diff --git a/webapp/src/js/controllers/contacts.js b/webapp/src/js/controllers/contacts.js
index b765d979acb..7483e4302e4 100644
--- a/webapp/src/js/controllers/contacts.js
+++ b/webapp/src/js/controllers/contacts.js
@@ -7,13 +7,11 @@ var _ = require('underscore'),
   var inboxControllers = angular.module('inboxControllers');
 
   inboxControllers.controller('ContactsCtrl', function(
-    $element,
     $log,
     $q,
     $scope,
     $state,
     $stateParams,
-    $timeout,
     $translate,
     Auth,
     Changes,
@@ -51,7 +49,10 @@ var _ = require('underscore'),
     var _initScroll = function() {
       scrollLoader.init(function() {
         if (!$scope.loading && $scope.moreItems) {
-          _query({ skip: true });
+          _query({
+            paginating: true,
+            reuseExistingDom: true,
+          });
         }
       });
     };
@@ -65,7 +66,7 @@ var _ = require('underscore'),
         $scope.error = false;
       }
 
-      if (options.skip) {
+      if (options.paginating) {
         $scope.appending = true;
         options.skip = liveList.count();
       } else if (!options.silent) {
@@ -146,8 +147,11 @@ var _ = require('underscore'),
           $scope.moreItems = liveList.moreItems =
             contacts.length >= options.limit;
 
-          contacts.forEach(liveList.update);
-          liveList.refresh();
+          const mergedList = options.paginating ?
+            _.uniq(contacts.concat(liveList.getList()), false, _.property('_id'))
+            : contacts;
+          liveList.set(mergedList, !!options.reuseExistingDom);
+
           _initScroll();
           $scope.loading = false;
           $scope.appending = false;
@@ -430,16 +434,33 @@ var _ = require('underscore'),
     var changeListener = Changes({
       key: 'contacts-list',
       callback: function(change) {
-        var limit = liveList.count();
+        const limit = liveList.count();
         if (change.deleted && change.doc.type !== 'data_record') {
           liveList.remove(change.doc);
         }
 
-        var withIds =
+        if (change.doc) {
+          liveList.invalidateCache(change.doc._id);
+
+          // Invalidate the contact for changing reports with visited_contact_uuid
+          if (change.doc.fields) {
+            liveList.invalidateCache(change.doc.fields.visited_contact_uuid);
+          }
+        }
+
+        const withIds =
           isSortedByLastVisited() &&
           !!isRelevantVisitReport(change.doc) &&
           !change.deleted;
-        return _query({ limit: limit, silent: true, withIds: withIds });
+        return _query({
+          limit,
+          withIds,
+          silent: true,
+
+          // The logic for updating Primary Contact changes is complex
+          // So redraw everything when a person changes
+          reuseExistingDom: change.doc && change.doc.type !== 'person',
+        });
       },
       filter: function(change) {
         return (
diff --git a/webapp/src/js/services/live-list.js b/webapp/src/js/services/live-list.js
index da11367bd96..bc576760c5c 100644
--- a/webapp/src/js/services/live-list.js
+++ b/webapp/src/js/services/live-list.js
@@ -328,9 +328,7 @@ angular.module('inboxServices').factory('LiveList',
       var activeDom = $(idx.selector);
       if(activeDom.length) {
         activeDom.empty();
-        _.each(idx.dom, function(li) {
-          activeDom.append(li);
-        });
+        appendDomWithListOrdering(activeDom, idx);
         ResourceIcons.replacePlaceholders(activeDom);
       }
     }
@@ -340,26 +338,29 @@ angular.module('inboxServices').factory('LiveList',
       return idx.list && idx.list.length;
     }
 
