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First Consulting Group

The Lucille and David Packard Foundation

Arthur Vining Davis Foundations

VHA, Inc.

VHA Upper Midwest, Inc.






    In 1998, IHI gathered a panel of industry experts to create a comprehensive redesign of the clinical office practice by consolidating existing innovations plus identifying areas where new design concepts would be needed in order to achieve fundamental new levels of practice performance. This effort was called the Idealized Design of Clinical Office Practices (IDCOP) initiative.


    The development of the IDCOP model was an iterative process. The design team and subsequent IDCOP faculty understood that the concepts and knowledge about system design would evolve with the testing of the components. In November of 1998, IHI first tested the developing concepts with a small set of voluntary organizations – this was a mock run of our first Prototype Session. Based on the success of this initial session, the IDCOP initiative was formally begun in January of 1999 when 34 “Prototype Sites” from across the US joined IHI in this effort. The role of the participating sites and their sponsoring organization was to test and implement the components of the emerging model, and to provide feedback for the refinement of the system components.


    The Prototype Sites were broadly representative of the health care landscape. Organizations from across the diverse health care spectrum joined in – urban and rural, primary care and specialty, private and public, academic and non-academic. Knowledge was sought from outside the US as well with expertise and participation coming from UK and Sweden.


    The first enrollment ‘wave’ was a three year initiative which contributed to the development and testing of change concepts.  Subsequent enrollment waves were 12 months where participants benefited from the prototype work contributed by wave one participants. 


    Wave One (1998-2001) : 24 Teams, 16 Organizations

    22  primary care teams

    3 specialty teams (ophthalmology, behavioral health, pediatrics)

    4 Academic Affiliations


    Wave Two (2000/2001): 6 Teams, 4  Organizations

    3 primary care teams

    2 specialty teams (breast health, GI)


    Wave Three (2001/2002): 5 Teams, 3 Organizations

    5 primary care teams