Currently submitted to: JMIR Formative Research
Date Submitted: Jul 7, 2026
Open Peer Review Period: Jul 9, 2026 - Sep 3, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Visualizing the Type 2 Diabetes Diagnostic Process in Primary Care: A Protocol for a Qualitative Process Mapping Study Using Semi-structured Interviews
ABSTRACT
Background:
Background:
Delays in the diagnostic process, particularly for chronic conditions such as Type 2 Diabetes (T2D), can lead to suboptimal treatment and poor health outcomes. Considering diagnosis as a process comprised of sequential tasks, clinical observations, and decisions, visualizing the sequence of events and decisions within the diagnostic process can help identify barriers to timely diagnosis and develop solutions to prevent diagnostic delay.
Objective:
Objective:
In this study, our objective was to visualize and analyze sequence of events and decisions made by providers and non-provider clinical staff when establishing a new T2D diagnosis in primary care.
Methods:
Methods:
Semi-structured interviews were conducted with primary care providers and non-provider clinical staff to explore their experiences in diagnosing, managing, and communicating with T2D patients. Interview transcripts were used to generate individual process maps, which were synthesized by integrating common elements across participants. A high-level map of the entire diagnostic process was developed by combining synthesized maps from provider and non-provider groups and identifying major subprocesses.
Results:
Results:
A total of 20 participants, including 10 healthcare providers and 10 non-provider clinical staff, were interviewed to develop individual and synthesized process maps of the T2D diagnostic process. The final process map illustrates a complex workflow comprising multiple interdependent subprocesses and decision points influencing clinicians’ workflow when gathering, integrating, and interpreting information, as well as forming a working diagnosis and communicating it to patients. Key bottlenecks included incomplete laboratory testing, patients’ lack of awareness or engagement with the diagnosis, and missed follow-up appointments.
Conclusions:
Conclusions:
This study provides a detailed visualization of the T2D diagnostic process from multiple provider and clinical staff perspectives. Future work will involve eliciting quantities related to diagnostic delay from domain experts to refine and validate the process map findings and develop targeted clinician-facing decision-support solutions.
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Copyright
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