What is ECHO OEM?

ECHO Occupational and Environmental Medicine (ECHO OEM) is a pilot telementoring program for primary health-care providers in Ontario. It aims to increase their capacity to treat and support patients with environmental exposures or conditions that affect their ability to work.

ECHO stands for Extension for Community Healthcare Outcomes. It is an innovative telementoring model conceived in 2003 by Dr. Sanjeev Arora at the University of New Mexico, who was looking for a way to improve health-care providers’ expertise in remote, rural and underserved communities.

The model uses a hub-and-spoke approach. Primary health-care providers (the "spokes") meet weekly via videoconference for interprofessional, case-based discussions. All providers have a chance to present their own patient cases and provide input on others' cases. A team of experts (the "hub") guide the discussions and provide summary recommendations to enable the providers to care for patients in their own communities. Learn more about the ECHO model.

The ECHO OEM project:

  • applies the ECHO model to primary health-care providers in Ontario who are treating patients with injuries and illnesses related to work or environmental exposures
  • includes a research component to determine its effectiveness in increasing the competency of health-care providers in occupational and environmental medicine
  • is a two-year pilot funded through the Workplace Safety and Insurance Board (WSIB) Grant Program
  • is being developed, implemented and evaluated by a team of researchers based at the Institute for Work & Health and University of Toronto (learn more about the research team)

Workplace safety and insurance board logo


Institute for Work & Health logo

University of Toronto logo

Who is ECHO OEM for?

ECHO OEM is for Ontario primary health-care providers who want to learn about best practices in occupational and environmental medicine to better support their patients in recovery and return to work or stay at work. Types of primary care providers include family physicians, physician assistants, nurse practitioners, registered nurses, psychologists, chiropractors, physical and occupational therapists, and more—any frontline health-care provider who treats patients with work-related injuries and illnesses.

It's for primary care providers who want to:

  • share their experience and knowledge with others
  • experience a learning approach that sticks
  • make new connections that last
  • obtain CME credits

To participate in ECHO OEM, providers must:

  • be licensed to practise in Ontario 
  • be currently practising (in a solo or team practice)
  • commit to present at least one patient case during a 12-week cycle
  • be able to communicate in English

Why is ECHO OEM needed?

Health-care providers in primary care settings play an important role in supporting patient recovery and return to work (RTW) or stay at work after a work-related injury or illness. However, providers typically receive little training in how to effectively support these patients and ensure their best recovery and return-to-work or stay-at-work outcomes.

As a result, frontline health-care providers are not always familiar with how to identify work injuries, illnesses or environmental exposures, how to assess a patient’s work function, or how to communicate with workplaces about modified work or accommodations. Many also experience difficulty dealing with workers’ compensation or other insurers and do not know how to communicate with them about medical diagnoses or recovery expectations.

It is not always possible for health-care providers to turn to colleagues for advice, especially providers who work in solo clinics or in remote, rural or under-served communities. This is where ECHO OEM comes in. It provides a forum for primary health-care providers to present complex patient cases and receive best practice advice from OEM specialists and other ECHO participants. This community of practice will build health-care provider capacity to improve the health and work outcomes of injured or ill patients.

How does ECHO OEM work?

The ECHO OEM pilot is being implemented in two cycles: one in Fall 2021 and one in Spring 2022. 

Each cycle comprises 12 videoconference sessions. Each session includes an expert-led didactic component and a case discussion component, in which participating health-care providers discuss their patient cases and hear recommendations from experts and each other about how to manage them.

Participation is open to primary care providers treating patients whose return to work or stay at work is not going as planned, whether the injury or health condition is work-related or not.

Participants must register to attend. Registration is free. See the program overview for details.

How was the ECHO OEM program developed?

The project team began developing the pilot ECHO OEM program in January 2021. It involved three main steps:  

  • an assessment of health-care provider learning needs to inform an OEM-specific ECHO curriculum  
  • recruitment of members for the "expert hub" to guide the ECHO OEM sessions, including professionals in occupational medicine, occupational health nursing, occupational therapy, occupational hygiene, chronic pain, mental health and workers' compensation  
  • consultations with other ECHO programs in Ontario and patient advocates to determine criteria for presenting patient cases and guidance recommendations for primary care providers. 

What is the ECHO OEM research component about?

Over the course of the pilot, the ECHO OEM research team will be conducting an evaluation of the feasibility and acceptability of ECHO OEM in Ontario. In particular, the team will assess the ability of the program to:

  • increase capacity of health-care professionals in primary care settings to manage patients with work-related injuries or illnesses and environmental exposures
  • improve communication between health-care providers and WSIB
  • improve access to care in remote and underserved communities
  • remain true to the ECHO model

The results of the ECHO OEM pilot project evaluation will be made available on this website.