Dr. Emily Gard Marshall

Research interests

Dr. Marshall’s mixed-methods research examines primary healthcare from patient, provider, and system perspectives to address the quadruple aim: promoting population health, optimizing costs, enhancing patient experience, and supporting care team well-being. Foci include access, continuity, and comprehensiveness to improve equity and optimize outcomes across the life course, involving population data and vulnerable populations. She leads multiple pan-Canadian studies including the CIHR COVID-19 Rapid Response funded PUPPY-Study. Her research has been supported by more than $40 million in grant funding from tri-council, national, provincial, and university funding agencies ($3.1 million as principal investigator and $38 million as co-investigator). She has published over 40 peer-reviewed articles (23 as first or senior author) and given more than 160 invited and peer-reviewed conference presentations. Dr. Marshall is the 2020 recipient of the NAPCRG Mid-Career Researcher Award.

Selected grants and studies in progress

Canadian Institutes of Health Research.; COVID-19 May 2020 Rapid Research Funding Operating Grant $407,552
2020-2021
PUPPY- Problems Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year: A Longitudinal Mixed Methods Study with Rapid Reporting and Planning for the Road Ahead
NPI: Marshall EG Co-PIs: Breton M, Green M, Iseonor J, Mathews M; Co-PI’s: Andrew M, Ashcroft R, Bayoumi I, Bishop A, Bowles S, Burge F, Christian E, Cossette B, Dahrouge S, Dolovich L, Duhoux A, Edwards L, Gibson R, Grant A, Guénette L, Harris M, Kiran T, Lawson B, Lenskjold A, MacKenzie A, Martin-Misener R, McDougall E, McKay M, Mccarthy L, Morrison B, Muphy A, Sampalli T, Smithman M, d'Entremont-MacVicar E.

Canadian Institutes of Health Research (CIHR); Project Grant
$380,309
2020
Pandemic Planning for Primary Care: Lessons from Four Provinces
NPI: Mathews M CoPIs: Hedden L, Lukewich J, Marshall EG; Co I’s: Asghari S, Aubrey-Bassler K, Brown J, Christian E, Freeman T, Gill P, Kim G, McCracken R, Ryan B, Schacter G, Sibbald S, Strydom N, Terry A, Thind A, Wong E, Alexaiadis M, McKay M, Summers A, Wickett J, Young J.

Nova Scotia COVID-19 Health Research Coalition $35,000
Competitive
2020-2021
Primary Care and Pandemics: How do we get care to those who need it?
NPI: F Burge, Lenskjold A; Co I’s: Marshall EG, Zed J, Christian E, Sabri S, Grandy M, Ricketts J, Holland M.

SPOR PIHCI Network & Larry A. Green Centre
April 2020
Canadian Quick COVID-19 Primary Care Survey
PI: Etz, R., Wong S; Co-I’s: Burge, F, Marshall EG et al.

Nova Scotia Health Authority (NSHA); Research Fund. $25,000 Competitive
2020-2021
Pharmacists managing care for Unattached Patients in Nova Scotia: An exploration of pharmacists' perspectives
NPI: Marshall EG; Co-Is: Bowles S, Isenor J, Bishop A, Morrison B, Kennie-Kaulback N, Woodill L.

Canadian Institute of Health Research (CIHR) Project Grant: $592,876
2019-2022
The CUP Study: Comparative analysis of centralized waitlist effectiveness, policies and innovations for Connecting Unattached Patients to primary care providers. 
Marshall EG (NPI), Co-PI’s: Breton M, Green M; Co-I’s: Andrew MK, Ashcroft R, Bayoumi I, Burge F, Correa Woodrow A, Dahrouge S, Duhoux A, Edwards L, Gibson RJ, Kiran T, Lawson B, MacKenzie A, Martin-Misener R, Mathews M, McPherson C, Peddle S, Ryan Carson S, Sampalli T, Wong S; Collaborators: Bell K, Dube F, Grise H, Weld Viscount P, Yampolsky R.

Canadian Institute of Health Research (CIHR); Operating Grant: Transitions in Care – Best and Wise Practices Grant: $99,987
2019-2020
Assessing the effect of primary care models and access on unplanned, repeat hospitalizations across communities in Nova Scotia.
Kephart G (NPI); PI: Marshall EG; PKU: McPherson C; KU: Blackmore G; Co-I’s: Andrew M, Edwards L, Gibson R, Mathews M, Reid M, Sampalli T; Collaborator: Robinson A.

