{
  "file_id": "dr_MF0618",
  "total_codes": 132,
  "codes": [
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "Wake up, no",
      "context": "Patient seems unsure or lacks knowledge about diabetes management",
      "file_id": "dr_MF0618",
      "chunk_id": 0
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I take Mounjaro once a week and that's about the only thing I'm on now",
      "context": "Patient is taking medication, indicating some level of health education",
      "file_id": "dr_MF0618",
      "chunk_id": 0
    },
    {
      "code": "Weight management",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "losing weight",
      "context": "Patient prioritizes weight loss, showing awareness of its importance in diabetes management",
      "file_id": "dr_MF0618",
      "chunk_id": 0
    },
    {
      "code": "Social support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "My wife",
      "context": "Patient mentions their wife, indicating a support system",
      "file_id": "dr_MF0618",
      "chunk_id": 0
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "what are some things that you watch out to tell you that your diabetes is getting worse?",
      "context": "Patient unsure of indicators for worsening diabetes",
      "file_id": "dr_MF0618",
      "chunk_id": 1
    },
    {
      "code": "Financial constraints",
      "category": "BARRIER - SDOH",
      "subcategory": "Financial constraints",
      "quote": "every 10 days you gotta rip the thing off",
      "context": "Patient mentions cost or hassle of replacing device",
      "file_id": "dr_MF0618",
      "chunk_id": 1
    },
    {
      "code": "Health education programs",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "what are some things that you watch out to tell you that your diabetes is getting worse?",
      "context": "Patient seeking knowledge about diabetes management",
      "file_id": "dr_MF0618",
      "chunk_id": 1
    },
    {
      "code": "Accessible devices",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Telehealth options",
      "quote": "I have the Dexcom 7 now",
      "context": "Patient using technology for health monitoring",
      "file_id": "dr_MF0618",
      "chunk_id": 1
    },
    {
      "code": "Lack of trust",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of patient-provider trust",
      "quote": "None",
      "context": "No relevant quote, but context implies potential distrust due to inconsistent readings",
      "file_id": "dr_MF0618",
      "chunk_id": 2
    },
    {
      "code": "Inconsistent readings",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Poor communication",
      "quote": "The readings were different than-",
      "context": "Patient experiences inconsistent glucose readings, potentially affecting trust in healthcare system",
      "file_id": "dr_MF0618",
      "chunk_id": 2
    },
    {
      "code": "Health literacy",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "I've learned that, don't feel it. Go do the finger stick.",
      "context": "Patient demonstrates understanding of glucose monitoring and takes proactive steps",
      "file_id": "dr_MF0618",
      "chunk_id": 2
    },
    {
      "code": "Self management",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "I've learned that, don't feel it. Go do the finger stick.",
      "context": "Patient takes initiative in managing glucose levels",
      "file_id": "dr_MF0618",
      "chunk_id": 2
    },
    {
      "code": "Lack of trust",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of patient-provider trust",
      "quote": "But I never rely solely on the numbers I get on here",
      "context": "Patient questions accuracy of medical device",
      "file_id": "dr_MF0618",
      "chunk_id": 3
    },
    {
      "code": "Effective self management",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "And I use this to monitor where my A1C is and where my average sugar levels are",
      "context": "Patient uses device to track health metrics",
      "file_id": "dr_MF0618",
      "chunk_id": 3
    },
    {
      "code": "Health literacy",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "So if it beeps and it's , 'Oh, you're 300.' Okay, what did I have that jumped up?",
      "context": "Patient understands device readings and takes action",
      "file_id": "dr_MF0618",
      "chunk_id": 3
    },
    {
      "code": "Lack of trust",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of patient-provider trust",
      "quote": "You can't go by that",
      "context": "Patient questioning the reliability of medical device",
      "file_id": "dr_MF0618",
      "chunk_id": 4
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "If I was 42 I'd be in a coma",
      "context": "Patient expressing fear of severe hypoglycemia",
      "file_id": "dr_MF0618",
