Re-Centering Diabetes Care through Community: The iHealthSpace Example

Wagner's modern construct for chronic care recognizes the primacy of ‘productive interactions’ among the patient, their personal community and the care provider team. No longer the only locus of care, the health system should operate within the context of and have access to the people and resources of the larger community involved in the patient's care. Shared medical visits in the care of patients with diabetes serve as a model for collaborative care inclusive of the patient community in complex chronic disease management. We describe the design considerations for a web-based personal health application iHealthSpace enabling multi-faceted connectivity and collaborative services needed to support shared medical visits for patients with diabetes in a large academic practice.