The Brown Primary Care Initiative Design for Strategies towards Patient- Centered Medical Home Practice Transformation

Introduction: Primary care providers are needed who provide cost-effective, comprehensive care that is teambased\nand patient-centered (i.e., Patient-Centered Medical Homes-PCMH). Although PCMH implementation is\nunderway in a variety of settings across the U.S, adopting the PCMH model can be challenging even in motivated\nand efficient practices. The purpose of this study was to help facilitate Patient-Centered Medical Home and other\npractice transformation initiatives in the state of Rhode Island. The objectives of the Brown Primary Care\nTransformation Initiative were to: train medical students, residents, and faculty/community family physicians in\npractice transformation; convene a series of Think Tanks with PCMH experts to discuss domains and data collection\ntools that could be used in the development of a comprehensive and feasible evaluation methodology for identifying\nhow transformation within the practice environment occurs; and helping with practice transformation of 8 primary\ncare practices.\nMethod: This paper describes the development and delivery of a curriculum utilizing PCMH principles to train\nmedical students and residents in practice transformation; convening three Think Tanks with PCMH experts to\naddress theoretical and practical problems associated with PCMH; the transformation of 8 primary care teaching\npractices; the development of a methodology for measuring transformation and evaluation of curriculum change;\nand dissemination of the findings.\nDiscussion: This study provides insights into how and why a diverse group of family medicine practices\ntransform and how training of primary care residents and providers prepares them to implement and/or teach the\nprinciples of PCMH.