and adolescents in a Canadian primary care population sample: a retrospective cohort study. CMAJ Open. 2016 May 5;4(2):E230-E235. Available from: http://cmajopen.ca/content/4/2/E230.full. Senior Responsible Author.
 

Greiver M, Aliarzadeh B, Meaney C, Moineddin R, Southgate CA, Barber DT, White DG, Martin KB, Ikhtiar T, Williamson T. Are We Asking Patients if They Smoke?: Missing Information on Tobacco Use in Canadian Electronic Medical Records. Am J Prev Med. 2015 Aug 1;49(2):264-8. Principal Author.
 

Leggett JA, Greiver M, Manca D, Williamson T, Martin K, Queenan J. Facilitating informatics for research using health data aggregated from EMRs across multiple jurisdictions through the implementation of a Privacy by Design privacy and information security architecture. Proceedings of the 17th international symposium for health information management. 2015 Jun 26;17:231-242. Coauthor or Collaborator.
 

An J, Keshavjee K, Mirza K, Vassanji K, Greiver M. Bridging a divide: architecture for a joint hospital-primary care data warehouse. Stud Health Technol Inform. 2015 Jan 1;208:45-9. Senior Responsible Author.
 

Greiver M, Williamson T, Barber D, Birtwhistle R, Aliarzadeh B, Khan S, Morkem R, Halas G, Harris S, Katz A. Prevalence and epidemiology of diabetes in Canadian primary care practices: a report from the Canadian Primary Care Sentinel Surveillance Network. Can J Diabetes. 2014 Jun 1;38(3):179-85. 2014 Jun;38(3):179-85. doi: 10.1016/j.jcjd.2014.02.030. Epub 2014 May 14. Principal Author.
 

Manca DP, Greiver M, Carroll JC, Salvalaggio G, Cave A, Rogers J, Pencharz J, Aguilar C, Barrett R, Bible S, Grunfeld E. Finding a BETTER way: A qualitative study exploring the prevention practitioner intervention to improve chronic disease prevention and screening in family practice. BMC Fam Pract. 2014 Apr 11;15(60):66. Coauthor or Collaborator.
 

Aliarzadeh B, Greiver M, Moineddin R, Meaney C, White D, Moazzam A, Moore KM, Belanger P. Association between socio-economic status and hemoglobin A1c levels in a Canadian primary care adult population without diabetes. BMC Fam Pract. 2014 Jan 10;15(1):7. Co-Principal Author.
 

Campbell-Scherer D, Rogers J, Manca D, Lang-Robertson K, Bell S, Salvalaggio G, Greiver M, Korownyk C, Klein D, Carroll JC, Kahan M, Meuser J, Buchman S, Barrett RM, Grunfeld E. Guideline harmonization and implementation plan for the BETTER trial: Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice. CMAJ Open. 2014 Jan 1;2(1):E1-E10. 2014 Jan 22;2(1):E1-E10. doi: 10.9778/cmajo.20130040. eCollection 2014 Jan. Coauthor or Collaborator.
 

Greiver M, Williamson T, Bennett TL, Drummond N, Savage C, Aliarzadeh B, Birtwhistle RV, Khan S, Canadian Primary Care Sentinel Surveillance Network. Developing a method to estimate practice denominators for a national Canadian electronic medical record database. Fam Pract. 2013 Jun;30(3):347-54. Principal Author.
 

Greiver M, White D, Kaplan DM, Katz K, Moineddin R, Dolabchian E. Where should automated blood pressure measurements be taken? Pilot RCT of BpTRU measurements taken in private or nonprivate areas of a primary care office. Blood Press Monit. 2012 Jun;17(3):137-8. Principal Author
 

Greiver M, Barnsley J, Glazier RH, Harvey BJ, Moineddin R. Measuring data reliability for preventive services in electronic medical records. BMC Health Serv Res. 2012 May 14;12:116 Principal Author.
 

Greiver M, Barnsley J, Glazier RH, Moineddin R, Harvey BJ. Implementation of electronic medical records: effect on the provision of preventive services in a pay-for-performance environment. Can Fam Physician. 2011 57: e381-e389. Principal Author.
 

Greiver M, Barnsley J, Glazier RH, Moineddin R, Harvey BJ. Implementation of electronic medical records: theory-informed qualitative study. Can Fam Physician. 2011 57: e390-e397. Principal Author.
 

