The purpose of the framework we presented was to provide what Ellison (2012) describes as a vision for what the transformation of primary care is trying to accomplish (the Institute for Healthcare Improvement's Triple Aim) and a road map for getting there. The framework identifies key characteristics of primary care practice and points to ways in which improvements can be introduced, while recognizing that there are many other system-level supports that need to be in place to enable this transformation. We saw this framework as a way to initiate further discussion about these issues, and this has been reflected in the thoughtful responses to our paper.
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