Health Informatics

“Our goal is to understand how to make health information technology practical in ways that directly engage patients and providers.”

James D. Ralston, MD, MPH
Kaiser Permanente Washington Health Research Institute Associate Investigator
Washington Permanente Medical Group, Internal Medicine 

Research overview

Research on health informatics at Kaiser Permanente Washington focuses on developing and using health information technology (IT) to transform health care delivery. By testing new paradigms of care that provide more opportunities to engage patients, this research is supplying valuable evidence that is helping shape federal policy and guiding innovative redesign of health care.

“We’re working to understand how to make health IT practical so patients and care teams find it useful and engaging,” explained Kaiser Permanente Washington Health Research Institute (KPWHRI) Senior Investigator James Ralston, MD, MPH. “We want to find ways to use information technologies to support patients and providers together, both inside and outside the office.”

Integral to this support is designing technologies that are user-friendly and meet the needs of both patients and providers. By applying human-centered methods that focus on needs, use, and usability, KPWHRI researchers inform the design of health IT with direct participation from users.

Groundbreaking methodological work by KPWHRI health informatics researchers includes developing natural language processing (NLP) to analyze text such as notes and written reports in electronic health records (EHRs). Assistant Investigator David Carrell, PhD, leads in the area of using NLP and machine learning to identify patient phenotypes, or specific health characteristics such as possible heart disease, risk of opioid overdose, or suggestion of colon cancer. This information can assist researchers in studying how genetics and other factors influence disease.

Other examples of KPWHRI health informatics research include projects using EHRs and secure electronic communications such as:

  • using a patient-shared EHR to improve care for chronic illnesses such as depression, diabetes, hypertension, and heart disease;
  • understanding the effects of technologies such as OpenNotes, which gives patients access to notes that their doctors write during office visits;
  • understanding and addressing differences in patient use of online health care services that could lead to disparities in care;
  • testing NLP to target mentions of specific words and phrases in EHRs to supplement or replace skilled chart abstraction—providing faster access to “big data” and actionable information about patients who may need follow up.

Examples of KPWHRI research in mobile health (mHealth) and user-centered design include:

  • evaluating mHealth smartphone tools: 1) to improve primary care for alcohol use disorders, 2) to support patients after bariatric surgery, and 3) to change smoking behavior;
  • the VITAL and Seeing Priorities studies to apply user-centered processes to learn how health care providers can elicit and honor what is most important to patients living with multiple chronic health conditions;
  • the REMIND project applying user-centered methods to redesign clinical reminders and notifications for patients with chronic and preventive health care needs;
  • the landmark Electronic Communications and Blood Pressure (eBP) study of home blood pressure monitoring and web-based care to increase hypertension control without office visits.

“Our studies on using health IT to improve care are showing that we can achieve better outcomes when we shift care from the doctor’s office to where people live: in their homes—and online,” said Senior Investigator Beverly B. Green, MD, MPH.

Recent publications on Health Informatics

Blumenthal-Barby J, Opel DJ, Dickert NW, Kramer DB, Tucker Edmonds B, Ladin K, Peek ME, Peppercorn J, Tilburt J. Potential unintended consequences of recent shared decision making policy initiatives. Health Aff (Millwood). 2019;38(11):1876-1881. doi: 10.1377/hlthaff.2019.00243. PubMed

Tong J, Huang J, Chubak J, Wang X, Moore JH, Hubbard RA, Chen Y. An augmented estimation procedure for EHR-based association studies accounting for differential misclassification. J Am Med Inform Assoc. 2019 Oct 16. pii: 5588595. doi: 10.1093/jamia/ocz180. [Epub ahead of print]. PubMed

McCurry SM, Von Korff M, Morin CM, Cunningham A, Pike KC, Thakral M, Wellman R, Yeung K, Zhu W, Vitiello MV. Telephone interventions for co-morbid insomnia and osteoarthritis pain: The OsteoArthritis and Therapy for Sleep (OATS) randomized trial design. Contemp Clin Trials. 2019 Oct 12:105851. doi: 10.1016/j.cct.2019.105851. [Epub ahead of print]. PubMed

Shang N, Liu C, Rasmussen LV, Ta CN, Caroll RJ, Benoit B, Lingren T, Dikilitas O, Mentch FD, Carrell DS, Wei WQ, Luo Y, Gainer VS, Kullo IJ, Pacheco JA, Hakonarson H, Walunas TL, Denny JC, Wiley K, Murphy SN, Hripcsak G, Weng C. Making work visible for electronic phenotype implementation: lessons learned from the eMERGE network.  J Biomed Inform. 2019 Sep 19:103293. doi: 10.1016/j.jbi.2019.103293. [Epub ahead of print]. PubMed

Gruß I, Firemark A, Mayhew M, McMullen CK, DeBar LL. Taking opioids in times of crisis: institutional oversight, chronic pain and suffering in an integrated healthcare delivery system in the U.S. Int J Drug Policy. 2019 Sep 16;74:62-68. doi: 10.1016/j.drugpo.2019.08.009. [Epub ahead of print]. PubMed

Researchers in Health Informatics

James D. Ralston, MD, MPH

Senior Investigator
206-287-2076
James.D.Ralston@kp.org

Curriculum vitae (CV)

Jennifer B. McClure, PhD

Director of Research, Faculty, & Development; Senior Investigator
206-287-2737
Jennifer.B.Mcclure@kp.org

Curriculum vitae (CV)

Beverly B. Green, MD, MPH

Senior Investigator
206-287-2997
Bev.B.Green@kp.org

Curriculum vitae (CV)

Katharine A. Bradley, MD, MPH

Senior Investigator
206-287-2151
Katharine.A.Bradley@kp.org

Curriculum vitae (CV)

Eric B. Larson, MD, MPH, MACP

Senior Investigator and former Executive Director, Kaiser Permanente Washington Health Research Institute; Former Vice President for Research and Health Care Innovation, Kaiser Permanente Washington
206-287-2988
Eric.B.Larson@kp.org

Curriculum vitae (CV)

Paula Lozano, MD, MPH

Senior Investigator, KPWHRI; Associate Medical Director for Research and Translation & Physician, Pediatrics, Washington Permanente Medical Group
206-287-2113
Paula.Lozano@kp.org

Curriculum vitae (CV)

Predrag Klasnja, PhD

Associate Investigator, KPWHRI; Assistant Professor of Information, University of Michigan School of Information
206-442-5207
Predrag.V.Klasnja@kp.org

Curriculum vitae (CV)

David S. Carrell, PhD

Assistant Investigator
206-287-2705
David.S.Carrell@kp.org

Curriculum vitae (CV)

Cara C. Lewis, PhD, HSPP

Associate Investigator
206-442-4076
Cara.C.Lewis@kp.org

Curriculum vitae (CV)

Yates Coley, PhD

Assistant Investigator
206-287-2071
Rebecca.Y.Coley@kp.org

Curriculum vitae (CV)

Lynn DeBar, PhD

Senior Investigator
(206) 287-2942
Lynn.Debar@kp.org

Curriculum vitae (CV)