title: The Harvard Medical School Academic Innovations Collaborative: transforming primary care practice and education.
abstract: OBJECTIVE
  Academic medical centers (AMCs) need new approaches to delivering higher-quality care at lower costs, and engaging trainees in the work of high-functioning primary care practices.
  
  
  METHODS
  In 2012, the Harvard Medical School Center for Primary Care, in partnership with with local AMCs, established an Academic Innovations Collaborative (AIC) with the goal of transforming primary care education and practice. This novel two-year learning collaborative consisted of hospital- and community-based primary care teaching practices, committed to building highly functional teams, managing populations, and engaging patients. The AIC built on models developed by Qualis Health and the Institute for Healthcare Improvement, optimized for the local AMC context. Foundational elements included leadership engagement and development, application of rapid-cycle process improvement, and the creation of teams to care for defined patient populations. Nineteen practices across six AMCs participated, with nearly 260,000 patients and 450 resident learners. The collaborative offered three 1.5-day learning sessions each year featuring shared learning, practice coaches, and improvement measures, along with monthly data reporting, webinars, and site visits.
  
  
  RESULTS
  Validated self-reports by transformation teams showed that practices made substantial improvement across all areas of change. Important factors for success included leadership development, practice-level resources, and engaging patients and trainees.
  
  
  CONCLUSIONS
  The AIC model shows promise as a path for AMCs to catalyze health system transformation through primary care improvement. In addition to further evaluating the impact of practice transformation, expansion will require support from AMCs and payers, and the application of similar approaches on a broader scale.
authors.affiliation: Dr. Bitton is associate physician and assistant professor of medicine, Division of General Medicine, Brigham and Women's Hospital, and faculty lead for transformation strategy and design, Center for Primary Care, Harvard Medical School, Boston, Massachusetts. Dr. Ellner is associate physician and assistant professor of medicine, Division of Global Health Equity, Brigham and Women's Hospital, and codirector, Center for Primary Care, Harvard Medical School, Boston, Massachusetts. Dr. Pabo is a postgraduate year 3 resident, Brigham and Women's Hospital, and clinical fellow in medicine, Harvard Medical School, Boston, Massachusetts. Dr. Stout is vice president of patient centered medical home development, Cambridge Health Alliance, instructor in medicine, and director, Academic Innovations Collaborative Leadership Academy, Center for Primary Care, Harvard Medical School, Boston, Massachusetts. Dr. Sugarman is president and CEO, Qualis Health and Clinical Professor, Departments of Family Medicine and Epidemiology, University of Washington, Seattle, Washington. Ms. Sevin is director, Institute for Healthcare Improvement, Cambridge, Massachusetts. Dr. Goodell is director, Innovation in Medical Education, and clinical instructor, Population Medicine, Center for Primary Care, Harvard Medical School, Boston, Massachusetts. Ms. Bassett is executive director, Center for Primary Care, Harvard Medical School, Boston, Massachusetts. Dr. Phillips is director, Center for Primary Care, and William S. Applebaum Professor of Medicine and Professor of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts.
authors.forename: Asaf
authors.initials: A
authors.lastname: Bitton
authors.forename: Andrew
authors.initials: A
authors.lastname: Ellner
authors.forename: Erika
authors.initials: E
authors.lastname: Pabo
authors.forename: Somava
authors.initials: S
authors.lastname: Stout
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Sugarman
authors.forename: Cory
authors.initials: C
authors.lastname: Sevin
authors.forename: Kristen
authors.initials: K
authors.lastname: Goodell
authors.forename: Jill S
authors.initials: JS
authors.lastname: Bassett
authors.forename: Russell S
authors.initials: RS
authors.lastname: Phillips
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D003299:Cooperative Behavior; D018166:Health Care Reform; D006801:Humans; D007857:Leadership; D008404:Massachusetts; D017145:Models, Educational; D017146:Models, Organizational; D009936:Organizational Innovation; D011320:Primary Health Care / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D012577:Schools, Medical