-    function _set(listName, items) {
-      var i, len,
-          idx = indexes[listName];
-
+    /* 
+    reuseExistingDom is a performance optimization wherein live-list can rely on the changes feed to 
+    specifically update dom elements (via update/remove interfaces) making it safe to re-use existing dom 
+    elements for certain scenarios
+    */ 
+    function _set(listName, items, reuseExistingDom) {
+      const idx = indexes[listName];
       if (!idx) {
         throw new Error('LiveList not configured for: ' + listName);
       }
 
       idx.lastUpdate = new Date();
-
-      // TODO we should sort the list in place with a suitable, efficient algorithm
-      idx.list = [];
-      idx.dom = [];
-      for (i=0, len=items.length; i<len; ++i) {
-        _insert(listName, items[i], true);
+      idx.list = items.sort(idx.orderBy);
+      const newDom = {};
+      for (let i = 0; i < items.length; ++i) {
+        const item = items[i];
+        const useCache = reuseExistingDom && idx.dom[item._id] && !idx.dom[item._id].invalidateCache;
+        const li = useCache ? idx.dom[item._id] : listItemFor(idx, item);
+        newDom[item._id] = li;
       }
-
-      $(idx.selector)
-          .empty()
-          .append(idx.dom);
+      idx.dom = newDom;
+      
+      _refresh(listName);
     }
 
     function _initialised(listName) {
@@ -367,18 +368,11 @@ angular.module('inboxServices').factory('LiveList',
     }
 
     function _contains(listName, item) {
-      var i, list = indexes[listName].list;
-
-      if (!list) {
+      if (!indexes[listName].list) {
         return false;
       }
 
-      for(i=list.length-1; i>=0; --i) {
-        if(list[i]._id === item._id) {
-          return true;
-        }
-      }
-      return false;
+      return !!indexes[listName].dom[item._id];
     }
 
     function _insert(listName, newItem, skipDomAppend, removedDomElement) {
@@ -392,7 +386,7 @@ angular.module('inboxServices').factory('LiveList',
 
       var newItemIndex = findSortedIndex(idx.list, newItem, idx.orderBy);
       idx.list.splice(newItemIndex, 0, newItem);
-      idx.dom.splice(newItemIndex, 0, li);
+      idx.dom[newItem._id] = li;
 
       if (skipDomAppend) {
         return;
@@ -410,6 +404,15 @@ angular.module('inboxServices').factory('LiveList',
       }
     }
 
+    function _invalidateCache(listName, id) {
+      const idx = indexes[listName];
+      if (!idx || !idx.dom || !id || !idx.dom[id]) {
+        return;
+      }
+
+      idx.dom[id].invalidateCache = true;
+    }
+
     function _update(listName, updatedItem) {
       var removed = _remove(listName, updatedItem);
       _insert(listName, updatedItem, false, removed);
@@ -431,55 +434,44 @@ angular.module('inboxServices').factory('LiveList',
       }
       if (removeIndex !== null) {
         idx.list.splice(removeIndex, 1);
-        var removed = idx.dom.splice(removeIndex, 1);
+        const removed = idx.dom[removedItem._id];
+        delete idx.dom[removedItem._id];
 
         $(idx.selector).children().eq(removeIndex).remove();
-        if (removed.length) {
-          return removed[0];
-        }
+        return removed;
       }
     }
 
     function _setSelected(listName, _id) {
-      var i, len, doc,
-          idx = indexes[listName],
-          list = idx.list,
-          previous = idx.selected;
+      const idx = indexes[listName],
+            previous = idx.selected;
 
       idx.selected = _id;
 
-      if (!list) {
+      if (!idx.list) {
         return;
       }
 
-      for (i=0, len=list.length; i<len; ++i) {
-        doc = list[i];
-        if (doc._id === previous) {
-          idx.dom[i]
-              .removeClass('selected');
-        }
-        if (doc._id === _id) {
-          idx.dom[i]
-              .addClass('selected');
-        }
+      if (previous && idx.dom[previous]) {
+        idx.dom[previous].removeClass('selected');
+      }
+
+      if (idx.dom[_id]) {
+        idx.dom[_id].addClass('selected');
       }
     }
 
     function _clearSelected(listName) {
-      var i, len,
-          idx = indexes[listName],
-          list = idx.list,
-          previous = idx.selected;
+      const idx = indexes[listName];
 