      "chunk_id": 4
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "She pricked her finger and she was , 'It's actually not that low.'",
      "context": "Patient receiving clear information from friend",
      "file_id": "dr_MF0618",
      "chunk_id": 4
    },
    {
      "code": "Accessible technology",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Telehealth options",
      "quote": "I have it on my phone",
      "context": "Patient using mobile device to monitor friend's glucose levels",
      "file_id": "dr_MF0618",
      "chunk_id": 4
    },
    {
      "code": "Reminder systems",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Reminder systems",
      "quote": "It woke you up with the alarm?",
      "context": "Patient receiving alerts from medical device",
      "file_id": "dr_MF0618",
      "chunk_id": 4
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "if I was 42 I'd be in a coma",
      "context": "Patient shows confusion about blood glucose levels",
      "file_id": "dr_MF0618",
      "chunk_id": 5
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "you could go into a coma and...",
      "context": "Patient expresses fear about potential health consequences",
      "file_id": "dr_MF0618",
      "chunk_id": 5
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "I said, you could go into a coma and...",
      "context": "Patient shows some understanding of health risks",
      "file_id": "dr_MF0618",
      "chunk_id": 5
    },
    {
      "code": "Accessible technology",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Telehealth options",
      "quote": "I have it on my phone, and that's the one thing you can't turn off, low alerts",
      "context": "Patient uses mobile device for health monitoring",
      "file_id": "dr_MF0618",
      "chunk_id": 5
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I never really thought it does",
      "context": "Patient lacks awareness of diabetes impact on eyes",
      "file_id": "dr_MF0618",
      "chunk_id": 6
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "See, I never really thought it does",
      "context": "Patient unsure of diabetes impact on eyes",
      "file_id": "dr_MF0618",
      "chunk_id": 7
    },
    {
      "code": "Family-related issues",
      "category": "BARRIER - SDOH",
      "subcategory": "Social Determinants of Health",
      "quote": "a lot of it is family-related and stuff",
      "context": "Patient mentions family as a factor",
      "file_id": "dr_MF0618",
      "chunk_id": 7
    },
    {
      "code": "Specialist access",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "So I see my glaucoma specialist every year, my retinal specialist every year",
      "context": "Patient has regular access to specialists",
      "file_id": "dr_MF0618",
      "chunk_id": 7
    },
    {
      "code": "Provider communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "They want me to see an optometrist, 'cause they're , , 'That's a different realm'",
      "context": "Providers communicate and coordinate care",
      "file_id": "dr_MF0618",
      "chunk_id": 7
    },
    {
      "code": "Regular follow-up",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Reminder systems",
      "quote": "So I see my glaucoma specialist every year, my retinal specialist every year",
      "context": "Patient has regular scheduled appointments",
      "file_id": "dr_MF0618",
      "chunk_id": 7
    },
    {
      "code": "Lack of access",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "'Cause unfortunately with COVID, I missed a year of being able to see doctors",
      "context": "Patient missed appointments due to COVID",
      "file_id": "dr_MF0618",
      "chunk_id": 8
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "They just say I am getting cataracts and glaucoma, which unfortunately is also a sign of age",
      "context": "Patient anxious about diagnosis",
      "file_id": "dr_MF0618",
      "chunk_id": 8
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "Well, basically , , to look out for the floaters and , sudden vision changes, the blurry visions and all that stuff",
      "context": "Doctor explained condition to patient",
      "file_id": "dr_MF0618",
      "chunk_id": 8
    },
    {
      "code": "Regular appointments",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "and I think I go almost every six months sometimes with a glaucoma doctor",
      "context": "Patient has regular check-ups",
      "file_id": "dr_MF0618",
      "chunk_id": 8
    },
    {
      "code": "Monitoring and testing",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Reminder systems",
      "quote": "where they're doing the pressure testing and all that stuff",
      "context": "Healthcare system provides regular monitoring",
      "file_id": "dr_MF0618",
      "chunk_id": 8
