Table 2.

PHP Approach in Four VHA Primary Care Clinics

	Case 1	Case 2	Case 3	Case 4
Geographic location	Urban Southwest	Urban Northeast	Urban Midwest	Semi-rural Pacific Northwest
Hospital	Stand-alone primary care clinic affiliated with a large hospital	Primary care clinic focused on wellness embedded in a large hospital	Primary care clinic embedded in a large hospital	Stand-alone clinic offering primary care and mental health services affiliated with a small hospital
PCMH teams in clinic studied	5 PCMH teams Other staff: Social work Nutrition PharmD	5 PCMH teams Other staff: Health coach Social work PharmD Acupuncture	12 PCMH teams Other staff: Health coach RN care managers Social work Nutrition PharmD	4 PCMH teams Other staff: PharmD Mental health Nutrition
PHP workflow	EHR template Structured assessment questions Referrals from pre-existing list	3 questions to identify priorities for all patients Full plan for subset of patients by health coach Health coaching to execute plan	Health coaching referrals to establish PHP and execute plan	Worksheet completed at check-in Worksheet reviewed by team members Referrals from pre-existing list
Involved team members	Nursing assistant RN PCP	PCP Health coach	Health coach RN care manager	Clerk Nursing assistant RN PCP Outside providers
Primary responsibility	Shared across team	Health coach	Health coach	Clerk
PHP plan dissemination	Team: EHR Outside clinic: EHR consult or not shared	Team: EHR, huddles (rarely) Outside clinic: EHR, phone	Team: EHR, shared appointments Outside clinic: EHR	Team: EHR, worksheet Outside team: EHR, shared clinic space
EHR integration of PHP	PHP progress notes accessible to all staff	PHP progress notes accessible to all staff	PHP progress notes accessible to all staff and a link to the PHP on the home screen	PHP progress notes accessible to all staff