-      if (!list || !previous) {
+      if (!idx.list || !idx.selected) {
         return;
       }
 
-      for (i=0, len=list.length; i<len; ++i) {
-        if (list[i]._id === previous) {
-          idx.dom[i].removeClass('selected');
-        }
+      if (idx.dom[idx.selected]) {
+        idx.dom[idx.selected].removeClass('selected');
       }
+
       delete idx.selected;
     }
 
@@ -499,19 +491,19 @@ angular.module('inboxServices').factory('LiveList',
     }
 
     function refreshAll() {
-      var i, now = new Date();
+      const now = new Date();
 
       _.forEach(indexes, function(idx, name) {
         // N.B. no need to update a list that's never been generated
         if (idx.lastUpdate && !sameDay(idx.lastUpdate, now)) {
           // regenerate all list contents so relative dates relate to today
           // instead of yesterday
-          for (i=idx.list.length-1; i>=0; --i) {
-            idx.dom[i] = listItemFor(idx, idx.list[i]);
+          for (let i = 0; i < idx.list.length; ++i) {
+            const item = idx.list[i];
+            idx.dom[item._id] = listItemFor(idx, item);
           }
 
           api[name].refresh();
-
           idx.lastUpdate = now;
         }
       });
@@ -534,6 +526,11 @@ angular.module('inboxServices').factory('LiveList',
       return midnight.getTime() - now.getTime();
     }
 
+    function appendDomWithListOrdering(activeDom, idx) {
+      const orderedDom = idx.list.map(item => idx.dom[item._id]);
+      activeDom.append(orderedDom);
+    }
+
     $timeout(refreshAll, millisTilMidnight(new Date()));
 
     api.$listFor = function(name, config) {
@@ -543,6 +540,7 @@ angular.module('inboxServices').factory('LiveList',
 
       api[name] = {
         insert: _.partial(_insert, name),
+        invalidateCache: _.partial(_invalidateCache, name),
         update: _.partial(_update, name),
         remove: _.partial(_remove, name),
         getList: _.partial(_getList, name),
diff --git a/webapp/tests/karma/unit/controllers/contacts.js b/webapp/tests/karma/unit/controllers/contacts.js
index 93c40aaa4d3..37dad6ce72d 100644
--- a/webapp/tests/karma/unit/controllers/contacts.js
+++ b/webapp/tests/karma/unit/controllers/contacts.js
@@ -50,6 +50,7 @@ describe('Contacts controller', () => {
         refresh: sinon.stub(),
         count: () => elements.length,
         insert: e => elements.push(e),
+        invalidateCache: () => {},
         set: es => (elements = es),
         update: e => {
           if (e !== district || elements[0] !== district) {
@@ -565,8 +566,12 @@ describe('Contacts controller', () => {
           const lhs = contactsLiveList.getList();
           assert.equal(lhs.length, 50);
           scrollLoaderCallback();
-          assert.equal(searchService.args[1][2].skip, 50);
-          assert.equal(searchService.args[1][2].limit, 50);
+          assert.deepEqual(searchService.args[1][2], { 
+            reuseExistingDom: true,
+            paginating: true,
+            limit: 50,
+            skip: 50,
+          });
         });
     });
 
@@ -580,8 +585,12 @@ describe('Contacts controller', () => {
           const lhs = contactsLiveList.getList();
           assert.equal(lhs.length, 51);
           scrollLoaderCallback();
-          assert.equal(searchService.args[1][2].skip, 50);
-          assert.equal(searchService.args[1][2].limit, 50);
+          assert.deepEqual(searchService.args[1][2], {
+            reuseExistingDom: true,
+            paginating: true,
+            limit: 50,
+            skip: 50,
+          });
         });
     });
 