Canadian Institute of Health Research (CIHR) Project Grant: $100,000
2019-2020
Increasing Indigenous Participation in the Physician Workforce.
Mathews M (NPI); Co-PI: Shea J; Co-I’s: Bombay A, Bourgeault I, Doria N, Lukewich J, Marshall EG, Myers A; Collaborators: Romme K, Sturge Sparkes C, Wood M.

Canadian Institute of Health Research (CIHR) Project Grant: $1.2 million
2018-2022
Practice Patterns Among Early-career Primary Care Physicians and Workforce Planning Implications: A Mixed Methods Study.
Lavergne R (NPI), Marshall EG (Co-PI), Goldsmith L (Co-PI), Grudniewicz A (Co-PI), Rudoler D (Co-PI), Burge F, Gibson R, Glazier R, Hawrylyshyn S,  Hedden L, Hernandez-Lee J, Horrey K, Joyce M, Kiran T, MacKenzie A, Mathews M, McGrail K, McPherson C, Sampalli T, Scott I, Snadden D, Tomblin-Murphy G, Wong S.

Canadian Institutes of Health Research (CIHR). SPOR Pan-Canadian Network in Primary and Integrated Health Care Innovations: Management & Operations Grant $500,00
2015-2020
Nova Scotia Primary and Integrated Health Care Innovations Network.
Burge F (PI), Bower I (PI), Gibson R (PI). Co-Is: Jackson L, Kirk S, Marshall EG, Martin-Misener, Natarajan N.

Technology Evaluation in the Elderly Network (TVN) Strategic Impact Grant ($304,368 + $92,000 from partners)
2015-2017
Enhancing the primary healthcare system’s ability to identify and plan with seriously ill frail elderly
Urquhart R, Burge F (PI), Johnston G, Natarajan N, Tschupruk C, Lau F, Sampalli T, Marshall EG, Kotecha J, Manuel D, Tanuseputro P, Cash C.

Capital Health Research Fund (CHRF) $15,000
Competitive
2014-2015
Medication appropriateness and polypharmacy in long term care.
Marshall EG, Andrew M, Bowles S, Clarke B, Natarajan N.

Canadian Partnership Against Cancer ($1,499,981)
Competitive
2012-2015
Building on existing tools to improve chronic disease prevention and screening in primary care: The BETTER 2 project.
Grunfeld E, Manca D, Marshall EG.

Strategic Research Initiative Fund (SRIF), Dalhousie University $200,000
Competitive
2013-2015
Primary Healthcare: The foundation of the health care system getting stronger.
Burge F, Martin-Misener R, Murphy A, Whelan AM, Warner G, Piccinni H, Brown M, McNally M, Vallis M, Natarajan N, Sampali T, Marshall EG, Asada Yukiko.

Nova Scotia Health Research Foundation (NSHRF) Establishment and Development/Innovative Grant ($150,000)
Competitive
2012-2015
MAAP-NS: Models and Access to Family Physicians in Nova Scotia.
Marshall EG, Lawson B, Burge F, Chisholm J, Gibson R.

Canadian Institutes of Health Research (CIHR) Café Scientifique Program $2,475
Competitive
2013-2014
Innovations in Nursing Homes – Are they making a difference?
Fancey P, Keefe J, Marshall EG.

Capital District Health Authority (CDHA) Capital Health Research Fund ($50,000); Canadian Institutes of Health Research (CIHR) Network for End-of-Life Studies (NELS) ($5,000); Dalhousie University Department of Family Medicine ($20,000); CDHA Office of the Director of Continuing Care ($34,000). Total: $109,000 (of which $55,000 Competitive).
2010-2014
Improved outcomes with a new model of dedicated primary care physician and team approach for long-term care facilities? A mixed-methods study.
Marshall EG, Andrew M, Clarke B, Burge F, Archibald G, Jensen JL, Taylor A, Travers AH, Edgecombe N, MacLeod G.

Northwood Foundation and Nova Scotia Health Research Foundation (NSHRF) Establishment and Development/Innovative Grant ($50,000)
Competitive
2011-2014
HOME-Tech: Assistive technologies improving health outcomes and maintaining independence in the Elderly.
Kirkland S, Marshall EG, et al.

