The Blueprint

Launching 45 medical homes in one year

by Amanda Berra

The most recent Medical Home Project Innovator Spotlight Series webconference showcased the work of Baylor Healthcare in building a system-level platform to support a major multi-site rollout of the PCMH model. Administrators walked through their approach, challenges, and lessons learned.

Slides and recorded audio for the webconference are both located here

The search for scalable approaches to PCMH transformation

The challenges for PCMH rollout remain formidable and executives must address fundamental questions:

What version of the medical home model is right for our system?

The PCMH model is flexible and can be altered to fit different health care organizations and markets, but administrative and clinical leaders must begin by determining what the medical home should look like in their unique health system and how much the model should differ across affiliated sites.

What kind of centralized transformation platform will we need?

Few resources are available to help systems estimate how many administrative and clinical leaders will be needed to support the project—both for the initial transformation effort and ongoing support.

How can we connect with so many individual physician sites?

Most physician sites are diverse, ranging from small practices to large groups of 30 or more. Each site brings its own unique combination of culture, operating parameters, and infrastructure. Baseline familiarity with—and initial support for—PCMH transformation always varies.

Learning from experience at Baylor Healthcare

At Baylor, the audacious goal of helping every Health Texas practice attain PCMH status within a year initially collided with the reality of the significant time and organizational effort required to design and implement such a complex project.

Now, with critical early lessons learned and a broad transformation platform built, the pace of transformation is quickening and over 65 practices are on track to be recognized as PCMH sites by the end of this year.

Key project management elements include:

  • A strategic transformation plan: Baylor quickly realized that the major, multi-site project would require a formal timeline of tasks and transparent accountability. It took months to write the plan, incorporate stakeholder input, secure buy-in, and reach the initial pilot phase.

  • Leadership role segmentation: Project leaders found they needed “an influential arm and an administrative arm” to accomplish multi-site PCMH transformation.

    Physician leaders fanned out to help their colleagues at each primary care site learn about the model. They framed the organization’s aspirations within the context of the future of the system and health care in general, and then collaborated with their peers to outline the elements of patient care, documentation, care coordination, and other operations that would need to be transformed to achieve the goals.

    Health system executives provided organizational and infrastructure support by creating centralized resources for education, operational transformation, IT solutions, and writing NCQA applications.


  • Major IT project planning and product customization: Baylor’s PCMH team found that extensive modifications to the existing electronic health record system were needed to make the functions easily accessible for physicians to use during a patient visit. Patient registration, population management, and patient portal systems are still being incorporated across the practices.

For more information

The Medical Home Project is dedicated to connecting members with the latest research, tools and benchmarking data related to medical home development.

Please refer to the following resources: