Healthcare systems are in the process of reforming themselves to better meet the needs of people with, or at risk of developing, chronic diseases and long term conditions. One goal of these efforts is the coproduction of activated, informed, engaged and motivated patients and citizens. The clinical, public health and financial benefits of achieving such a goal may be dramatic. Motivational Interviewing (MI) is a proven and practical front-line approach which can help deliver this goal whilst also helping to deliver such policy objectives and intermediate outcomes as increased levels of patient centered care, participatory or shared decision making, evidence-based healthcare and improved clinician-patient relationships. Until now, MI has been passively diffusing through the system as a result of the innovation and early uptake by insightful individuals and organizations. If healthcare systems want to breakthrough to higher levels of performance, investment in the conscious and deliberate implementation of MI into front-line settings may prove helpful.