Selected publications

Nemiroff L, Marshall EG, Jensen JL, Clarke B, Andrew MK. Adherence to "No Transfer to Hospital" Advance Directives among Nursing Home Residents. Journal of the American Medical Directors Association, Epub ahead of print 2019 May 27. DOI: 10.1016/j.jamda.2019.03.034. https://www.jamda.com/article/S1525-8610(19)30329-9/fulltext?rss=yes

Breton M, Smithman MA, Vandesrasier A, Kreindler S, Sasseville M, Sutherland J, Green M, Jbilou J, Shaw J,  Marshall EG, Crooks VA, Brousselle A, Contandriopoulos D, Wong ST. Attaching Patients In Primary Care Through Centralized Waiting Lists: Seven Canadian Provinces Compared.  Health Reform Observer – Observatoire des Réformes de Santé, March 11, 2019; (4)1. https://mulpress.mcmaster.ca/hro-ors/article/view/3773

Lavergne MR, Scott I, Mitra G, Snadden D, Blackie D, Goldsmith LJ, Rudoler D, Hedden L, Grudniewicz A, Ahuja M, Marshall EG. (2019). Regional differences in where and how family medicine residents intend to practice: A cross-sectional survey analysis. CMAJ Open, February 2019; Vol. 7, No. 1: E124-E130, February 2019.  http://cmajopen.ca/content/7/1/E124.full. 

Marshall EG, Clarke B, Peddle S, Jensen JL (2015) “Care by Design”: A New Model of Care in Long-Term Care Facilities Providing Residents Coordinated On-Site Primary and Acute Care. Canadian Family Physician. Vol 61:e129-34 Advance web-publication: March 2015. http://www.cfp.ca/content/61/3/e129.full.pdf+html

Marshall EG, Clarke, BS, Varatharasan, N and, Andrew M (2015) A Long Term Care – Comprehensive Geriatric Assessment (LTC-CGA) Tool: Improving Care for Frail Older Adults? Canadian Journal of Geriatric. Vol 18, No. 1, P. 2-10, March 31, 2015.

Jensen JL, Travers AH, Marshall EG, Cain E, Leadlay, S, Carter AJ (In press) The Impact of a Novel Collaborative Long Term Care-EMS Model: A Before-and-After Cohort Analysis. Submitted to Academic Emergency Medicine August 2014. Accepted March 2015.

Latham LP and Marshall EG (2015) Performance-based Financial Incentives for Diabetes Care: An Effective Strategy? Canadian Journal of Diabetes. Vol. 39, No. 1, P.83-97, February. 2015.  (Published first online October 24, 2014) . DOI: http://dx.doi.org/10.1016/j.jcjd.2014.06.002  PMID: 25444683.

Jensen JL, Travers AH, Marshall EG, Cain E, Leadlay, S, Carter AJ (2014) Insights into the Implementation and Operation of a Novel Paramedic Long-term Care Program. Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors, 2014 Jan-Mar;18(1): P86-91. Epub 2013 Oct 11. PMID: 24116961.

Marshall EG, Boudreau M, Jenson, JL, Edgecombe, N, Clarke B, Burge, F, Archibald, G, Taylor, A, Andrew, M (2013) Protocol for A Mixed-Methods Study of “Care by Design”: A New Model of Care in Long-Term Care Facilities in Nova Scotia, Canada. JMIR Research Protocols, 2013;2(2):e56) doi:10.2196/resprot.2915. Type of publication: Peer Review On-line Open Access Journal. Full Article. Research Protocol.

Marshall EG (2011) Do Young Adults Have Unmet Needs? Journal of Adolescent Health, 49(5), P490-497. Type of publication: Peer Review Journal, Original Research. Full Article.

Marshall EG, Wong ST, Haggerty JL, Levesque JF (2010) Perceptions of Unmet Healthcare Needs: What do Punjabi and Chinese-Speaking Immigrants Think? A Qualitative Study. BMC Health Services Research 2010, 10:46 (22 February 2010) MS ID: 9950910333011381. Type of publication: Peer Review Journal, Original Research. Full Article. 8 pages.

Selected presentations and posters

Marshall EG, Burge F, Lawson B, Gibson R, Chisholm J, Harvie B, Able H. Are Family Physicians Accepting New Patients on Opioids (Narcotics)? Findings and Implications from the Models and Access Atlas of Primary Care in Nova Scotia Study (MAAP-NS). North American Primary Care Research Group Conference, Cancun, Mexico, October 27, 2015. [oral]

Marshall EG, Burge F, Able H, Lawson B, Chisholm J, Harvie B, Gibson R. Do provider and practice characteristics predict availability of and access to primary care? Findings from the MAAP-NS: Models and Access Atlas to Primary Care Providers in Nova Scotia Study. North American Primary Care Research Group Conference, Cancun, Mexico, October 27, 2015. [oral]

