Group Health Cooperative (GHC) is a nonprofit, consumer-governed health care organization serving 580,000 members in Washington State and Idaho through an integrated multispecialty group practice and a network of community providers. Integrated financing and delivery--supported by a partnership between health plan administrators and medical group physicians--enable GHC to launch innovations and organize services in ways that make the most sense operationally and clinically. Exemplifying this approach is GHC's implementation of a patient-centered medical home model of primary care that enhances the roles of a multidisciplinary care team and uses electronic health records to deliver proactive, coordinated care. Information technology is a key to improving patients' communication with their care team, engaging them in evidence-based care, and reducing fragmentation of services. GHC is using "lean" techniques to involve care teams and other frontline staff in standardizing their work, an approach that can likely be expanded to include other organizations.
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