Greiver M, Aliarzadeh B, Moineddin R, Meaney C, Ivers N. Diabetes screening with hemoglobin A1c prior to a change in guideline recommendations: prevalence and patient characteristics. BMC Fam Pract. 2011 Aug 24;12:91 Principal Author.

Honours and Awards

2017 Best QI poster, NAPCRG PBRN Conference.  Choosing Wisely: Monitoring Quality Improvement efforts to reduce thyroid screening in primary care.  Kimberly Wintemute, Michelle Greiver, Warren McIsaac, Lisa DelGiudice, Frank Sullivan, Babak Aliarzadeh, Sumeet Kalia, Chris Meaney, Rahim Moineddin, Alex Singer, Marwan Asalya, Deepak Sharma.

2017 Research Program Awards; Third Place. Implementation of data management and effect on chronic disease coding in a primary care organization: A parallel cohort observational study. University of Toronto Department of Family and community Medicine.

2017 Best Research Poster, DFCM Conference.  Trends in systematic recording errors for blood pressure in a Canadian Primary Care Population.  Sumeet Kalia, Michelle Greiver, Babak Aliarzadeh, Teja Voruganti, Rahim Moineddin, Martin Dawes, Frank Sullivan, Saddaf Syed, Simon de Lusignan.

2017 Best Poster, Joint Centre for Bioethics 2017 Annual Research and Awards Celebration. Diabetes Action Canada’s data repository for patient-oriented research. Willison DJ, Trowbridge J, Sullivan F, Keshavjee K, Greiver M.

2012 Canadian Family Physician Best Original Research Article Award, College of Family Physicians of Canada. (Distinction)
Award given for a scientific article published in 2011 in Canadian Family Physician resulting from a research project developed, financed and completed by the authors.  
Greiver M, Barnsley J, Glazier R, Moineddin R, Harvey B.  Implementation of electronic medical records:  Effect on the provision of preventive services in a pay-for-performance environment.  Can Fam Phys October 2011;57;e381-e389.

2015 Research Excellence (Junior), University of Toronto Department of Family and community Medicine. (Distinction)
Awarded by Department once a year for excellence in research

2014 Bright Light, Principal investigator, Association of Family Health Teams of Ontario, Ontario, Canada. (Distinction, Specialty: Family Medicine). Using data to improve transitions of care and care coordination: Making it easier for teams to access data needed to improve care.  Awarded to North York Family Health Team for its use of the Data Presentation Tool software to enable the return of cleaned and standardized data to the Team.  This enabled the generation of multiple reports to support feedback and quality improvement activities.  The project has been spread to multiple other teams and left a legacy of tools and templates. Total Amount: 3,000 CAD

2001 Pfizer Investigator-in-Practice Award, North American Primary Care Research Group. (Distinction).  Best research project by a practicing family physician in North America.

Grants

2018 - 2022    Co-Investigator. Operating Grant: SPOR Innovative Clinical Trial Multi-Year Grant / Subv. de fonctionnement: Subv. pluriannuelle :essais clin. novateurs de la SRAP. CIHR and the Strategy for Patient-Oriented Research (SPOR), 398514. PIs: Ivers NM, Garber GW, Greenberg A, Gomes T, Grimshaw JM, Angle EN, Taljaard M. Co-Investigator: Brehaut J, Brown K, Daneman N, Desveaux L, Francis J, Glazier R, Greiver M, Kidd M, Kiran T, McIsaac W, Morris A, Presseau J, Szhwarts K, Silverman M, Tepper J, Travorn K, Vance G, Witteman H, Zwarenstein M.  $1,000,000 CAD. [Grants]

2018 - 2022    Principal Investigator.  SPIDER-NET, A Structured Process Informed by Data, Evidence and Research-Network: An approach to support primary cared practices in optimizing the management of patients with complex needs. CIHR Primary and Integrated Care Innovation Networks Programmatic Grant .PI: Greiver M.  Knowledge Users: O’Brien T; Twohig M. Co-Investigators: Burge F, Ivers NM, Singer AG, O’Brian PA, Dahrouge S, Lussier  MT,  Drummond NA, Manca DP. $1,000,000 CAD. [Grants]

2018 - 2020    Collaborator A Structured Process Informed by Data, Evidence and Research – Network (SPIDERNET) in Optimizing the Care for Patients with Complex Needs and Multiple Medications. MEDTEQ. FSISSS. PI: Lussier MT; Collaborators: Greiver M, Dahrouge S, Vachon B, Duhoux A, Turner J, Pomey MP, Menear M, Motulsky A, Skrobik Y, Gaboury I, Tremblay JL. $144,000 CAD. [Grants]

