From Revolution to Evolution: Early Experience with Virtual-First, Outcomes-Based Primary Care.

Primary care is foundational to health systems and a common good. The workforce is threatened by outdated approaches to organizing work, payment, and technology. Primary care work should be restructured to support a team-based model, optimized to efficiently achieve the best population health outcomes. In a virtual-first, outcomes-based primary care model, a majority of professional time for primary care team members is protected for virtual, asynchronous patient interactions, collaboration across clinical disciplines, and real-time management of patients with acute and complex concerns. Payments must be re-structured to cover the cost of, and reward the value created by, this advanced model. Technology investments should shift from legacy electronic health records to patient relationship management systems, built to support continuous, outcome-based care. These changes enable primary care team members to focus on building engaged, trusting relationships with patients and their families and collaborating on complex management decisions, and reconnecting team members with joy in clinical practice.