Enhancing the Role of Medical Office Assistants in Primary Care 

At the Heart of Every Clinic: The MOA Perspective

Project Introduction

A collaborative project on the evolving role of Medical Office Assistants (MOAs) in primary care. This project brings together researchers, frontline staff, and clinic leaders to better understand the realities of MOA work—what it looks like, what it demands, and how it is changing. Through surveys, interviews, and co-design sessions, we capture the voices of MOAs across Ontario to explore their responsibilities, challenges, and ideas for the future of care.

The outcome? A series of co-designed and scalable solutions for primary care that both improve the MOA experience and support better delivery of care. 

Get in Touch

Have questions about the project? Want to get involved or continue the conversation? Want to take part in our bi-annual working group meetings? Reach out to our team—we’d love to hear from you.

Research Coordinator: Jawairia Mohammed at jawairia.mohammed@wchospital.ca

Lead Scientist: Jennifer Shuldiner at jennifer.shuldiner@wchospital.ca  

The work was completed in collaboration with co-being design

This work is supported by a grant from the Canadian Institute of Health Research. 

Ongoing Work

Our team launched this research program to better understand and support the critical role of Medical Office Assistants (MOAs) in primary care. MOAs are essential to the functioning of primary care clinics, supporting everything from administrative coordination to direct patient care. Yet despite their critical role, MOAs remain underrecognized in health system planning, research, and policy. As clinics face rising patient volumes, digital demands, and staffing shortages, MOAs are increasingly tasked with managing complex care needs, despite there being a lack of standardized training, adequate compensation, or a clearly defined role. Through this work, we aimed to document their experiences, highlight their contributions, and co-create practical solutions to strengthen their training, retention, and recognition across Ontario.

Research Activities

  1. Scoping review
    • We conducted a scoping review to map the existing literature on MOA roles, training, and workforce development.  
    • Manuscript Coming Soon
  1. Co-creation workshops and prioritization surveys to develop solutions to support MOAs
    • Collaboratively mapped the challenges MOAs face at work, explored what an “ideal” work day would look like for them, and co-created solutions to their most pressing problems.
    • Manuscript Coming Soon
  1. MOA survey across Ontario
    • We distributed an Ontario-wide survey to capture MOAs’ perspectives on their training, role clarity, workload, and current workplace support and received 939 responses. The mixed-methods results revealed both the strengths and challenges of being an MOA, which have continued to guide our recommendations.
    • Manuscript Coming Soon 
  1. Interviews with MOAs:
    • Through in-depth interviews, we explored MOAs’ daily responsibilities, the barriers they face, and their insights into improving clinic operations. These stories provided a deeper understanding of the realities behind the survey numbers.
    • Manuscript Coming Soon 

The Primary Care MOA Collaborative

We launched the Primary Care MOA Collaborative to foster a space for discussion between MOAs, health researchers, and system leaders. The goal is to build a community where MOAs can share experiences, shape solutions, and elevate their voices in system-level conversations.

March 2025 discussion:

Our first discussion group gathered MOAs and researchers across the health system to examine the current landscape of MOA work. Together, the group developed actionable recommendations to strengthen MOA training, retention, and recognition in primary care clinics. The following report summarizes the discussion for our workshop and outlines co-created solutions and recommendations for supporting MOAs in primary care offices.

September 2025 discussion:

Our second meeting featured a panel of MOAs who shared their frontline experiences, challenges in a strained health system, and ideas for strengthening this vital role. The discussion group highlighted how MOAs and primary care leaders work together to improve patient care and team success.

To listen to the panel below, please insert passcode: 2EW?eH=f

Future Steps

We’re building momentum to raise the profile of MOAs and drive changes that strengthen their role in primary care. By expanding the conversation and deepening collaborations, we aim to improve recognition, retention, training, and support for MOAs. To move this work forward, we’re looking for partners across primary care, health organizations, and policy who want to join us in strengthening and supporting the MOA workforce.

Are you interested in collaborating with The Primary Care MOA Collaborative? Connect with our team!

Meet the Core Team

We’re a multidisciplinary team of researchers, designers, physicians, and medical office assistants, committed to improving the experience of MOAs in primary care. Through our research, we aim to strengthen and support the vital role MOAs play.

