Redesigning a practice into one that is more efficient and patient-centered begins with a readiness assessment tool and goal-setting with key organization members, says Dr. John Michos, medical director of the Virginia Health Quality Center. The size of the practice can affect the approach to transformation. Smaller practices may find it easier to implement change, while larger practices may need to launch innovations on a small scale, then foster the spread of that success to other departments. Getting health IT and its associated efficiencies into a physician practice will help transform it into a medical home, but so will mapping communications processes for patient interactions such as phone calls, discharges and other situations. Dr. Michos and Dr. Lonnie E. Fuller, medical director for the Pennsylvania Medicaid ACCESS Plus PCCM-DM Program, described the critical steps in physician practice transformation during a May 29, 2008 webinar, Physician Practice Transformation: Charting a Path Toward Increased Revenue and Improved Efficiency, Patient Satisfaction and Outcomes.