Introduction from the Agency for Healthcare Research and Quality

The Agency for Health care Research and Quality (AHRQ) believes that a robust primary care system is the foundation of a health care system that delivers high quality, high touch, high value health care for all Americans. In 2010, as part of our work to support the revitalization of primary care in the United States (US), AHRQ's Center for Primary Care examined the rapidly changing health care landscape and decided to expand our scope, take a step back, and consider what we could learn from our colleagues in other countries. In partnership with the Commonwealth Fund, we provided funds for an international invitational conference focused on lessons learned from reforms within primary care systems around the world. With support from the team at the Robert Graham Center, we invited health policy, health system researchers, and primary care leaders from six nations and the US to spend a day and half with us teaching about what they do, what works well, and how they got there. We also invited them to share their challenges and shortcomings.

The dialogue that took place was exceedingly rich and diverse. No one had all the answers and everyone had something to share and something to learn. Every country had a unique story to tell and there appeared to be no one right way to build a robust primary care system. Almost every delegation at some time during the conference bemoaned the short comings of their system and experiences, reminding all us that health care reform is an iterative journey and not a magical one-time burst of transformation. Discussions also focused on the role of payment reform, the importance of team-based care, and the use of health IT to support population management. In this supplement of JABFM, we are pleased to share reports from each of the international delegations in the hope that this work will stimulate thinking and conversations among all those interested in primary care health policy, design, research, and implementation. Additionally, we have captured many of the sessions from the conference and made them available on our website.

The conference and this supplement were a collective effort. We would like to thank our partners at the Commonwealth Fund, the Australian Primary Health Care Institute, and Queensland University for their contributions to the meeting, the members of the US delegation and our international guests, and the exceptional team at the Robert Graham Center led by Bob Phillips for making the meeting “hum” and for undertaking the daunting task of herding the authors to produce this supplement.

• Received for publication February 1, 2012.
• Revision received February 1, 2012.
• Accepted for publication February 1, 2012.