Jennifer Shuldiner is a Scientist at Women’s College Hospital and an Associate Professor at the Institute of Health Policy, Management and Evaluation at the University of Toronto. She also holds an AMS Healthcare Fellowship in Compassion and Artificial Intelligence and Digital Health. Her research program is centered on strengthening primary care and advancing health system transformation through rigorous evaluation, thoughtful design, and real-time learning. She integrates human-centered design, behavioral science, implementation science, and mixed methods to design, implement, and evaluate programs that improve patient and provider experiences and outcomes. Jennifer is passionate about co-producing research with patients, providers, and policymakers to develop innovations that are both effective and sustainable. She has collaborated widely across health system and community partners, guiding the design, delivery, and evaluation of innovations that improve how primary care and health services are organized and delivered.

Nadine Hare is a medical design anthropologist whose work focuses on embedding ethnographic methods and decolonial thinking within human-centred design processes. She serves as an Innovation Fellow at Women’s College Hospital (WCH) and as Adjunct faculty at OCAD University and the University of Toronto. Nadine is also the co-founder of co-being design—a design mentoring firm. Previously VP of Design Anthropology at FSI; Head of Insights at Idea Couture.

Tieni Meninato is a seasoned strategist, designer, and design mentor. She integrates her background in graphic design, service design and strategic foresight to work on projects where design intersects with social change. She is the co-founder at co-being design, helping teams embed design and participatory research in their work. She is the design coordinator of the Pluriversal Futures Lab at Cornell U and serves as an Innovation Fellow at WCH. Previously VP of Innovation and Foresight at FSI and co-founder of Wake Insights Brazil.

Jawairia Mohammed is a Research Coordinator at the Women’s College Hospital Institute for Health System Solutions and Virtual Care. She oversees the MOA Project as well as various primary care research initiatives, including the implementation and evaluation of electronic communication strategies and nurse prescribing practices. She holds both an Honours Bachelor of Science (HBSc) in Population Health and a Master of Public Health (MPH) in Social and Behavioural Health Sciences from the University of Toronto. Her work advances evidence-based innovations in health systems and primary care research, focusing on improving access, equity, and policy standards to strengthen patient care in Canada.

Amber Khan is a Research Assistant at the Women’s College Hospital Institute for Health System Solutions and Virtual Care (WIHV), where she supports the MOA research initiative. Drawing on her experience working across public health sectors and holding an MPH from the Dalla Lana School of Public Health, she brings a strong understanding of system-level health issues and their effects on frontline providers and patients. Amber is passionate about amplifying the voices of primary care staff and working with them to develop practical solutions to improve patient care.

Apira Ragunathan works as a Research Coordinator at WIHV and co-chairs the WIHV Equity Committee. She has contributed to the MOA project and is presently engaged in the evaluation of virtual care initiatives. Holding a Master’s degree in Public Health from the Dalla Lana School of Public Health, Apira’s professional interests center on health equity, program evaluation, and implementation science.

Noah Ivers is a family physician at Women’s College Hospital Academic Family Health Team, and also leads a research program in implementation science at Women’s College Hospital. He is a full Professor in the Department of Family and Community Medicine at the University of Toronto. He holds a Canada Research Chair in the Implementation of Evidence Based Practice. Noah’s research focuses on the use of data to drive evidence-based, patient-centred improvements in healthcare. He has conducted multiple pragmatic randomized trials, systematic reviews, and qualitative work on health services and quality improvement interventions. Most recently, he has consulted with Health Canada on understanding how to apply evidence for team-based primary care and with Ontario Health to understand effects of the most recent investments in primary care.

MOA Advisory Panel Members:

  • Susanna Emmanue
  • Linda Hong
  • Olympia Magarro
  • Corrie Procak

Our Collaborators and partners

Contact Us

Have questions about the project? Want to get involved? Reach out to our team—we’d love to hear from you.

Jennifer Shuldiner, Lead Scientist
jennifer.shuldiner@wchospital.ca
Jawairia Mohammed, Research Coordinator
jawairia.mohammed@wchospital.ca