BACKGROUND: The introduction of Ontario Health Teams in Canada is a step toward achieving an equitable integrated system of care. The Middlesex-London Ontario Health Team (MLOHT) has been developed in parallel to the London-Middlesex Primary Care Alliance (LMPCA), a grassroots network for primary care physicians, health care administrators, and nurse practitioners. Key in the growth of the LMPCA was hiring a primary care transformation lead to support in engagement. This qualitative case study aims to describe the implementation of a primary care transformation lead within an integrated care setting through feedback from healthcare personnel. METHODS AND FINDINGS: Family physicians, healthcare administrators, and administrative support personnel were recruited from the LMPCA and the MLOHT and interviewed. This analysis revealed 4 key components central to the role of a primary care transformation lead: (re)-building relationships, flexibility and adaptability, importance of role clarity, and motivation for change. Findings suggested that a primary care transformation lead can improve workflow among physicians by assisting in administrative tasks. Through streamlining information for primary care physicians, and building community networks, transformation leads can also enhance communication. Additionally, they can maintain an open environment for physicians to share their challenges to collaboratively develop solutions. CONCLUSION: This study exemplifies the role of primary care transformation leads in improving workflow, building networks, decreasing administrative burden, and facilitating an open environment in a primary care setting.