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "You're a little bit high, we'll watch it.",
      "context": "Patient seems unsure about their condition",
      "file_id": "dr_MF0618",
      "chunk_id": 9
    },
    {
      "code": "Effective treatment",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "And then after a year, did laser surgery in both eyes.",
      "context": "Patient received timely and effective treatment",
      "file_id": "dr_MF0618",
      "chunk_id": 9
    },
    {
      "code": "Regular follow-up",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Reminder systems",
      "quote": "I go about every six months, what- Six months to a year.",
      "context": "Patient has regular follow-up appointments",
      "file_id": "dr_MF0618",
      "chunk_id": 9
    },
    {
      "code": "Accessible care",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Adequate insurance coverage",
      "quote": "Here.",
      "context": "Patient receives care at a convenient location",
      "file_id": "dr_MF0618",
      "chunk_id": 9
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "(laughs)",
      "context": "Provider shows empathy and builds rapport with patient",
      "file_id": "dr_MF0618",
      "chunk_id": 9
    },
    {
      "code": "Lack of recall",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "February or March? Speaker 2: May.",
      "context": "Patient has difficulty remembering last appointment",
      "file_id": "dr_MF0618",
      "chunk_id": 10
    },
    {
      "code": "Good medical plan",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Adequate insurance coverage",
      "quote": "I have a good medical plan, so.",
      "context": "Patient has adequate insurance coverage for eye exams",
      "file_id": "dr_MF0618",
      "chunk_id": 10
    },
    {
      "code": "Multiple appointments",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Appointment scheduling difficulties",
      "quote": "I got so many doctor things going on",
      "context": "Patient has multiple appointments to manage",
      "file_id": "dr_MF0618",
      "chunk_id": 10
    },
    {
      "code": "Good medical plan",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Adequate insurance coverage",
      "quote": "I have a good medical plan, so",
      "context": "Patient has adequate insurance coverage",
      "file_id": "dr_MF0618",
      "chunk_id": 11
    },
    {
      "code": "Easy scheduling",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "Pretty easy",
      "context": "Patient finds scheduling appointments easy",
      "file_id": "dr_MF0618",
      "chunk_id": 11
    },
    {
      "code": "Light sensitivity",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Feeling overwhelmed",
      "quote": "I cannot take sunlight at all",
      "context": "Patient experiences discomfort due to light sensitivity after eye dilation",
      "file_id": "dr_MF0618",
      "chunk_id": 11
    },
    {
      "code": "Accessible location",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Adequate access to care",
      "quote": "because I live in Morgantown... and everything's here in Morgantown",
      "context": "Patient finds it easy to receive eye care due to proximity to medical hub",
      "file_id": "dr_MF0618",
      "chunk_id": 12
    },
    {
      "code": "Good provider availability",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "It's usually pretty good",
      "context": "Patient finds doctor's availability satisfactory",
      "file_id": "dr_MF0618",
      "chunk_id": 12
    },
    {
      "code": "Transportation issues",
      "category": "A. BARRIERS TO FOLLOW-UP",
      "subcategory": "1. Social Determinants of Health (SDOH)",
      "quote": "Sometimes there's no choice",
      "context": "Patient implies difficulty with transportation at night",
      "file_id": "dr_MF0618",
      "chunk_id": 13
    },
    {
      "code": "Lack of access",
      "category": "A. BARRIERS TO FOLLOW-UP",
      "subcategory": "1. Social Determinants of Health (SDOH)",
      "quote": "Sometimes there's no choice",
      "context": "Patient may be implying lack of access to transportation",
      "file_id": "dr_MF0618",
      "chunk_id": 13
    },
    {
      "code": "Fear of diagnosis",
      "category": "A. BARRIERS TO FOLLOW-UP",
      "subcategory": "2. Patient Beliefs & Perceptions",
      "quote": "Then I'm blind",
      "context": "Patient expresses fear or anxiety about vision loss",
      "file_id": "dr_MF0618",
      "chunk_id": 13
    },
    {
      "code": "Health education",
      "category": "B. FACILITATORS TO FOLLOW-UP",
      "subcategory": "3. Patient Empowerment",
      "quote": "You're near a hub of medical... information and things that",
      "context": "Patient is aware of available health resources",
      "file_id": "dr_MF0618",
      "chunk_id": 13
