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National Demonstration Project

In June 2006, TransforMED launched an innovative 24-month National Demonstration Project (NDP) to rigorously pilot test a new model of flexible, patient-centered care in 36 family medicine practices from all across the United States.

The NDP pilot project concluded in June of 2008. The Center for Research in Family Medicine and Primary Care evaluation team continues to conduct an intensive analysis of the results— summarizing and synthesizing both the data and the insights gleaned from the project.

Key findings on the process and outcomes will be submitted for publication in the peer-reviewed literature. The evaluation team has the authority to independently publish both positive and negative findings from this project. A final report is expected in early 2009.

Origins of the NDP

The goal of the Future of Family Medicine project was "to develop a strategy to transform and renew the specialty of family medicine to meet the needs of patients in a changing health care environment." The project was a joint effort of the Family Medicine Working Party and the Academic Family Medicine Organizations. The 4-year project resulted in a series of Task Force reports culminating in a final report that offered specific recommendations and an urgent call for action.

A centerpiece of the transformation proposed by the project is the new model practice. The FFM project proposed the creation of a national-level organization that would evaluate, support, and guide family and primary practices in their efforts to adopt this new model of care.

The American Academy of Family Physicians (AAFP) took a leadership role in creating a new initiative, TransforMED, to put the FFM recommendations into action.

Participating Practices

Thirty-six practices selected to participate in the NDP. Eighteen practices were engaged in facilitated implementation of the TransforMED Patient-Centered Model; 18 practices were engaged in self-directed implementation.

Visit the Web sites of the family practices that participated in the TransforMED NDP.

Goals and Process

The goal of the National Demonstration Project was to assess the usefulness and impact on quality of care and business performance of the Future of Family Medicine Report's new model. The hypothesis was that the new model's best practices would improve patient care, patient satisfaction, physician satisfaction and business performance. Additionally, it was hypothesized that facilitated practice redesign, in which practices receive tailored consultation and support from experts in the area of redesign and change management would result in faster improved outcomes than self-directed transformation.

The participating practices were randomly assigned to one of two groups:

• 18 facilitated practices engaged in a transformative process to fully implement a new model of care
  
• 18 self directed practices were allowed to implement the model of care in a self-directed manner.

Proven methods and measures helped the project identify the most efficient and effective way to implement transformative practice redesign as well as potential unintended consequences. Real-time evaluation determining the impact of the new model on quality of care and business performance was coupled with a learning lab model emphasizing "lessons learned". Key learnings have been synthesized and disseminated on an on-going basis among the demonstration sites and within the larger practice community.

Knowledge gained from this project has informed the development of TransforMED's practice enhancement tools and processes and further benefited family physicians and their patients across the country by inspiring change, contributing to the literature, policy and practice work on health care improvement.