Before we can begin spreading and scaling a model of high-performance primary care, we must first determine whether or not it can be replicated. We call this initial replication effort a Limited Market Test (LMT), the objectives of which are to:
As part of this effort, we are teaming up with experts in practice improvement, systems engineering, change management, patient engagement and data analysis at the following primary care practices in order to help them adopt the features that have shown to deliver high-quality care at a lower-than-average total cost:
With an eye towards scale, we’ve developed a set of operating principles for the LMT that are guiding its design:
During the LMT, health systems associated with the practices will participate in the refinement of the change package and advise as to when the content is sufficiently refined for them to use in the next phase of scale. Patients and family caregivers will also be involved to ensure a patient-centered approach is integrated into the content.
The process and the content together provide the roadmap and the skeleton key to unlock a successful transformation effort, helping a practice identify its own pain points and opportunities, and to find the most efficient path to transformation based on its own priorities. We have already learned, for example, that some changes may precede others to create capacity for subsequent implementation, others contribute to multiple features, and help practice teams pinpoint where they have the most control to create quick wins. Learning more about how the LMT sites transform will enrich our change package for others.
The Center’s primary care model is rooted in rigorous research and its change package is steeped in practice improvement science. We will closely manage how it evolves in the scale-up process to maintain integrity to the science and will endeavor to design sufficient flexibility to be responsive to the needs of the practices. As we deepen the integration between process and content, the change package can be deployed on a digital platform to facilitate the implementation process at scale while retaining fidelity to the evidence-based model.
The LMT sites will continue as learning labs and testing sites to continue refinement of the change package and digital platform so we can ensure change is not only transformational, but also sustainable.