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "'cause I can see better at night except when a car comes at me. Then I'm blind.",
      "context": "Patient lacks understanding of their condition",
      "file_id": "dr_MF0618",
      "chunk_id": 14
    },
    {
      "code": "No perceived urgency",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "'I can see fine now'",
      "quote": "'cause I can see better at night except when a car comes at me. Then I'm blind.",
      "context": "Patient does not perceive their condition as urgent",
      "file_id": "dr_MF0618",
      "chunk_id": 14
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "Yeah, pretty freeing with 'em",
      "context": "Patient feels comfortable discussing eye issues with doctor",
      "file_id": "dr_MF0618",
      "chunk_id": 15
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "Yeah, pretty freeing with 'em",
      "context": "Patient feels comfortable discussing eye issues with doctor",
      "file_id": "dr_MF0618",
      "chunk_id": 16
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "So I asked my doctor, I said, 'Okay, is this-'",
      "context": "Patient able to express concerns and ask questions",
      "file_id": "dr_MF0618",
      "chunk_id": 16
    },
    {
      "code": "Lack of understanding about DR progression",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "Because it's derived from iguanas... And they said that it deteriorates your eyes",
      "context": "Patient has misconceptions about medication and eye health",
      "file_id": "dr_MF0618",
      "chunk_id": 16
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "I think things have changed",
      "context": "Patient believes diabetes treatment has improved over time",
      "file_id": "dr_MF0618",
      "chunk_id": 17
    },
    {
      "code": "No perceived urgency",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "'I can see fine now'",
      "quote": "I don't think I'm there yet",
      "context": "Patient does not feel at risk for vision loss",
      "file_id": "dr_MF0618",
      "chunk_id": 17
    },
    {
      "code": "Lack of urgency",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "I can see fine now",
      "quote": "as long as I can see basically things in front of me and stuff that, then I'm happy",
      "context": "Patient feels they can see well enough",
      "file_id": "dr_MF0618",
      "chunk_id": 18
    },
    {
      "code": "Fear of surgery",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "I'm holding off on surgery for both",
      "context": "Patient is hesitant about undergoing surgery",
      "file_id": "dr_MF0618",
      "chunk_id": 18
    },
    {
      "code": "Monitoring by provider",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "But they're monitoring it, so",
      "context": "Provider is actively monitoring patient's condition",
      "file_id": "dr_MF0618",
      "chunk_id": 18
    },
    {
      "code": "Fear of treatment",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "I was a little leery on the laser surgery",
      "context": "Patient expresses fear about undergoing laser surgery",
      "file_id": "dr_MF0618",
      "chunk_id": 19
    },
    {
      "code": "Social support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "my wife had it",
      "context": "Patient mentions spouse's experience as a source of support",
      "file_id": "dr_MF0618",
      "chunk_id": 19
    },
    {
      "code": "Fear of treatment",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "I was a little leery on the laser surgery",
      "context": "Patient is hesitant about undergoing laser surgery",
      "file_id": "dr_MF0618",
      "chunk_id": 20
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "that hurt. So little leery if I have to go through it again, that's why I'm holding off, hoping-",
      "context": "Patient lacks understanding of treatment and its effects",
      "file_id": "dr_MF0618",
      "chunk_id": 20
    },
    {
      "code": "Fear of complications",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "what if they're doing that and they sneeze and it's , 'Ope, we gotta do a corneal transplant.'",
      "context": "Patient fears potential complications of treatment",
      "file_id": "dr_MF0618",
      "chunk_id": 20
    },
    {
      "code": "Waiting for technology improvement",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "hoping- ... that technology gets a little bit better.",
      "context": "Patient is waiting for advancements in treatment technology",
      "file_id": "dr_MF0618",
      "chunk_id": 20
    },
    {
      "code": "Fear of diagnosis",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Fear of diagnosis/treatment",
      "quote": "what if they're doing that and they sneeze and it's , 'Ope, we gotta do a corneal transplant.'",
