For the past 30 years in Louisville Ohio, I have been in private practice of Internal Medicine with my husband.  We joined Pioneer Physician Network in 2011, an independent collaborative of 39 forward thinking physicians.  I have worked on various Performance Improvement projects for more than 25 years.  As Director of the Ohio Northeast Region for Peer Review Systems, we engaged in TQM, the Deming method of PI for CMS PRO.  I revamped the Quality Management program of Mercy Medical Center in Canton Ohio, consolidating their program to one large multidisciplinary committee.  I have also been a reviewer for Keypro, served on the Performance Improvement group of the Integrated Health Collaborative of Canton, Ohio.  I currently chair the Patient Centered Care Committee that oversees the PCMH and CPC+ Track II programs for Pioneer Physicians Network. I have a Purple Belt in Lean Six Sigma.   Our practice became the first NCQA PCMH in our county; first Level I 2010 (paper charts) then 2011 Level III(EMR) and then recertified in 2015.