As Vineyard nonprofits large and small confront the realities of competing for a shrinking pool of donor dollars, The Foundation for Island Health (FIH) announced this week that it will eliminate the bulk of its paid staff and convert to an organization that is run almost entirely by volunteers.

Call it a laboratory for learning about health care on Martha's Vineyard. Or call it the Foundation for Island Health.

Either way you get the same thing: A young Island foundation aimed at testing a patient-centered, self-funded community health system whose cornerstones are prevention, education and state-of-the-art technology.

Now, two years after it was launched, the outlines for the foundation have begun to take on a little more definition.

The idea is not new. Dr.