      "context": "Patient expresses fear of potential complications from treatment",
      "file_id": "dr_MF0618",
      "chunk_id": 21
    },
    {
      "code": "Adequate insurance coverage",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Adequate insurance coverage",
      "quote": "my wife has a good, , medical plan. So cost isn't really much of a factor.",
      "context": "Patient's wife has good medical insurance, reducing financial burden",
      "file_id": "dr_MF0618",
      "chunk_id": 21
    },
    {
      "code": "Accessible location",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Transportation assistance",
      "quote": "the proximity of everything here. Is good.",
      "context": "Patient finds clinic location convenient and accessible",
      "file_id": "dr_MF0618",
      "chunk_id": 21
    },
    {
      "code": "Convenient location",
      "category": "FACILITATOR - Resources & Access",
      "subcategory": "Accessible providers",
      "quote": "And with everything being around here, it's convenient",
      "context": "Patient finds healthcare services conveniently located",
      "file_id": "dr_MF0618",
      "chunk_id": 22
    },
    {
      "code": "Positive provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "if the doctor says, 'I advise you to do this, this'",
      "context": "Patient values doctor's advice and guidance",
      "file_id": "dr_MF0618",
      "chunk_id": 22
    },
    {
      "code": "Accessible healthcare system",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "If nobody's around, I go to the Medi Center",
      "context": "Patient has access to alternative healthcare services",
      "file_id": "dr_MF0618",
      "chunk_id": 22
    },
    {
      "code": "Efficient referral process",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Patient navigation services",
      "quote": "they sent me right over to the ER and then...",
      "context": "Patient experiences efficient referral to emergency services",
      "file_id": "dr_MF0618",
      "chunk_id": 22
    },
    {
      "code": "Long wait times",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Appointment scheduling difficulties",
      "quote": "if you call up or even do an appointment, it's , you know, I just had to do one with the optometrist",
      "context": "Patient experiences difficulty with appointment scheduling",
      "file_id": "dr_MF0618",
      "chunk_id": 22
    },
    {
      "code": "Long wait times",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Appointment scheduling difficulties",
      "quote": "'Okay, the earliest one I get get you is August.'",
      "context": "Patient experiences long wait for appointment",
      "file_id": "dr_MF0618",
      "chunk_id": 23
    },
    {
      "code": "Appointment scheduling difficulties",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Appointment scheduling difficulties",
      "quote": "'Put me on a wait list,' which is what happened with today's appointment.",
      "context": "Patient has to request waitlist for earlier appointment",
      "file_id": "dr_MF0618",
      "chunk_id": 23
    },
    {
      "code": "Wait list",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Appointment scheduling difficulties",
      "quote": "'Put me on a wait list because I gotta see if there's an issue with the left eye.'",
      "context": "Patient uses waitlist to get earlier appointment",
      "file_id": "dr_MF0618",
      "chunk_id": 23
    },
    {
      "code": "Poor communication",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "The first person I spoke to was , 'Yeah, lemme see what I could do. I'll call you back tomorrow.' And never called me back.",
      "context": "Patient experienced poor communication with healthcare staff",
      "file_id": "dr_MF0618",
      "chunk_id": 24
    },
    {
      "code": "Appointment scheduling difficulties",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "The first person I spoke to was , 'Yeah, lemme see what I could do. I'll call you back tomorrow.' And never called me back.",
      "context": "Patient had difficulty scheduling an appointment",
      "file_id": "dr_MF0618",
      "chunk_id": 24
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Healthcare System Support",
      "quote": "So I had called up and they said, 'Okay, well, let me talk to Dr. Paco's nurse,' and then gave me the appointment the next day.",
      "context": "Patient was able to access a provider after initial difficulty",
      "file_id": "dr_MF0618",
      "chunk_id": 24
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider Relationship",
      "quote": "So I had called up and they said, 'Okay, well, let me talk to Dr. Paco's nurse,' and then gave me the appointment the next day.",
      "context": "Patient experienced effective communication with healthcare staff after initial difficulty",
