The overall goal of this K22 career development proposal is to develop the PI, a PhD trained researcher in biomedical informatics, into an independent researcher. The proposal contains both career development activities and a structured plan of community-based biomedical informatics research. The PI completed undergraduate training in biomedical engineering and completed graduate training in biomedical informatics. Her biomedical informatics graduate training was through the NLM-funded training program in the Vanderbilt University School of Medicine Department of Biomedical Informatics. During her masters and doctoral research, the PI developed knowledge and research skills in qualitative research applied to understanding workflow, information flow, and the role of health information technology in healthcare delivery. The PI's long-term career goals are to develop techniques to rapidly characterize existing work practices and to develop new paradigms for patient- and provider-centric HIT design and implementation. To begin the path towards achieving her long-term career goals, the PI's goals for this career development proposal are: 1) to gain the knowledge, skills, and experience needed to become an independent investigator in biomedical informatics, 2) to move my research into the community setting and build the research relationships necessary for successful community-based research, 3) to conduct innovative research on cross- organizational workflow and the role of technology in collaboration in order to gather preliminary data for R01 funding proposals, and 4) to obtain independent research funding. The career development activities in this proposal focus on four areas: health system design, design theory and methods, biomedical informatics methods, and general professional development activities. The health system design career development activities will focus on formal education on the structure of the health system, including innovative approaches health system design. Design theory and methods will focus on education in principles of design thinking and hands on experiences with design processes. Biomedical informatics methods development will involve continuing education and networking in biomedical informatics. General professional development activities will involve networking with peers and career skill- building activities. These activities provide a logical foundation for the PI's intended community- based biomedical informatics research career. The proposed research plan moves the PI's research from the academic medical center setting to the community. Building on her prior research experiences, the PI will conduct a study of workflow, information flow, and barriers to collaboration in a recently established community- based collaboration focused on sickle cell disease care. The proposed research will provide important data regarding informatics components needed to support inter-organizational collaboration and will build a foundation of community-based research tools and techniques that will facilitate future grant-funded studies of other organizational collaborations. In summary, the proposed research addresses an important biomedical informatics challenge in supporting inter-organizational collaboration while facilitating the PI's career development and providing preliminary data for future research.