2018 - 2020    Co-Investigator. Automated screening, triage, and follow-up to facilitate proactive, personalized postpartum mental health treatment for new parents. Catalyst Grant: Personalized Health Catalyst Grants PI: Ivers NM, Greenberg A, Agarwal P, Dennis CLE, Vigod SN. Co-Investigators: Brown EM, Greiver M, Heisey RE, Kaplan DM, Bhatia RS, Desveaux L, Griffith J, Jamieson T, Witteman HM:  $189,943 CAD [Grants]

2017 Nov - 2021 Nov    Co-Investigator A Cluster-Randomized Trial Comparing Team-Based versus Primary Care Clinician-Focused Advance Care Planning in Practice-Based Research Networks. PI Totten A.M., Legare F. Patient Centered Outcomes Research Institute (PCORI) $8,009,505 USD [Grants]

2017    Co-Investigator OCE# 27016, Patient Portal for Breast Cancer Survivorship. Osman F, Enmore M, Wood M, Kastner M, Greiver M, Millar M, Cheung D, Pejic S, Squires-Cooper S. Ontario Centres of Excellence’s (OCE’s) Health Technologies fund (HTF) $500,000 CAD. [Grants}

2016 Mar - 2021 Mar    Co-Investigator. SPOR Network in diabetes and its related complications. Canadian Institutes of Health Research (CIHR). SPOR networks in chronic disease. 358047. PI: Lewis, Gary. Collaborator(s): Brown, Adalsteinn; Maberley, David; Rochon, Paula; Sullivan, Frank; Brent, Michael; Belanger, Mathieu; Cafazzo, Joseph. 25,000,000 CAD. [Grants]

2016 Feb - 2017 Feb    Co-Principal Investigator. Generation and evaluation of a cohort of high risk heart failure and COPD patients using the NYGH Joint Data Warehouse. North York General Hospital. Exploration Fund. PI: Greiver, Michelle. Collaborator(s): Sullivan Frank, Eisen David, Aliarzadeh Babak, Wong Eugene, Sharma Deepak, Meaney Christopher, Moieneddin Rahim, D’Urzo Tony, Abdelhalim Tarek. 20,520 CAD. [Grants]

2012 Dec - 2013 Jun    Co-Investigator. Effect of Craving Change-Plus on chronic disease self-management: a pilot RCT. University of Toronto. DFCM, UTOPIAN PBRN seed funding. PI: Soutgate, Danuta. Collaborator(s): Greiver M, Bogetta H, Wymer R, Wintemute K, Ryall P, Kostka K, Hubka G, Grunfeld E. 25,000 CAD. [Grants]

2010 Jun    Principal Investigator. EMR data quality management methods: a feasibility study. Ontario Ministry of Health and Long-Term Care. Primary Health Care System Program. Collaborator(s): Greiver M, Barnsley J, Krueger P, Aliarzadeh B, Moineddin R, Butt D, Drummond N, Jaakkimainen L, Keshavjee K, White D, Kaplan D. 10,000 CAD. [Grants]

2010 Mar - 2015 Mar    Co-Investigator. A Canadian Primary Care Sentinel Surveillance Network (CPCSSN). Public Health Agency of Canada (PHAC). PI: Birtwhistle R, Rosser W. Collaborator(s): Lambert-Lanning A, Grava-Gubins I, Drummond N, Godwin M, Greiver M, Katz A, Lussier M-T, Manca D, Putnam W, Stewart M. (Co-investigators). 11,682,685 CAD. [Grants]
Enhanced Chronic Disease Surveillance Contribution Program of the Healthy Living and Chronic Disease Strategy Component: Sentinel Surveillance for Primary Care contributon: $11,682,685 / In-kind contributions: $3,705,749; local budget: $661,734 / In-kind: $347,500.

2009 Oct - 2012 Mar    Co-Investigator. Building on Existing Tools to Improve Chronic Disease Prevention in Family Practice: The BETTER Coalition. Canadian Partnership Against Cancer. Coalitions Linking Action and Science for Prevention (CLASP). PI: Grunfeld, Eva. Collaborator(s): Grunfeld E and the BETTER Investigators. 2,500,000 CAD. [Grants]