      "file_id": "dr_MF0618",
      "chunk_id": 24
    },
    {
      "code": "Long wait times",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "today was a long appointment. I mean it was almost two hours and I heard a guy in the other room go, , I've been here for an hour and a half, when am I, , gonna see the doctor.",
      "context": "Patient experiences long wait time at clinic",
      "file_id": "dr_MF0618",
      "chunk_id": 25
    },
    {
      "code": "Appointment scheduling difficulties",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "So there should be a way of putting somebody in.",
      "context": "Patient suggests improvement for scheduling appointments",
      "file_id": "dr_MF0618",
      "chunk_id": 25
    },
    {
      "code": "Frustration with wait times",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Emotional/Psychological",
      "quote": "That does get frustrating.",
      "context": "Patient expresses frustration due to long wait times",
      "file_id": "dr_MF0618",
      "chunk_id": 25
    },
    {
      "code": "Understanding of vision issues",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "If it's a specific issue, I can't really see outta my left eye, I want to know if there's an issue.",
      "context": "Patient shows awareness of their vision health",
      "file_id": "dr_MF0618",
      "chunk_id": 25
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Healthcare System Support",
      "quote": "So there should be a way of putting somebody in.",
      "context": "Patient suggests improvement for accessing providers",
      "file_id": "dr_MF0618",
      "chunk_id": 25
    },
    {
      "code": "Long wait times",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "It might be an hour, two hours",
      "context": "Patient experiences long wait times",
      "file_id": "dr_MF0618",
      "chunk_id": 26
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Healthcare System Support",
      "quote": "at least have, say, even a nurse practitioner",
      "context": "Patient suggests having accessible providers for quicker appointments",
      "file_id": "dr_MF0618",
      "chunk_id": 26
    },
    {
      "code": "Priority scheduling",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Healthcare System Support",
      "quote": "there should be some type of... on-ramp to... get you in",
      "context": "Patient suggests having a priority scheduling system",
      "file_id": "dr_MF0618",
      "chunk_id": 26
    },
    {
      "code": "Long wait times",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "to say 2, 3, 4 months- ... to even be seen",
      "context": "Patient experiences long wait times for appointments",
      "file_id": "dr_MF0618",
      "chunk_id": 27
    },
    {
      "code": "Lack of access to healthcare",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "to say 2, 3, 4 months- ... to even be seen",
      "context": "Patient has difficulty accessing healthcare services",
      "file_id": "dr_MF0618",
      "chunk_id": 27
    },
    {
      "code": "Poor communication",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Provider/System Issues",
      "quote": "There's a doctor here, I'll get him when I can get 'em in",
      "context": "Patient experiences poor communication from healthcare providers",
      "file_id": "dr_MF0618",
      "chunk_id": 27
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Healthcare System Support",
      "quote": "at least have, say, even a nurse practitioner",
      "context": "Patient suggests having accessible providers for timely care",
      "file_id": "dr_MF0618",
      "chunk_id": 27
    },
    {
      "code": "Patient empowerment",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Patient Empowerment",
      "quote": "You do it yourself?",
      "context": "Patient takes responsibility for their own diabetes care",
      "file_id": "dr_MF0618",
      "chunk_id": 27
    },
    {
      "code": "Lack of social support",
      "category": "BARRIER - Social Determinants of Health (SDOH)",
      "subcategory": "Education/health literacy barriers",
      "quote": "I do most of the stuff around the house, the cooking, the cleaning, the shopping",
      "context": "Patient lacks help with daily tasks",
      "file_id": "dr_MF0618",
      "chunk_id": 28
    },
    {
      "code": "Financial constraints",
      "category": "BARRIER - Social Determinants of Health (SDOH)",
      "subcategory": "Financial constraints",
      "quote": "Over $100,000 later after being in the hospital",
      "context": "Patient experienced high medical expenses",
      "file_id": "dr_MF0618",
      "chunk_id": 28
    },
    {
      "code": "Emotional distress",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Depression/anxiety",