@@ -599,8 +608,11 @@ describe('Contacts controller', () => {
           const lhs = contactsLiveList.getList();
           changesCallback({});
           assert.equal(lhs.length, 10);
-          assert.equal(searchService.args[1][2].limit, 10);
-          assert.equal(searchService.args[1][2].skip, undefined);
+          assert.deepInclude(searchService.args[1][2], {
+            limit: 10,
+            silent: true,
+            withIds: false,
+          });
         });
     });
 
@@ -633,8 +645,7 @@ describe('Contacts controller', () => {
           searchResults = Array(50).fill(searchResult);
           searchService.returns(Promise.resolve(searchResults));
           scope.search();
-          assert.equal(searchService.args[1][2].limit, 50);
-          assert.equal(searchService.args[1][2].skip, undefined);
+          assert.deepEqual(searchService.args[1][2], { limit: 50 });
           return Promise.resolve();
         })
         .then(() => {
@@ -642,8 +653,12 @@ describe('Contacts controller', () => {
           assert.equal(lhs.length, 50);
           //aand paginate the search results, also not skipping the extra place
           scrollLoaderCallback();
-          assert.equal(searchService.args[2][2].skip, 50);
-          assert.equal(searchService.args[2][2].limit, 50);
+          assert.deepEqual(searchService.args[2][2], {
+            limit: 50,
+            paginating: true,
+            reuseExistingDom: true,
+            skip: 50,
+          });
         });
     });
 
@@ -658,36 +673,54 @@ describe('Contacts controller', () => {
           const lhs = contactsLiveList.getList();
           assert.equal(lhs.length, 50);
           scrollLoaderCallback();
-          assert.equal(searchService.args[1][2].skip, 50);
-          assert.equal(searchService.args[1][2].limit, 50);
+          assert.deepEqual(searchService.args[1][2], {
+            limit: 50,
+            paginating: true,
+            reuseExistingDom: true,
+            skip: 50,
+          });
         });
     });
 
     it('when paginating, does not modify the skip when it finds homeplace on subsequent pages #4085', () => {
-      const searchResult = { _id: 'search-result' };
-      searchResults = Array(50).fill(searchResult);
+      const mockResults = (count, startAt = 0) => {
+        const result = [];
+        for (let i = startAt; i < startAt + count; i++) {
+          result.push({ _id: `search-result${i}` });
+        }
+        return result;
+      };
+      searchResults = mockResults(50);
 
