Background The production, delivery of services and scope of health outcomes have generated new forms of organization of the Colombian Healthcare System. Complex solutions developed with a focused techno vision have not been functional, nor adaptable to territories of scattered high rurality (TARD), mainly on the Colombian Pacific coast. Objective To build a differential PHC model for rural communities (TARD), ensuring access to quality health care services and improving social determinants. Methodology Four municipalities of the Pacific coast were selected. Based on the analysis of the implementation of PHC and RISS, the innovation and problem-solving method -design-thinking- was used to generate knowledge in a practical way. The method was developed with communities and experts. Results The prototype model is based on Healing the Territory as its core, and governance in health, intersectoral, social capital, own health, health services and interculturality as its differential elements. The model requires serving the population based on risks and complementary actions, with new hiring models, access routes to services and traditional practices. Another actor is institutionally, which from governance and public policy must define guidelines for service delivery, accountability and incentives. Finally, intersectorality as a binding node for defining cross-sectoral development and joint intervention policies that facilitate the improvement of social determinants of health. Conclusions The health model in TARD contributes to reflection and generates social innovation from the territories so that decision makers propose changes in public policy for its implementation. The post-conflict brought hope to the community, to build a better, more equitable society, with access to quality health services and improved living conditions. Key messages The model makes a theoretical contribution on the role of innovation in health, to provide solutions to problems in the territories of scattered high rurality. The model requires serving the population based on risks and complementary actions.