Marshall EG, Burge F, Lawson B, Gibson R, Chisholm J, Harvie B, Able H. First contact access to family physicians for patients requiring narcotics. Findings from the MAAP-NS: Models and Access Atlas to Primary Care Providers in Nova Scotia Study. Canadian Association for Health Services and Policy Research (CAHSPR) Conference, Montreal, QC, May 28, 2015. [oral paper presentation]

Marshall EG, Burge F, Lawson B, Gibson R, Chisholm J, Harvie B, Nadeau S, Varatharasan N. MAAP-NS: Models & Access Atlas to Primary Care in Nova Scotia.  Preliminary Findings of Phase 1 Phone Surveys. Presentation to Doctors Nova Scotia, Halifax, NS, April 22, 2015.

Veselskiy O, Marshall EG, Varatharsan N, Andrew MK. Prevalence and Correlates Of Behavioral And Psychological Symptoms Of Dementia Among Residents Of Long Term Care Facilities. Dalhousie Department of Medicine Research Day, Halifax, NS, March 17, 2015.

Marshall EG, Andrew MK. Results from the evaluation of Care by Design: a research collaborative between Family Medicine and Geriatric Medicine. Geriatric Rounds, QEII Health Sciences Center, Halifax, NS, March 11, 2015.

Marshall EG.  MAAP-NS: Access for patients. Findings for Nova Scotia, Capital Health and you. District Department of Family Practice Community Council. Halifax, NS. January 22, 2015.

Marshall EG, Lawson B, Chisholm J, Gibson R, Varatharasan N, Burge F. How prevalent are “meet and greet” screening appointments for new patients? Implications for access equity. NAPCRG, New York City, NY, November 22, 2014. [oral]

Marshall EG,  Varatharasan N, Clarke B, Andrew M, Burge F. Providing Interdisciplinary Coordinated Care in Long-Term Care Facilities and Reduced ED Transfers with “Care by Design”: A New Model of Care. NAPCRG, New York City, NY, November 25, 2014. [oral]

Marshall EG, Lawson B, Burge F, Gibson R, Chisholm J, Varatharasan N. Do socioeconomic status or having a chronic condition affect whether family physicians accept a new patient? NAPCRG, New York City, NY, November 24, 2014. [oral]

Andrew M, Marshall EG, Varatharasan N, Clarke B. A Long Term Care Comprehensive Geriatric Assessment (LTC-CGA) Tool: Improving care for frail older adults? NAPCRG, New York City, NY, November 22, 2014. [poster]

Marshall EG, Lawson B, Chisholm J, Gibson R, Varatharasan N, Burge F. How prevalent are “meet and greet” screening appointments for new patients? Implications for access equity. Family Medicine Forum, Quebec City, QC, November 12, 2014. [Oral and published abstract in upcoming supplement of Canadian Family Physician]

Theriault R, Marshall EG, Burge F, Clarke B. Discussing End-of-Life Issues in a New Model of Long-term Care: A qualitative study. Family Medicine Forum, Quebec City, QC, November 12, 2014.

Purcell C, Bowles S, Marshall EG, Andrew MK, Varatharasan N, Clarke B, Natarajan N. Polypharmacy rates decreased in elderly long term care residents in association with implementation of the Care by Design program. 15th Annual College of Pharmacy Research Event, Halifax, NS, November 9, 2014. [poster]

Marshall EG, Burge F, Gibson R. MAAP-NS: Models and Access Atlas to Primary Care in Nova Scotia. What have we learned about accessibility for patients and 5 easy ways you could we make it better. District Department of Family Practice and Primary Health Care Spring Forum, Halifax, NS, May 28, 2014. [oral]

Marshall EG, Lawson B, Gibson R., Varatharasan N, Nadeau S. What are the experiences of patient calling primary care provider offices after hours? MAAP-NS: A Nova Scotia Population Study. Canadian Association for Health Services and Policy Research (CAHSPR) Conference, Toronto, ON, May 2014. [poster]

Marshall EG, Burge F, Lawson B, Chisholm J, Gibson R, Varatharasan N, Nadeau S. MAAP-NS: Models and Access Atlas of Primary Care Providers in Nova Scotia: Preliminary findings of a population study. Canadian Association for Health Services and Policy Research (CAHSPR) Conference, Toronto, ON, May 2014. [poster]

Marshall EG, Andrew M. A Long Term Care – Comprehensive Geriatric Assessment (LTC-CGA) Tool:  Improving care for frail older adults? Dalhousie University Department of Medicine Research Day, Halifax, NS, May 2014. [poster]