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The lack of patient engagement and wide spread value based healthcare delivery is well established. Obtaining better outcomes at a cheaper cost is the goal of value based healthcare and is vital for the future of healthcare. Positive deviance is a quality improvement/cultural change approach that looks for positive, value based, outliers that reside in a high risk population. These outliers could be within your healthcare community or the patient and family community. Once identified these outliers help teach others within their respective community to obtain better outcomes at a reduced cost. This approach has already shown success within the healthcare community by addressing hospital acquired infections as well as chronic disease management. Thus far this approach has not been utilized for patient engagement. This approach would allow patients with proven value based outcomes to help change direct patient care, clinic design and policy development within a healthcare system.