       return createController()
         .getSetupPromiseForTesting({ scrollLoaderStub })
         .then(() => {
           const lhs = contactsLiveList.getList();
           assert.equal(lhs.length, 51);
-          searchResults = Array(49).fill(searchResult);
+          searchResults = mockResults(49, 50);
           searchResults.push(district);
           searchService.returns(Promise.resolve(searchResults));
           scrollLoaderCallback();
-          assert.equal(searchService.args[1][2].skip, 50);
-          assert.equal(searchService.args[1][2].limit, 50);
+          assert.deepEqual(searchService.args[1][2], {
+            limit: 50,
+            paginating: true,
+            reuseExistingDom: true,
+            skip: 50,
+          });
           return Promise.resolve();
         })
         .then(() => {
           const lhs = contactsLiveList.getList();
           assert.equal(lhs.length, 100);
-          searchResults = Array(50).fill(searchResult);
+          searchResults = mockResults(50, 100);
           searchService.returns(Promise.resolve(searchResults));
           scrollLoaderCallback();
-          assert.equal(searchService.args[2][2].skip, 100);
-          assert.equal(searchService.args[2][2].limit, 50);
+          assert.deepEqual(searchService.args[2][2], {
+            limit: 50,
+            paginating: true,
+            reuseExistingDom: true,
+            skip: 100,
+          });
           return Promise.resolve();
         })
         .then(() => {
@@ -1114,7 +1147,7 @@ describe('Contacts controller', () => {
                     assert.deepEqual(searchService.args[i], [
                       'contacts',
                       { types: { selected: ['childType'] } },
-                      { limit: 5, withIds: false, silent: true },
+                      { limit: 5, withIds: false, silent: true, reuseExistingDom: i !== 5 },
                       { displayLastVisitedDate: true, visitCountSettings: {} },
                       undefined,
                     ]);
@@ -1144,7 +1177,7 @@ describe('Contacts controller', () => {
                   assert.deepEqual(searchService.args[1], [
                     'contacts',
                     { types: { selected: ['childType'] } },
-                    { limit: 5, withIds: true, silent: true },
+                    { limit: 5, withIds: true, silent: true, reuseExistingDom: true },
                     {
                       displayLastVisitedDate: true,
                       visitCountSettings: {},
@@ -1157,7 +1190,7 @@ describe('Contacts controller', () => {
                     assert.deepEqual(searchService.args[i], [
                       'contacts',
                       { types: { selected: ['childType'] } },
-                      { limit: 5, withIds: false, silent: true },
+                      { limit: 5, withIds: false, silent: true, reuseExistingDom: i !== 5 },
                       {
                         displayLastVisitedDate: true,
                         visitCountSettings: {},
@@ -1200,7 +1233,7 @@ describe('Contacts controller', () => {
                     assert.deepEqual(searchService.args[i], [
                       'contacts',
                       { types: { selected: ['childType'] } },
-                      { limit: 5, withIds: false, silent: true },
+                      { limit: 5, withIds: false, silent: true, reuseExistingDom: i !== 5 },
                       { displayLastVisitedDate: true, visitCountSettings: {} },
                       undefined,
                     ]);
@@ -1229,7 +1262,7 @@ describe('Contacts controller', () => {
                   assert.deepEqual(searchService.args[1], [
                     'contacts',
                     { types: { selected: ['childType'] } },
-                    { limit: 5, withIds: true, silent: true },
+                    { limit: 5, withIds: true, silent: true, reuseExistingDom: true },
                     {
                       displayLastVisitedDate: true,
                       visitCountSettings: {},
@@ -1242,7 +1275,7 @@ describe('Contacts controller', () => {
                     assert.deepEqual(searchService.args[i], [
                       'contacts',
                       { types: { selected: ['childType'] } },
-                      { limit: 5, withIds: false, silent: true },
+                      { limit: 5, withIds: false, silent: true, reuseExistingDom: i !== 5 },
                       {
                         displayLastVisitedDate: true,
                         visitCountSettings: {},
@@ -1285,7 +1318,7 @@ describe('Contacts controller', () => {
                     assert.deepEqual(searchService.args[i], [
                       'contacts',
                       { types: { selected: ['childType'] } },
-                      { limit: 5, withIds: false, silent: true },
+                      { limit: 5, withIds: false, silent: true, reuseExistingDom: i !== 5 },
                       {},
                       undefined,
                     ]);
@@ -1324,7 +1357,7 @@ describe('Contacts controller', () => {
                     assert.deepEqual(searchService.args[2], [
                       'contacts',
                       { types: { selected: ['childType'] } },
-                      { limit: 5, withIds: false, silent: true },
+                      { limit: 5, withIds: false, silent: true, reuseExistingDom: true },
                       {},
                       undefined,
                     ]);
diff --git a/webapp/tests/karma/unit/services/live-list.js b/webapp/tests/karma/unit/services/live-list.js
index fbc220f7bb3..8fb40b52f76 100644
--- a/webapp/tests/karma/unit/services/live-list.js
+++ b/webapp/tests/karma/unit/services/live-list.js
@@ -123,6 +123,7 @@ describe('LiveListSrv', function() {
     // then
     assert.deepEqual(_.keys(service.name), [
       'insert',
+      'invalidateCache',
       'update',
       'remove',
       'getList',