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