      "quote": "I just need to lay down",
      "context": "Patient experiences physical and emotional exhaustion",
      "file_id": "dr_MF0618",
      "chunk_id": 28
    },
    {
      "code": "Social support network",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "My wife knows that there are times where I just do not feel right",
      "context": "Patient has a supportive spouse",
      "file_id": "dr_MF0618",
      "chunk_id": 28
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "Had nothing to do with my sugar",
      "context": "Patient believes their condition is unrelated to sugar levels",
      "file_id": "dr_MF0618",
      "chunk_id": 29
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "So she at least listened to me",
      "context": "Patient feels heard by their provider",
      "file_id": "dr_MF0618",
      "chunk_id": 29
    },
    {
      "code": "Health literacy",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "I can tell when I'm high, when I'm low",
      "context": "Patient has knowledge of their condition and can self-manage",
      "file_id": "dr_MF0618",
      "chunk_id": 29
    },
    {
      "code": "Health education programs",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "Because I've taken enough different classes",
      "context": "Patient has taken education courses to manage diabetes",
      "file_id": "dr_MF0618",
      "chunk_id": 30
    },
    {
      "code": "Diabetes self-management support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Diabetes self-management support",
      "quote": "I know what I can eat, what I can't eat, I know what I can splurge",
      "context": "Patient has learned to manage diabetes through education",
      "file_id": "dr_MF0618",
      "chunk_id": 30
    },
    {
      "code": "Health literacy",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health literacy",
      "quote": "I know what I can eat, what I can't eat",
      "context": "Patient understands how to manage diet for diabetes",
      "file_id": "dr_MF0618",
      "chunk_id": 30
    },
    {
      "code": "Lack of access",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "Just wish they'd have more",
      "context": "Patient desires more resources or services",
      "file_id": "dr_MF0618",
      "chunk_id": 31
    },
    {
      "code": "Social support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "So you had a lot of people with, 'Oh, well, I did this,' 'Oh, did you try this?'",
      "context": "Patient benefits from peer support and discussion",
      "file_id": "dr_MF0618",
      "chunk_id": 31
    },
    {
      "code": "Health education",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "it teach, talk, , it was a little bit of everything",
      "context": "Patient receives educational content",
      "file_id": "dr_MF0618",
      "chunk_id": 31
    },
    {
      "code": "Emotional support",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Social support networks",
      "quote": "Your wife listens to you",
      "context": "Patient has a supportive partner",
      "file_id": "dr_MF0618",
      "chunk_id": 31
    },
    {
      "code": "Lack of podiatrist",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of continuity of care",
      "quote": "I don't have a podiatrist anymore",
      "context": "Patient mentions not having a podiatrist",
      "file_id": "dr_MF0618",
      "chunk_id": 32
    },
    {
      "code": "Specialist access",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "I have a PCP, a glaucoma doctor, immunologist, dermatologist",
      "context": "Patient has access to multiple specialists",
      "file_id": "dr_MF0618",
      "chunk_id": 32
    },
    {
      "code": "Effective communication",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Effective communication",
      "quote": "Do you feel comfortable sharing any worries that you have about your vision or your diabetes care with her?",
      "context": "Patient is asked about comfort level with provider",
      "file_id": "dr_MF0618",
      "chunk_id": 32
    },
    {
      "code": "Lack of understanding",
      "category": "BARRIER - Patient Beliefs & Perceptions",
      "subcategory": "Lack of understanding about DR progression",
      "quote": "It, it... Moderate.",
      "context": "Patient seems uncertain about their condition",
      "file_id": "dr_MF0618",
      "chunk_id": 33
    },
    {
      "code": "Financial constraints",
      "category": "BARRIER - SDOH",
      "subcategory": "Financial constraints",
      "quote": "None mentioned in this chunk",
      "context": "No direct mention, but could be inferred from glasses and potential costs",
      "file_id": "dr_MF0618",
      "chunk_id": 33
    },
    {
      "code": "Health literacy barriers",
      "category": "BARRIER - SDOH",
      "subcategory": "Education/health literacy barriers",
