November 6, 2019

HOME Trial Team wins 2019 Birnbaum Award

HOME Trial team members: Front: Susan Carol Bradford, Tara Beatty, Jun Castillo, Dina Greene.
Back: Chris Thayer, Diana Buist.

Interdisciplinary group shows that home-based HPV tests can boost cervical cancer screening for women at high risk.

The Kaiser Permanente Washington delivery-system team that helped with a landmark study on using home-based HPV tests for cervical cancer screening will receive 2019 Birnbaum Award during the annual Birnbaum Endowed Lecture at Benaroya Hall on Wednesday, November 13.

Kaiser Permanente Washington Health Research Institute (KPWHRI) presents the annual Birnbaum Award to partners in the health system who support the institute’s research to benefit Kaiser Permanente members.

This year’s award goes to those helping with a randomized clinical trial called “HOME,” which stands for “Home-based Options to Make cervical cancer screening Easy.” The awardees are:

  • Chris Thayer, MD, a Washington Permanente Medical Group (WPMG) family physician who is Kaiser Permanente’s chief information officer and who was medical director of clinical knowledge support and the institute’s clinical partner and champion during the trial;
  • Susan Carol Bradford, manager of the Screening and Outreach Program in Kaiser Permanente Washington’s Department of Clinical Improvement and Prevention; and
  • Kaiser Permanente Washington’s Laboratory Services’ Jun Castillo; Lin Thach; Shaun Auld; Kim Riddell, MD; Dina Greene, PhD; and the microbiology laboratory staff. 

“We’re extremely grateful to this team for its sustained efforts to ensure the success of this trial,” said Diana Buist, PhD, KPWHRI’s director of research and strategic partnerships and its lead investigator for the study.   

Comparing the home-based HPV test to in-clinic Pap tests, the researchers found that the home test increased cervical cancer screening by 50 percent among women who were overdue for Pap tests—but with no significant difference in cancer or precancer detection or treatment. This is the first-ever study of home-based screening in a U.S. health care system. The study also showed that a screening approach that allows either in-clinic or home-based primary screening may increase access by removing the in-clinic Pap test for most women who choose home screening. Many study participants interviewed following test said they found the home HPV test much easier than Pap screening.

The study was published this week in JAMA Network Open. Rachel Winer, PhD, professor of epidemiology at the University of Washington School of Public Health, and an affiliate investigator at KPWHRI, was co-PI of the study and first author of the article.

Dr. Thayer, who now serves as WPMG’s medical director for clinical information systems, says he’s enthusiastic about the innovation that happens when care delivery collaborates with research. For example, the team was able to adapt the medical record so that providers had relevant information about the trial and were able to interpret and communicate the HPV test results to their patients just as they would other results.

This ability to adapt the medical record to support trials like HOME “is a huge strength that speaks to Kaiser Permanente Washington’s commitment to supporting patient safety and our clinical teams when testing innovations,” said Dr Buist.

“New approaches to care like this will help us continue to deliver on the promise of offering the best clinical care in the most patient-centered way possible,” Dr. Thayer added.

Since completing the trial, the team has received funding for further research, which could lead to making home-HPV testing more widely available.

“We could not have done this complex project without the help of our dedicated delivery system partners and many hardworking staff at the institute,” said KPWPHRI Project Manager Tara Beatty, who joined Dr. Buist in nominating delivery-system staff for the award.

Other Birnbaum Award nominees

Three other teams were also nominated:

Rebecca Parrish and Cindee DeWitt for work on Community Resource Specialist (CRS) evaluation: CRSs work onsite at Kaiser Permanente Washington primary care centers, providing health coaching and helping patients access community resources that can improve their overall health and well-being. Rebecca Parrish, Integrated Mental Health and Wellness Clinical Consultant and Social Work Manager, and Cindee DeWitt, Community Resource Specialist Assistant Manager in Mental Health and Wellness, were nominated for their contributions to an evaluation of this new role. (Nominating team: KPWHRI’s Dr. Cara Lewis, Amy Lee, Dr. Clarissa Hsu, Jess Mogk, Craig Sewald, Dr. Paula Lozano, Katie Coleman, and Emily Westbrook.)

South Lake Union Medical Office team: This team was nominated for its collaboration in designing and evaluating the evidence-based model of care at Kaiser Permanente Washington’s innovative new primary care office in South Lake Union—a facility that prioritizes a convenient, accessible, and high-quality patient experience; expanded use of technology; and enhanced well-being of staff and providers. Those nominated were South Lake Union Medical Office leaders Dr. Hannah Burdge, Esther Hong, and Justin Hendricks, and Kaiser Permanente Washington Innovation team members Elizabeth Fleming, Connor Shea, Dr. Trina Davis, Julie Song, and Ana Skwierinski. (Nominating team: KPWHRI’s Katie Coleman, Maggie Jones, Carly Levitz, Jennie Schoeppe, Erin Hertel, Tyler Ross, Sharon Fuller, Melissa Anderson, and Paula Blasi.)

Matt Szymoniak and the Kaiser Permanente Washington Patient Access and Business Operations’ Pre-Visit Unit: Mr. Szymoniak is supervisor of this unit, which was nominated for its ongoing collaboration in research on patient financial hardship. The team helped KPWHRI identify opportunities, promote initiatives, and build relationships with administrative and clinical teams across the organization. The collaboration has supported ongoing research aimed at improving cost-of-care communication, increasing price transparency, and achieving efficient, affordable, patient-centered care. (Nominating team: KPWHRI’s Dr. Nora Henrikson and Leah Tuzzio.)

All invited to attend the Birnbaum Lecture

The Birnbaum Award will be presented at the Hilde and Bill Birnbaum Endowed Lecture at the Illsley Ball Nordstrom Recital Hall at Benaroya Hall in Downtown Seattle, from 7 to 9 p.m. on Wednesday, November 13.

Following the award presentation, Dr. Eric B. Larson, former Vice President for Research and Health Care Innovation at Kaiser Permanente Washington and Executive Director of KPWHRI, will deliver the 18th Annual Birnbaum Endowed Lecture.  The title of his lecture is “The Affordability Imperative: Delivering on the Promise of Health and Health Care for All.”

All are invited to attend the lecture.  RSVP by Thursday, November 8 at 206-442-5220 or​​​​​​

cancer screening


Mailing home HPV test may offer alternative to Pap screen

Dr. Diana Buist and team reflect on HOME trial showing 50 percent screening boost in underscreened women.

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Kaiser Permanente is at the forefront of research looking at using home tests for HPV, a leading cause of cervical cancer.

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Dr. Eric Larson to deliver Birnbaum Lecture Nov. 13

‘The Affordability Imperative’ will address our nation’s need to reduce disparities, address social determinants, and promote value in health care systems.

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Patients benefit when behavioral health and substance use screening are part of primary care. A Group Health team was honored for this care improvement.