Diabetes is one of the most significant global healthcare challenges of the 21st century: it is estimated that one in three adults will have diabetes in the year 2050 in the United States. As a result, healthcare organizations are integrating systemic changes to address the needs of expanding chronic care patient population, including implementing patient-centered medical homes and new health information technology (IT) tools to help share the workload care activities. Advanced educational opportunities, collaborative-practice agreements, and a shifting model towards community-based care clinics affords opportunities for pharmacy professionals to participate in a more central role on the diabetes care team.

This dissertation work explores the intersection of diabetes care coordination and health IT with a specific focus on the potential for pharmacist involvement on diabetes care teams. Studies I and II aimed to define the existing diabetes care team as a system, with identifying roles, information flows, tasks, and temporal and geospatial attributes for providing effective care. Study I used a questionnaire and social network analysis to identify key members of diabetes care teams. Results indicated that team members were the primary care provider, endocrinologist, nurse, pharmacist, dietitian, and social worker. Study II used semi-structured interviews and team task analysis for thirty (N=30) diabetes care team participants (N=5 for each category indicated in Study I). Results from study II led to the creation of a new systems engineering analytical framework, titled Diabetes care Roles Information Flows and Team Coordination (DRIFT). DRIFT expands existing healthcare systems engineering frameworks through the inclusion of granularity, temporal, and sociotechnical factors in a three-dimensional model.

Studies I and II results were synthesized to identify potential health IT solutions to gaps in diabetes care activities. This lead to the development of a new health IT prototype, eVincio, which is comprised of a patient-facing mobile application and a provider-facing desktop software that work together to help visualize patient care activities. Study III was a formative usability assessment of the eVincio prototypes with six (N=6) pharmacist participants. Results revealed that eVincio could be very beneficial for visualizing patient care activities and identifying gaps in care coordination, particularly for professionals who work as case managers, population health analysts, or have some aspect of quality monitoring in their role. As the eVincio system is still in a prototype stage of development, additional studies need to be conducted to determine system requirements for interoperability, evidence-based guidelines, and fulfilling end-user requirements.