      "quote": "Percentage wise?",
      "context": "Patient seems unsure about how to answer question about eyesight limitation",
      "file_id": "dr_MF0618",
      "chunk_id": 33
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "So if I have an issue, , call dermatology, .",
      "context": "Patient mentions ability to contact dermatology, implying accessible care",
      "file_id": "dr_MF0618",
      "chunk_id": 33
    },
    {
      "code": "Health education programs",
      "category": "FACILITATOR - Patient Empowerment",
      "subcategory": "Health education programs",
      "quote": "None mentioned in this chunk",
      "context": "No direct mention, but could be inferred from patient's understanding of their condition",
      "file_id": "dr_MF0618",
      "chunk_id": 33
    },
    {
      "code": "Lack of access",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "You gotta wait until... they clear",
      "context": "Patient experiences delay in accessing care",
      "file_id": "dr_MF0618",
      "chunk_id": 34
    },
    {
      "code": "Financial constraints",
      "category": "BARRIER - SDOH",
      "subcategory": "Financial constraints",
      "quote": "get over glasses for sunglasses",
      "context": "Patient implies cost concerns for prescription glasses",
      "file_id": "dr_MF0618",
      "chunk_id": 34
    },
    {
      "code": "Poor communication",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Poor communication",
      "quote": "You gotta wait until... they clear",
      "context": "Patient lacks clarity on appointment process",
      "file_id": "dr_MF0618",
      "chunk_id": 34
    },
    {
      "code": "Lack of patient-provider trust",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of patient-provider trust",
      "quote": "I get really annoyed",
      "context": "Patient expresses frustration with care experience",
      "file_id": "dr_MF0618",
      "chunk_id": 34
    },
    {
      "code": "Feeling overwhelmed",
      "category": "BARRIER - Emotional/Psychological",
      "subcategory": "Feeling overwhelmed",
      "quote": "I'm , man, I might as well just not do anything",
      "context": "Patient feels overwhelmed by daily tasks",
      "file_id": "dr_MF0618",
      "chunk_id": 34
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "what was your expectation for your visit today?",
      "context": "Patient expects accessible care from provider",
      "file_id": "dr_MF0618",
      "chunk_id": 34
    },
    {
      "code": "Lack of access",
      "category": "BARRIER - SDOH",
      "subcategory": "Lack of access to healthcare",
      "quote": "Seven years ago that would've been",
      "context": "Patient implies limited access to specialized care",
      "file_id": "dr_MF0618",
      "chunk_id": 35
    },
    {
      "code": "Poor communication",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Poor communication",
      "quote": "So he wanted me to see an optometrist",
      "context": "Patient was referred without clear explanation",
      "file_id": "dr_MF0618",
      "chunk_id": 35
    },
    {
      "code": "Accessible providers",
      "category": "FACILITATOR - Healthcare System Support",
      "subcategory": "Accessible providers",
      "quote": "set up an appointment with the optometrist",
      "context": "Patient was able to get a referral to a specialist",
      "file_id": "dr_MF0618",
      "chunk_id": 35
    },
    {
      "code": "Provider empathy",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Provider empathy",
      "quote": "So that's when he said, 'That's not really our realm'",
      "context": "Provider shows understanding of patient's concern",
      "file_id": "dr_MF0618",
      "chunk_id": 35
    },
    {
      "code": "Appointment scheduling difficulties",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Appointment scheduling difficulties",
      "quote": "'cause August appointment, so",
      "context": "Patient experiences difficulty with scheduling follow-up appointments",
      "file_id": "dr_MF0618",
      "chunk_id": 36
    },
    {
      "code": "Lack of continuity of care",
      "category": "BARRIER - Provider/System Issues",
      "subcategory": "Lack of continuity of care",
      "quote": "So he wanted me to see an optometrist",
      "context": "Patient is referred to another provider, indicating potential lack of continuity",
      "file_id": "dr_MF0618",
      "chunk_id": 36
    },
    {
      "code": "Positive patient-provider relationship",
      "category": "FACILITATOR - Provider Relationship",
      "subcategory": "Positive patient-provider relationship",
      "quote": "No they’re pretty good here",
      "context": "Patient expresses satisfaction with their healthcare providers",
      "file_id": "dr_MF0618",
      "chunk_id": 36
    }
  ]
}