RT Journal Article SR Electronic T1 Innovative and Diverse Strategies Toward Primary Health Care Reform: Lessons Learned from the Canadian Experience JF The Journal of the American Board of Family Medicine JO J Am Board Fam Med FD American Board of Family Medicine SP S27 OP S33 DO 10.3122/jabfm.2012.02.110215 VO 25 IS Suppl 1 A1 Strumpf, Erin A1 Levesque, Jean-Frédéric A1 Coyle, Natalie A1 Hutchison, Brian A1 Barnes, Marsha A1 Wedel, Robert J. YR 2012 UL http://www.jabfm.org/content/25/Suppl_1/S27.abstract AB Introduction: In the last decade, Canadian provincial and territorial health systems have taken diverse approaches to strengthening primary care delivery. Although the Canadian and US systems differ in significant ways, important commonalities include the organization of care delivery, core principles guiding primary care reform, and some degree of provincial/state autonomy. This suggests that Canadian experiences, which employed a variety of tools, strategies, and policies, may be informative for US efforts to improve primary care. Innovations: The range of primary care reform initiatives implemented across Canada target organizational infrastructure, provider payment, health care workforce, and quality and safety. Primary care teams and networks in which multiple physicians work in concert with other providers have become widespread in some provinces; they vary on a number of dimensions, including physician payment, incorporation of other providers, and formal enrolment of patients. Family medicine is attracting more recent medical school graduates, a trend likely affected by new physician payment models, increases in the number of primary care providers, and efforts to better integrate nonphysician providers into clinical practice. Efforts to integrate electronic medical records into practice and pursue quality improvement strategies are gaining ground in some provinces. Conclusions: Canadian primary care reform initiatives rely on voluntary participation, incremental change, and diverse models, encouraging engagement and collaboration from a range of stakeholders including patients, providers, and policymakers. Cross-country collaboration in evaluating and translating Canada's primary care reform efforts are likely to yield important lessons for the US experience.